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Weight Loss Forum / Low Carb / August 2005how insulin works?
I did very well LCing about a year ago - losing about 30 pounds in a few months. I've gained about 10 back over the last year and am looking to get serious again and begin another induction period. As a diabetic, I will soon begin taking glyburide because I haven't been controlling my blood sugar as well as I should have. I realize this drug makes it more difficult to lose weight because it stimulates the release of more insulin by the pancreas. When I took it previously, my blood sugar would sometimes drop to the 60-80 mg/dl range -- too low (which was why I stopped it). My question is this: Does increased insulin still make it hard to lose weight if your blood sugar is low? (i.e. 80mg/dl) I have a very vague understanding of insulin being used to store sugar as fat -- but what if there's not much sugar around to store? Could operating with low blood sugar in the 80mg/dl range prompt for more gluconeogenesis and hence more weight loss? Does the body work like that, where low bs would cause for more glucose to be created by the liver? I understand that would be very dangerous to try to keep blood sugar in that range - and keeping blood sugar too low could instead prompt coma or even death. I'm just wondering if there's any fat-losing advantage to, instead of 100mg/dl fasting levels to having 80mg/dl fasting levels. -RA > As a diabetic, I will soon begin taking glyburide because I haven't > been controlling my blood sugar as well as I should have. I realize [quoted text clipped - 3 lines] > When I took it previously, my blood sugar would sometimes drop to the > 60-80 mg/dl range -- too low (which was why I stopped it). Which is why you stopped the pills or why you stopped the low carbing? Consider that low carbing may give you the theraputic effect without taking the pills. What is a "cure"? No symptoms plus no medication? Then low carbing would be a "cure". Reverse all previous damage? Then low carbing is merely a treatment not a cure. > My question is this: > Does increased insulin still make it hard to lose weight if your blood > sugar is low? (i.e. 80mg/dl) Yes. Insulin blocks fat from moving out of storage. In normal circumstances that might not apply to a diabetic. Glucagon moves fat out of storage. Insulin suppresses glucagon. Low dietary carb normally causes low insulin, high dietary fat normally causes high glucagon. Take an insulin stimulating drug and you'll likely end up with a trickle of loss (pound a month) rather than faster loss (pound a week). > I have a very vague understanding of insulin being used to store sugar > as fat -- but what if there's not much sugar around to store? Insulin blocks fat withdrawal. I don't know how much effect it has on the conversion of sugar to fat, so I can't say on that. > Could operating with low blood sugar in the 80mg/dl range prompt for > more gluconeogenesis and hence more weight loss? Does the body work > like that, where low bs would cause for more glucose to be created by > the liver? No. Blood sugar levels are an effect of the underlying mechanism not the driving cause. > I understand that would be very dangerous to try to keep blood sugar in > that range - and keeping blood sugar too low could instead prompt coma > or even death. I'm just wondering if there's any fat-losing advantage > to, instead of 100mg/dl fasting levels to having 80mg/dl fasting > levels. If low carbing allows you to reduce or eliminate the pills that should remove the block. Of source you would need to work with your doc to arrange that, continue testing to see if you ever need to resume pills, and so on. What Doug said... >> I have a very vague understanding of insulin being used to store sugar >> as fat -- but what if there's not much sugar around to store? > > Insulin blocks fat withdrawal. I don't know how much > effect it has on the conversion of sugar to fat, so I > can't say on that. It doesn't directly. What it does is move sugar to places where it is either used directly as fuel, or stored as fat. That's why people who go on insulin and don't up their exercise levels often put on weight - because they're facilitating fuel transport, and not using it up. It's sad the OP has had to go on insulin. My use of low-carb is specifically designed to put as little a load as possible on my beta cells, avoiding insulin use for as long as possible. However, when/if my diabetes progresses to the point of needing something more than metformin (which attacks insulin resistance, helping beta cells), I'd prefer to go directly to insulin rather than use a beta cell stimulator - gives you a better chance of stable blood glucose levels. Nicky.  SignatureA1c 10.5/5.6/<6 T2 DX 05/2004 1g Metformin, 100ug Thyroxine 95/75/72Kg For a type 2, I feel LC needs to be a way of life (WOL). I make no comments about type 1, due to the complications of medications and doctors.... However, there are books on such things.... > I did very well LCing about a year ago - losing about 30 pounds in a > few months. I've gained about 10 back over the last year and am [quoted text clipped - 27 lines] > > -RA > For a type 2, I feel LC needs to be a way of life (WOL). > > I make no comments about type 1 The OP's got to be a T2. No point in giving a T1 a beta cell stimulator, there's nothing left to stimulate. Nicky. SignatureA1c 10.5/5.6/<6 T2 DX 05/2004 1g Metformin, 100ug Thyroxine 95/75/72Kg ; ;I did very well LCing about a year ago - losing about 30 pounds in a ;few months. I've gained about 10 back over the last year and am ;looking to get serious again and begin another induction period. ; [snip] ; ;When I took it previously, my blood sugar would sometimes drop to the ;60-80 mg/dl range -- too low (which was why I stopped it). [snip] ; ;I understand that would be very dangerous to try to keep blood sugar in ;that range - and keeping blood sugar too low could instead prompt coma ;or even death. I'm just wondering if there's any fat-losing advantage ;to, instead of 100mg/dl fasting levels to having 80mg/dl fasting ;levels. ; I don't see that anyone else has addressed this point, so I'll ask it - is 60-80 mg/dl really dangerously low? I thought that was normal range and "forty's the floor". Or is she using a different range than I'm familiar w/. Not a diabetic myself, just interested. Martha :> ; :> ;I did very well LCing about a year ago - losing about 30 pounds in a [quoted text clipped - 18 lines] :> it - is 60-80 mg/dl really dangerously low? I thought that was :> normal range and "forty's the floor". It depends on the person. I typically will have fasting BG in the low 80s...but if they get lower I start to feel bad. ;Martha S. Gallagher <martha@wam.umd.edu> wrote: ;:> On Wed, 24 Aug 2005 wisestrength@yahoo.com wrote: ;:> ;:> ; ;:> ;I did very well LCing about a year ago - losing about 30 pounds in a ;:> ;few months. I've gained about 10 back over the last year and am ;:> ;looking to get serious again and begin another induction period. ;:> ; ;:> [snip] ;:> ; ;:> ;When I took it previously, my blood sugar would sometimes drop to ;:> the ;60-80 mg/dl range -- too low (which was why I stopped it). ;:> ;:> [snip] ;:> ; ;:> ;I understand that would be very dangerous to try to keep blood ;:> sugar in ;that range - and keeping blood sugar too low could instead ;:> prompt coma ;or even death. I'm just wondering if there's any ;:> fat-losing advantage ;to, instead of 100mg/dl fasting levels to ;:> having 80mg/dl fasting ;levels. ;:> ; ;:> ;:> I don't see that anyone else has addressed this point, so I'll ask ;:> it - is 60-80 mg/dl really dangerously low? I thought that was ;:> normal range and "forty's the floor". ; ;It depends on the person. I typically will have fasting BG in the low ;80s...but if they get lower I start to feel bad. ; Right, but my point was that unless the OP is using a different scale than we're talking about, a range of 60-80 isn't dangerously low, at least not towards the 80 end. I just did a quick google search, some of the sites said that anything under 70 would be considered hypoglycemia, while others said below 60 are too low. In any case, it seems that as long as the OP keeps her BG over 70, she shouldn't have any problems (well, problems from hypoglycemia, anyway). Naturally, if her health care practitioner is telling her to keep it over 80, that trumps anything she reads here, but it's worth checking the assumptions. Martha :> On Wed, 24 Aug 2005, Roger Zoul wrote: :> [quoted text clipped - 40 lines] :> over 80, that trumps anything she reads here, but it's worth :> checking the assumptions. Well, from what I've read hypoglycemia is a more complicated issue than just a low reading. Many times the symptoms are brought about by how quickly the BG levels drop, not just their absolute values. While 80mg/dl isn't _too low_ I guess that at that point I start to feel cold and at about 70 I'd might feel shaky. I understand the glyburide negatively impacts fat burning by increasing insulin levels. Taking it once a day, in the morning, do you think the insulin levels may decrease to the point of allowing fat burning later? I may try half a pill, or 1.5mg, to start with and see if that gets my bs under better control and doesn't lead to hypo. Now, I'm also taking Actos - which I just read "inhibits hepatic gluconeogenesis" ... Now isn't that exactly what I _don't_ want to inhibit while trying to lose weight on a low-carb diet? Isn't gluconeogenesis the way that fat gets burned up? I was able to lose weight on Actos a year ago - but it sounds like it's built to block fat-burning. Is that right? http://www.healthcentral.com/druglibrary/408/actos.html Thanks for all of your helpful tips and information! -RA > Now, I'm also taking Actos - which I just read "inhibits hepatic > gluconeogenesis" ... Now isn't that exactly what I _don't_ want to > inhibit while trying to lose weight on a low-carb diet? Isn't > gluconeogenesis the way that fat gets burned up? No, hepatic glucogenesis involves pumping stored glucose into your blood. To burn fat you need to reduce the insulin in your blood and increase glucagon, another pancreatic hormone. Have you tried metformin, it does support weight loss in the first year you take it? Avandia and Actos mainly reduce insulin resistance in the muscles, the effect on the liver is secondary. SignatureNo Husband Has Ever Been Shot While Doing The Dishes Thank you folks. I'm happy to report that, despite taking 1.5mg of glyburide each morning, I've acheived 'moderate' ketosis and dropped the usual starting 5 lbs. This is a relief, as I thought the glyburide might nix any chance at it -- perhaps my insulin levels aren't that high from it -- or they go down as the day goes on. As I lose weight, I likely will be able to stop taking it again. -RA 6"2 226/221/185 > I'm happy to report that, despite taking 1.5mg of glyburide each > morning, I've acheived 'moderate' ketosis and dropped the usual [quoted text clipped - 3 lines] > > As I lose weight, I likely will be able to stop taking it again. You may need to cut it faster than that, depending on how much you've cut back on the carb. SignatureNo Husband Has Ever Been Shot While Doing The Dishes > I don't see that anyone else has addressed this point, so I'll ask it - is > 60-80 mg/dl really dangerously low? I thought that was normal range and > "forty's the floor". I'd be absolutely delighted if I could get my fasting numbers to 80. I normally lurk around the 100 mark (6 in my numbers), which is one of the criteria for diabetes diagnosis. Going below 70 would worry me. Nicky. SignatureA1c 10.5/5.6/<6 T2 DX 05/2004 1g Metformin, 100ug Thyroxine 95/75/72Kg > I don't see that anyone else has addressed this point, so I'll ask it - is > 60-80 mg/dl really dangerously low? I thought that was normal range and [quoted text clipped - 3 lines] > > Not a diabetic myself, just interested. Technically <70 is low, <50 is hypoglycemic. Really, you feel low at whatever number you've trained your hypothalamus to feel low at or you feel it when the drop in BG is too fast. At dx I could feel really bad <200, now I don't start to feel bad until I've dropped below 70. I cut carbs so I could reduce the glyburide and hopefully eliminate it completely, as I have cut down on both the med and the carbs, my lows are less and less frequent and not as low. SignatureNo Husband Has Ever Been Shot While Doing The Dishes |
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