Insulin, Glycogen, and Glucagon
Chemicals in the body that play an important
role in the regulation of blood glucose
Diabetics, or perhaps some of those newly diagnosed as diabetic, wonder why it is that their self monitored blood test readings can sometimes be higher than they were on their previous test reading taken a while earlier, even though they have not eaten anything in the interim. Similarly, higher readings might be the case in the early morning after an overnight fast since the last meal of the evening before. Logically, it might be assumed that with no food having been eaten and therefore no source of carbohydrates, the blood glucose levels would be lower not higher, but higher they may be, as the meter readings show.
In reality, the amount of glucose in the blood would have dropped to a lower level during the passing time since the latest meal. But when the blood glucose level gets too low, through being used up by the body’s cells, it would then generate a signal and cause the body itself to manufacture glucose from its own store of carbohydrates that have been accumulated in the body from previous occasions when there was an over-supply of glucose in the bloodstream. That is why the meter readings are higher, correctly, because the body has manufactured a supply of insulin without depending on the usual food source.
The regulators, insulin and glucagon
Among its many activities, the pancreas produces two hormones, insulin and glucagon. These are activated, in separate ways, in response to blood-glucose levels.
In a normal functioning system, the organs of the body, including the pancreas, liver, thyroid and pituitary glands, usually work together to achieve a constant blood-glucose balance in the blood stream. Just as when glucose becomes too low, when glucose begins to reach too high a level in the blood, insulin is released and works to get the glucose from the blood into the cells of the body’s organs where it becomes the fuel needed by the cell to produce energy to support its multitude of chemical activities to keep the body functioning.
Glycogen, a major form of carbohydrate storage,
is converted to glucose when needed
When there is a surplus of glucose in the blood, beyond the needs of the cells, the body stores the glucose in the liver, fat cells, and in muscles, by converting it to Glycogen, a more complex form of glucose.
On the other hand, when the level of glucose in the blood becomes sufficiently lowered through the lack of food intake or overnight fasting, the pancreas is signaled to produce the hormone glucagon and, working in the opposite fashion to that of insulin, it stimulates the liver and muscles to break down their previously stored glycogen back to the original glucose form, thus enabling it to be once again circulated as glucose into the bloodstream for the use of the body’s needy cells.
In non-diabetic people, the insulin-glucagon hormone mechanism works efficiently to prevent the blood sugar levels from rising too high or falling too dangerously low.
But unfortunately it does not succeed that way for the diabetic person. In this case, in the absence of food intake, the liver does convert stored glycogen to glucose but the diabetic’s impaired insulin-glucose activity does not work well enough for it to be regulated or fully absorbed by the body’s cells, thus leaving an elevated blood glucose level to puzzle the self testing diabetic when reading their monitor results after a period of time when they have not eaten.
So what’s the solution?
My medical support professionals advise to not go too long without eating, to have between-meals snacks that contain about 15 grams of carbs. For overnight they suggest a small late evening snack, some carbs and protein such as a slice of bread, maybe toasted, with peanut butter or cheese and maybe half a glass of milk. Adjustments can be made depending on the results indicated by the recommended morning blood test.
That has worked for me for a while in the past but I should also mention that sometimes everything, day or night, goes wrong and I lose control for a few days. It is always a battle but worth the effort when the alternatives are considered.
For occasions when blood sugar levels do fall too low, the diabetic should always have available a suitable glucose-containing-food, a small quantity of which can quickly bring the blood sugars back to within a normal range. I favor half a small glass of apple juice, I have found it works quickly and enables a reasonably fast recovery from that queasy feeling that often accompanies a low sugar incident, a condition called hypoglycemia.
In preparation is a post to explain Hypoglycemia and Hyperglycemia (low and high blood sugar).
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