The Laws of Small Numbers – Part 3
Working With Your Own Bodies Capacity
Many years ago, John Galloway, then medical director of Eli Lilly and
Company, performed an eye-opening experiment. He gave one injection
of 70 units of regular insulin (a very large dose) to a non-diabetic
volunteer who was connected to an intravenous glucose infusion.
Dr. Galloway then measured blood sugars every few minutes and adjusted
the glucose drip to keep the patient’s blood sugars clamped at
90 mg/dl. How long would you guess the glucose infusion had to be continued
to prevent dangerously low blood sugars, or hypoglycemia?
It took a week, even though the package insert says that regular insulin
lasts only 4–12 hours. So the conclusion is that even the timing
of injected insulin is very much dependent upon how much was injected.
In practice, larger insulin injections start working sooner, last longer,
and have less predictable timing.
If you eat a meal not specifically tailored to our restricted-carbohydrate
diet and try to cover it with insulin, you’ll get a postprandial
(after-eating) increase in blood sugar, eventually followed by a decrease
as the fast-acting insulin catches up. This means that you’ll
have high blood sugars after every meal, and you could still fall prey
to the long-term complications of diabetes. If you try to prevent the
inevitable postprandial blood sugar spike by waiting to eat until after
the start time of your insulin, you may easily make yourself hypoglycemic,
which could in turn cause you to overcompensate by overeating—
that is, presuming you don’t lose consciousness first.
Type 2 diabetics have a diminished or absent phase I insulin response,
and so they face a problem similar to that of type 1s. They have to
wait hours for the phase II insulin to catch up if they eat fast-acting
carbohydrate or large amounts of slow-acting carbohydrate.
The key to timing insulin injections is to know how carbohydrates and
insulin affect your blood sugar and to use that knowledge to minimize
the swings. Since you can’t approximate phase I insulin response,
you have to eat foods that allow you to work within the limits of the
insulin you make or inject.
If you think you that the prior method of eating a high-carbohydrate,
low-fat diet that has often been recommended in the past is better,
which, if you look at the statistics, has only succeeded in raising
levels of obesity, elevating triglycerides and LDL, and causing an epidemic
of diabetes. Then think again, there is considerable evidence that restricting
carbohydrate is healthier not only for diabetics but for everyone. (For
more details on this point, see Protein Power, by Drs.Michael and Mary
Dan Eades, Bantam Books, 1996; or go to www.diabetes-book.com and, under
“Articles,” read “What If It’s All Been a Big
Fat Lie?” by Gary Taubes.)
If you consume only small amounts of slow-acting carbohydrate, you
can actually prevent postprandial blood sugar elevation with injected
preprandial rapid-acting insulin. In fact, by restricting carbohydrate
intake, many type 2 diabetics will be able to prevent this rise with
their phase II insulin response and will not need injected insulin before
meals.
____________________________________________________________________________
We would like to thank the publisher Little Brown and
Company and Dr. Richard K. Bernstein, for allowing us to provide excerpts
from Diabetes Solution.
Copyright ©1997, 2003 by Richard K. Bernstein,
M.D.
All rights reserved. No part of this book may be reproduced in any form
or by
any electronic or mechanical means, including information storage and
retrieval
systems, without permission in writing from the publisher, except by
a
reviewer who may quote brief passages in a review.
Revised Edition
Author’s Note
This book is not intended as a substitute for professional medical care.
The reader should regularly consult a physician for all health-related
problems and routine care.
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