A Finnish study that shows that alcohol isn’t a large contributing factor to death of Type 1 diabetics, rather diabetes complications were.
So glucagon doesn’t work while drunk or after a marathon… are there any OTHER times it won’t work??
Where do you GET this stuff?
I want to have some idea what you’re talking about…
I’ll try.
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I think there are other possibilities.
Like with glycogen storage disorders that some people have, they may not be able to fully store glycogen, and a glucagon shot would not work as well for them.
Or with long periods of fasting or a ketogenic diet, people may have diminished liver glycogen capacity.
If you recently had a glucagon shot, and before eating to replenish the liver glycogen, you do another glucagon shot, you would probably be missing glycogen in that situation.
Definitely after a long glycogen depleting workout.
The body is complex. I know better than to say “only under these conditions”, because there is always something else that is a possibility.
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I know after a bad/prolonged low, I’m suddenly more prone to subsequent lows that seem basal driven in the next 12 hours or so. I assume that’s from glycogen depletion, indicating that my liver does still respond naturally to some lows, also suggesting that at least for me, glucagon would be less effective in that period.
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Well that sounds like a time to experiment! Do you have any expired Glucagon kits laying around? Obviously just start with a fraction. My guess is you will pleasantly surprised by how well it works.
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I’m bad and actually have neither expired nor unexpired glucagon kits around. I haven’t for many many years. I probably should for stomach illness, but I live alone, so the emergency aspect is less likely to come into play, unless my cat learns how to administer it. And I agree it would be an interesting experiment, but I don’t think I’m likely to purposefully induce that kind of low in the near future, and then glucagon, ideally twice, both after that and at a different time, to compare effects.
Also, I suspect it will still work somewhat, but efficacy significantly reduced, since it sure seems to me like in those moments my liver is super depleted, very similar to when I’ve got alcohol in my system.
Also, I suspect I have much more liver output and responsiveness to lows than most T1s (who supposedly don’t usually get much for lows after a while)—I’ve been T1 for 27 years and have very rarely had super severe lows and have never once gotten to the point of being unable to assist myself (at worst I’ve gotten a bit disoriented and very cranky a couple of times, and certainly I’ve been in states where I couldn’t function as normal many times). I think my liver is in play, buffering things, which also maybe is why I have a stronger effect of alcohol on my blood sugars than some, since there’s more liver activity to suppress, and why metformin has been so helpful for me too.
Do you come back from lows without needing to eat anything? Like at night?
I have heard that there are some T1’s who have functional alpha cells. That would be nice.
Not usually fully, but I’ve bumped up a little bit, and I’ve also held stable at mild low level, which seems to be what my liver is more capable of—doing that is when it gets depleted, like if I ride a 60 for long time. I don’t think my liver can fully handle a fast dropping low, but between having a hyperactive sympathetic nervous system (very good early warnings) and a little bit of buffering from the liver, I stayed out of trouble for many years even before my CGM.
Also I wonder if the hyperactive SNS, which meant venturing much less often into deep low territory and finding even mild lows more unpleasant (which drove my trying to avoid them, including years of running higher as a result) helped prevent my alpha cells from getting totally burned out. It could be that as I use my CGM and spend more time in tighter range and have a lot more mild lows, that will change.
FWIW, if I could choose between alpha or beta cells being functional, I would pick alpha cells. 
Fair! So wait, if you are say 55-60 for an extended flat period of time, do you not find that you get at all glycogen-depleted then? For me, it’s so similar to the effects of prolonged exercise or alcohol. My endo did not seem particularly surprised when I described that phenomenon to him, which made me think it wasn’t super unusual, but I didn’t directly ask him that.
No, I can stay flat in that range and feel no bad effects from it. I don’t think it affects my glycogen at all. I don’t feel a loss of energy from it.
Interesting! It’s very pronounced for me, but only for prolonged lows like that, or if I have multiple shorter lows in a brief period of time. Whatever alpha cell functioning is happening is definitely not enough to make me not worry about having to treat the lows though.
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