As you already know, your liver gives out glycogen as needed for fuel. And also the liver gives out glycogen to adjust for low BG (at least in the non-D, glycogenolysis and the response to glucagon).
But your liver only has about 100 grams worth. So it’s reasonable to think your body adjusts metabolism rapidly, because 100 grams of glucose in that spare fuel tank is not very much!
It’s kind of part of the whole adage everyone always heard as a kid, “Breakfast is the most important meal of the day.” It’s because your liver glycogen store is very depleted when you wake up, and breakfast helps replenish that.
i never skip breakfast, even when i am not hungry. i truly believe it sets off my day on a good note. also, bc i know that i will be swimming, i’ve got to get those carbs/protein in my system. (also, if i skip a meal, my BGs tend to crash, even if i am doing abosolutely nothing but sitting like a coach potato watching tv on a saturday afternoon.)
@Beacher The answer is just the opposite. Fasting increases basal metabolism:
" Studies of fasting show that basal metabolism doesn’t shut down during fasting, it revvs itself up . Four consecutive days of fasting increases basal metabolism by 13%."
That was a great link. Lots of fascinating stuff over there
Even though fasting increases metabolism, according to the article that increase comes from fat, and is triggered by the lower insulin levels. It then makes sense that we need to take less insulin when fasting. I guess the point is that lower metabolism and lowered basal insulin needs are two different things.
Are you currently still using Levemir split and MDI ? Just so that I can get a sense, how do you split the Levemir, quantity and timing? It’s understandable that we don’t want to go long when we sleep. I’d be frightened out of my mind, (not to mention my husband- I don’t think he would know what to do) if I were to go low at night. Do I wake up drenched in sweat or something else? I have no idea. On the other hand, we don’t want to drift higher and higher during the day time. I understand that everyone can be so different; just trying to get a sense of quantity and timing and what has worked for some.
I tend to eat my largest, and heaviest meal at dinner time. I wonder if I have so much extra sugar, carbs that my liver stores the excess during the night time. At night, we are not ‘active’. We are not taking in food, we’re passive.
If someone awakes at 6 am, takes a BG, eats nothing until 12 noon, what is likely to happen to the BG? Does the liver assume - no food -starvation- danger- and proceed to dump sugar into our body causing a BG rise? Curious how this works.
Yes, I’m still on MDI with Levemir basal. I split 50 50 currently, dosed immediately on waking (usually 6am) and at 830 pm. 830pm is my ideal, but sometimes this slides to 900pm, and it’s still ok. I have a daily alarm on my phone’s diabetes app set for 830pm so I remember to inject.
As far as symptoms of overnight low: this varies per person. For a bad low…often it’s waking in a sweat, or confusion. For a mild low, I might wake with from strange/vivid dreams, etc, or may wake with mild insomnia. it’s best if you go thru symptoms with your significant other, so they aren’t flying blind if/ when you do go low
If the basal insulin dose is right, the BG should stay steady. That’s the goal in setting the basal. The problem is that for many people they need more basal at some times of the day, and less at other times. This is handled well by a pump, which lets you list a schedule of basal rates for different times of the day. If it’s just a night vs. day change, that can be handled to some degree with levemir (which lasts about a half day, so you can take a different dose for morning and night) and to a lesser extent by lantus (you can split the dose in half, but rather than giving half every 12 hours you can go longer where you want the lower dose, and shorter where you want to double-up the dose, like katers said in the other thread.
The opposite, actually. For a while the normal basal will continue to work. But eventually if the body thinks it is starving it cuts back to conserve the remaining stores of glucose, so the basal requirement becomes lower, not higher. When I was told to fast prior to a medical procedure they advised me to cut my basal in half to avoid the possibility of going low.
I thought that during sleep, the liver dumps sugar into our body to keep us going because we’re not eating. Therefore, basal is needed to address this liver sugar dump. Please correct me if I got this all wrong. Similarly, I thought that if I don’t eat for a long time, the liver, if it has reserve from previous meals may also dump sugar to keep us going.
You are correct that the liver releases glucose into the bloodstream when we’re fasting. It also stores it during times of abundance, acting as a buffer.
However, this does not mean that the total level of glucose goes up, as the wrod dump might suggest. On the contrary, the amount of glucose released by the liver during fasting is far less than what’s absorbed from food after a meal. That’s why a bolus can elevate the amount of active insulin many times over, compared to basal.
