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42 Factors that affect BG
- Thread starter Northerner
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The long term metformin use and vitamin B12 deficiency. The effects of a B12 deficiency is actually to mimic worsening T2D symptoms. It causes a drop in red blood cell count which in turn causes the HbA1c test to give a false high value. Low red blood cell counts also causes the blood test meter to indicate a false high value.
Interesting reading...
Factors Affecting Blood Glucose Monitoring: Sources of Errors in Measurement
Drugs affecting HbA1c levels
Interesting reading...
Factors Affecting Blood Glucose Monitoring: Sources of Errors in Measurement
Drugs affecting HbA1c levels
stephknits
Well-Known Member
- Relationship to Diabetes
- Type 1
I have printed it out and have already shown it to two people who have asked if I'm back on track and keeping my numbers in range.
nonethewiser
Well-Known Member
- Relationship to Diabetes
- Type 1
44th, watching footie when team is on losing side.
Northerner
Admin (Retired)
- Relationship to Diabetes
- Type 1
I imagine that there is no precise answer to that, as our unique gut biome plays a part in how food is digested and absorbed, hence i would vary from person to person.
Docb
Moderator
- Relationship to Diabetes
- Type 2
Yes and it prompted me to look at some numbers! It's a long time since I did any serious chemistry but here goes. Everything that follows is very much first approximation - not precise but trying to get a feel for things.
The mol wt of glucose is as near as dammit 180. So, 1mmol of glucose weighs in at about 0.180g. Round that up to 0.2g
The average body contains about 5 litres of blood. So, as a crude estimate, a rise of 1 mmol/l in blood glucose is equivalent to adding 5x0.2 = 1g of glucose to the system. This is quite handy because it means that there is a one to one relationship between blood glucose level and glucose in the system.
Now, I will shortly be having my lunch which will contain around 30g of carbohydrate. Again to a first approximation this has the potential to make 30g of glucose. If all of this got dumped into my blood stream then it would in theory give me a 30 mmol/l spike. It won't. It will give me an increase of about 3 mmol/l suggesting an extra 3g of glucose has been dumped in my system.
I know it is a dynamic system and that glucose is being taken out but it still seems to me that the conversion of carbohydrate to glucose in my gut is not particularly efficient (thank goodness) and that this is the same for most people, otherwise diabetes would be rife amongst the whole population. Also would suggest that relatively small changes in gut efficiency could give a significant change in effect of carbohydrate intake on blood glucose levels.
PS, if I have make a ****-up and got decimal points in the wrong place, then please tell me!
The mol wt of glucose is as near as dammit 180. So, 1mmol of glucose weighs in at about 0.180g. Round that up to 0.2g
The average body contains about 5 litres of blood. So, as a crude estimate, a rise of 1 mmol/l in blood glucose is equivalent to adding 5x0.2 = 1g of glucose to the system. This is quite handy because it means that there is a one to one relationship between blood glucose level and glucose in the system.
Now, I will shortly be having my lunch which will contain around 30g of carbohydrate. Again to a first approximation this has the potential to make 30g of glucose. If all of this got dumped into my blood stream then it would in theory give me a 30 mmol/l spike. It won't. It will give me an increase of about 3 mmol/l suggesting an extra 3g of glucose has been dumped in my system.
I know it is a dynamic system and that glucose is being taken out but it still seems to me that the conversion of carbohydrate to glucose in my gut is not particularly efficient (thank goodness) and that this is the same for most people, otherwise diabetes would be rife amongst the whole population. Also would suggest that relatively small changes in gut efficiency could give a significant change in effect of carbohydrate intake on blood glucose levels.
PS, if I have make a ****-up and got decimal points in the wrong place, then please tell me!
Northerner
Admin (Retired)
- Relationship to Diabetes
- Type 1
It's why I've always had a degree of scepticism about the micro-managing of carbs down to the gram and insulin delivered in fractions of units to correspond according to a certain ratio - it's a start, of course, but you also need a pretty good understanding of your own body's tolerances and reactions in order to include those little intuitive adjustments that relate entirely to you 🙂
Northerner
Admin (Retired)
- Relationship to Diabetes
- Type 1
Are you considering though that it's not just the glucose that is consumed that has an impact on the levels - the pancreas will produce minute amounts of insulin to correspond to the rise in blood glucose levels so it can be removed from the blood and stored in cells. The efficiency of this will depend on the insulin sensitivity of the person. So, you could get the whole 30g of glucose, but most of it gets moved into cells or converted to fat etc., so the gut may be very efficient. In fact, in a newly-diagnosed Type 1 who is producing no insulin then it's quite likely that the whole of that 30g would stay in the blood and cause a huge spike! 😱
Eddy Edson
Well-Known Member
- Relationship to Diabetes
- In remission from Type 2
As Northie says, on a quick read I don't think you're taking sufficient account of the bod's efficiency in clearing glucose.
Eg: the OGTT, 75g of pure glucose. According to some protocols, a "normal" reading at the 1 hr mark is < 10 mmol/L, so say a < 5 mmol/L rise from a pest-test level of 5 mmol/L, or something like that. If the bod didn't quickly clear glucose, then on yr assumptions the rise would be something like 75 mmol/L, right?
Obviously, it may be that the "normal" subject might go above 10 mmol/L before the 1 hr mark, but nothing like a 75 mmol/L rise.
There's a "first insulin response", impaired in T2, by which insulin starts to be released pretty much as soon as you start eating.
Northerner
Admin (Retired)
- Relationship to Diabetes
- Type 1
I believe it's actually so fine-tuned that it starts before you begin eating, as you salivate in anticipation of the food! 😱 🙂
Docb
Moderator
- Relationship to Diabetes
- Type 2
Take your points Eddy and Northerner. Totally aware that we are talking about a highly dynamic system that has mechanisms for removing glucose whose efficiency varies from individual to individual. The thing I was trying to explore, albeit in a very crude way, was the production side of the equation and trying to get a feel for whether it is something that can be forgotten about.
Eddy, yes my crude sums would suggest 75g of pure glucose would give a spike of 75 mmol/l and that just does not happen in real life. Could be because the "normal" body is very efficient at removing glucose from the blood. Could be that the gut processes limit the rate at which glucose is absorbed into the blood stream. Probably a bit of both. I was a bit more interested in the conversion of carbohydrates in general into glucose. My calcs assume that all that can be converted is converted instantaneously and dumped immediately into the blood. That is obviously not the case. This leads on to the questions of how much carbohydrate is converted, over what timescale is it converted and what controls absorption into the blood stream.
No wonder there was a question mark against this topic in the original list. I like question marks. Getting to grips with them is often a fruitful way of making progress in understanding.
Eddy, yes my crude sums would suggest 75g of pure glucose would give a spike of 75 mmol/l and that just does not happen in real life. Could be because the "normal" body is very efficient at removing glucose from the blood. Could be that the gut processes limit the rate at which glucose is absorbed into the blood stream. Probably a bit of both. I was a bit more interested in the conversion of carbohydrates in general into glucose. My calcs assume that all that can be converted is converted instantaneously and dumped immediately into the blood. That is obviously not the case. This leads on to the questions of how much carbohydrate is converted, over what timescale is it converted and what controls absorption into the blood stream.
No wonder there was a question mark against this topic in the original list. I like question marks. Getting to grips with them is often a fruitful way of making progress in understanding.
Eddy Edson
Well-Known Member
- Relationship to Diabetes
- In remission from Type 2
I found this kind of interesting:
UCCS = incooked corn starch; CP = corn pasta. 50g of glucose-equivalents in each case.
From https://academic.oup.com/jn/article/136/6/1511/4664360
Docb
Moderator
- Relationship to Diabetes
- Type 2
I found this kind of interesting:
UCCS = incooked corn starch; CP = corn pasta. 50g of glucose-equivalents in each case.
From https://academic.oup.com/jn/article/136/6/1511/4664360
Interesting Eddy, especially the way the insulin follows the blood glucose. Read the paper and got about half of it. I wonder what the results would look like if they had a cohort of people with diabetes rather than a group of very healthy individuals. Stats were a bit beyond my level so could not really work out how much variability there was between the participants. Liked the area under graph approach to looking at the results. Bet they did not do the analysis by hand - probably all done by the software package they reference.
littlevoice359
Well-Known Member
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- Type 1
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- He/Him
It is a bit of a laundry list really, isn't it? I've come to think of T1D as like taking a car engine and pulling off a wire to one of the key sensors. The result is that the engine might run, but how exactly is likely to be very unpredictable. Or, another analogy is like piloting one of those leisure boats where, when you move the rudder/wheel, nothing happens for 20-30 seconds, but then you find you've over-steered and you're directly perpendicular to where you want to go. Most of my friends and family are totally oblivious to how tricky it can be to keep my blood sugar in target. I'll keep a copy of this chart on my phone to show them - might be useful that 🙂
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