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Discussion Starter · #1 · (Edited)
As most of you know, I'm a Type 2 managing through diet, exercise and Metformin (ER). My biggest complaint is liver dumping...

This is just some thoughts/reports on my testing/observance of liver dump, eating, exercise, etc. based solely on ME. I'm posting this more because writing this down helps me think about it and hopefully find the best way to manage my sugars. Anyway...

For me (from my own testing/observance) I get a liver-dump (additional glucose released into the bloodstream by my liver) for two reasons: 1) my BG drops below 4.5 mmoL/L (81 on the US scale), or; 2) I've gone without food for 4hrs (regardless of the BG reading.)

For the past two weeks my liver dump raises my BG levels by EXACTLY 2.0 mmoL/L (36 points on US scale). I've observed that my normal nightly fasting readings while low-carbing drop to about 4.2 (75) at the lowest, and my morning dump puts me to 6.1 or 6.2 (about 110) every day. My pre-meal readings, regardless of what they are (typically between 5.5 and 6.5 though) will jump the same amount (2.0 mmoL/L) if I delay my meal >4hrs since previous.

The pre-meal dump is the worst for me (and thus I try to avoid it), because once I DO eat, the post-meal BG climb (even from a low-carb meal) can put me well above the 7.8 (140) danger mark.

For example, last night's test I tested 5.7 (102) just prior to supper, then delayed eating another 1/2 hour. Tested again and was 7.6 (138) without yet eating. I then ate my very low-carb meal (Caesar salad, no-carb full-fat dressing, no croutons, leftover fajitas without a tortilla) and 1hr later posted a 9.4 (170) and at 2hrs was 8.6 (155). Had I NOT dumped prior to the meal my own testing shows I would have peaked around mid 7's (135-ish) and 2-hr post would be mid 6's (<120). Those are obviously the numbers I prefer.

So today I decided to do an exercise test with numerous blood tests in there. I normally do NOT exercise more than 20-25 minutes at a time due to pain from osteoarthritis, but decided to take an NSAID just before and 'suck it up' in the name of 'science' (oh I use that term loosely...)

I tested at 7:00am, 6.2mmoL/L (111) and immediately ate breakfast.

I was 7.3 (131) one hour after my breakfast (8:00am) which was 2 eggs, 2 strips bacon, one piece of sprouted grain bread with a little natural peanut butter and some no-sugar jam. I measure my intake carefully, and this meal was:

Calories 525
Carbs (g) 21 (total)
Net Carbs 16 (less fibre)
Protein (g) 24
Fat (g) 37

I hopped on the exercise bike immediately after testing (8:00am) and warmed up for two minutes, then began a moderate-intensity ride. After 10 minutes I cranked up the tension, stood and pushed like a madman for 2 minutes, then went easy for 2 minutes, then back to normal. 5 minutes later I did it again... Then I started to have that 'feeling' I get when I think I'm getting low.

At 8:20 I did another quick reading (quick wash of hands, no soap, towel-dry, then test) and was at 4.4 (79) which is typical of 20 minutes of moderate for me. I jumped back on the bike and kept going. I felt like crap for a couple of minutes, but soon the riding was going fine again. I did another quick interval of high intensity after a bit and then went easy for 2 minutes.

At 8:30 I took another 30 seconds and tested. I was back up to 6.4 (115). Hopped back on the bike, more interval training followed.

At 8:42 I started noticing I was rocking a bit on the bike, feeling slightly dizzy and nauseous. I jumped off and did a quick test which returned a 4.2 (75) :eek: and then got back on the bike.

By 8:47 I felt better again, like I had a second-wind ... so I rode moderately until 8:50.

8:50 I tested at 6.5 (117). I climbed back on quick and kept my moderate pace for 2 minutes... Then at 8:52 I stood up and pushed HARD. I mean, REALLY REALLY HARD. To the point of a massive side-ache, burning legs which actually gave out on me and forced me to sit (more collapse) back on the bike and turn the tension way down. I spent about 5 minutes cooling down and got off the bike at 8:57.

Tested immediately and was up to 7.3 (131). It's my theory that the moderate-intensity and intervals dumps about 2.0mmoL/L into my system, but that the extremely HIGH intensity I did near the end signaled the liver to dump even more. It would make sense that the homeostasis effect tries to balance out the blood glucose level based on the output of your workload, and seems to be the case in this test.

Interestingly, one hour AFTER I finished the ride, at 9:57 I tested at 7.1 (128) which isn't much of a reduction... I normally drop much more than that in an hour without food... I would've thought that the increased metabolic effect of exercise continues to burn the blood glucose... I can only guess that one of three things is happening:

1) Because of the intensity and increased metabolic rate, my liver is continuing to secrete glucose, or;
2) My insulin response is insufficient to handle the glucose secreted, (basically 3 dumps in an hour) or;
3) My insulin resistance is somehow increased after exercise

Any thoughts? (other that I'm kinda crazy...I know that.)
 

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Discussion Starter · #2 ·
Bah... just realized that I'm sitting at a 7.1 (128) and it's time for my next meal. Argh. Hopefully I don't spike much off this one, LOL.
 

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1) Because of the intensity and increased metabolic rate, my liver is continuing to secrete glucose, or;
2) My insulin response is insufficient to handle the glucose secreted, (basically 3 dumps in an hour) or;
3) My insulin resistance is somehow increased after exercise

Any thoughts? (other that I'm kinda crazy...I know that.)
the adrenaline and other stuff created from intense exercising can raise sugars in some cases a lot and for me at least working out does reduce my insulin resistance and I get better results. think reduce insulin resistnace is the typical result but we're all an experiment of one so your results may vary
 

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Discussion Starter · #4 ·
the adrenaline and other stuff created from intense exercising can raise sugars in some cases a lot and for me at least working out does reduce my insulin resistance and I get better results. think reduce insulin resistnace is the typical result but we're all an experiment of one so your results may vary
I hope I don't 'vary' too much, LOL. All the research I've read suggest that even short-term aerobic exercise improves insulin-resistance. Maybe my 3 months just isn't enough to make a big difference yet, considering I still have about 40lbs of excess, mostly visceral, fat...
 

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always so many variables. well keep up the great work
 

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I think all the testing will drive you nuts. I spike with exercise. The longer I exercise the higher I spike. It is usually around 30 points. My doctor told me not to be concerned since I do need exercise. But I think it keeps my HbA1c higher than I would like. How much metformin are you taking? I have found upping my metformin to the maximum has helped limit the spikes over night but I still get them with extreme exercise.
 

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Discussion Starter · #8 ·
I think all the testing will drive you nuts.
Heh... sorry, but I was nuts LONG before the testing ...

I spike with exercise. The longer I exercise the higher I spike. It is usually around 30 points.
That's pretty close to mine. My normal 'dump' during exercise is about 2.0 mmoL/L which is about 36 points on your scale. It would appear I dump slightly more during extreme intensity activities.

My doctor told me not to be concerned since I do need exercise. But I think it keeps my HbA1c higher than I would like.
That's certainly one of my concerns, is the HbA1c. I do my next test in about a week. I'd love to be in "the 5% club" but with all my dumping, I doubt I'll make it this soon. Heck, I was 12.1% not even 3 months ago, so I'll be thrilled if this result is in the 6-7% range.

How much metformin are you taking? I have found upping my metformin to the maximum has helped limit the spikes over night but I still get them with extreme exercise.
I currently take the maximum dosage, 2x1000Mg of the extended-release version. I was taking the 2 nightly, but they want me to take one in the AM and one in the PM now. We'll see how that changes things.
 

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Discussion Starter · #9 ·
Bah... just realized that I'm sitting at a 7.1 (128) and it's time for my next meal. Argh. Hopefully I don't spike much off this one, LOL.
Oddly enough, I ate right after I posted this. I had a small bowl of chili and about 3/4c of broccoli steamed and topped with butter, salt and pepper.

I tested 1hr later to see how much higher I got... and I'd DROPPED down to 6.1 (110). My 2hr post was down to 5.7 (103) ...

It's odd I dropped for both 1hr and 2hr post meal... I'm guessing the exercise kept my metabolism burning after all...
 

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that's how it works for me as well. sugars the day after a workout are usually better
 

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So many variables!

Exercise - timing, intensity, muscle groups used, duration.......
Diet - foods eaten, timing, amount
Medications - how they react under different conditions of diet and exercise
Variations in our own bodies and how they handle glucose........
Overall condition of our current health - little infections, other stresses
Variations in the accuracy/reliability of our meters

And all of the unknowns of diabetes that medical science has yet to discover.

I simplify things for myself by avoiding drugs, but still my glucose scores are a complete mystery to me.
 

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Interesting. This suggests that you have a good fight/flight response, the hard intervals are making you secrete adrenaline then your liver dumps to give you the chance to get away. Liver dumps are higher when you eat higher/moderate carbs.

Now do it again as an aerobic only exercise, no fast intervals, keep heart rate below 120, but don't dawdle either. It should feel like an easy ride, no puffing. ;) Should feel like a fast walk not a jog in difficulty terms.
 

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Discussion Starter · #13 ·
Now do it again as an aerobic only exercise, no fast intervals, keep heart rate below 120, but don't dawdle either. It should feel like an easy ride, no puffing. ;) Should feel like a fast walk not a jog in difficulty terms.
Interesting...

I did today's ride for 55 minutes (just over an hour if you include warmup/cooldown time) and kept my heart rate around 120-125. (I would go lower, but I have a very high exercising heart rate, much higher than 'normal')

It took about 35 minutes before I felt my BG get low (at my normal exercise level it takes about 20). I can feel it because I sit up (no hands) every so often on the bike, and when I'm getting low I feel slightly dizzy and unsteady in that position. (I've tested in the low-to-mid 4's whenever I'm feeling that way.)

It took about 7 minutes before I felt steady again. Usually when I exercise at a moderate-to-intense level it takes only 2-3 minutes before I'm feeling good, so obviously the lower intensity exercise has it take longer before a 'dump' happens. I only rode for another 15 minutes or so after that, and continued to feel steady the whole time. I cooled-down for 3 minutes, then got off and tested.

5.4mmoL/L after the ride, and then I made my normal post-exercise smoothie (today's being 1 scoop protein powder, glutamine, 1/2C 1/% milk, 2 strawberries, 1/3 froz. banana, 1 small clementine orange, vanilla extract, ice cubes, water and stevia - about 260 calories, 30g total carb) so that I don't continue to drop too much.

Interesting difference vs. the more intense test.
 

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I spike with exercise..may be thats why after starting the day at 94, I ended up atmore than 260 by the evening after climbing stairs several times. It was very hot outside for a walk, so I thought I was doing a favour to the body. By tomoro I' start wearing it out. But this inbetween period is a hell, hotflushes, thirst, hunger, cravings etc will certainly make me MAD.
 

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Dump the Stevia, and you have my after workout smoothie if I score less than 4.5, though I do whey powder not milk. Mind you if I tested as 5 or above, I wouldn't bother. The liver holds enough fuel for up to 1hr 30 mins of aerobic style workout.

Many people have very efficient livers even if they have insulin problems, so overloading is not a good idea, but it does depend on personal choice.
 

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Any idea if cantaloupe is good! It has sufficient mositure content, and low calories too..summer is here so I am checking out all other than apples and oranges. @Judy..you are a real help with information, I unerstand what I am reading but I dont recall easily, may be cannot explain properly. I am making some fellow diabetics with similar problems read the forum posts, they dont have any access to PC as we live in suburbs. They are appreciating the efforts you people take to answer the doubts..Passing their Thanks to you guys....:D
 

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Discussion Starter · #17 ·
Any idea if cantaloupe is good! It has sufficient mositure content, and low calories too..
You may be able to eat cantaloupe in moderation - I can, but we are ALL different.

Although it has a reported GI (Glycemic index) of 65, because it's low-calorie, 120g (about 4oz) has a GL (Glycemic Load) of only 4, which is a very low GL.

The best way to know is to eat it and test with your meter.
 

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I can't tolerate most fruits except for a few berries once in awhile. My husband also a Type 2 does eat fruit including cantaloupe and is able to keep HbA1c in the mid 5's. We are all so different.
 

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Thanks guys, lod off my mind! I luv the fruit and markets are flooded, will definitely test after eating. I've not seen much high even after watermelon, like you said different body, different reading!::D
 
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