carbohydrates, protein, type 1s and canaries

Quantification of insulin demand is of particular interest for type 1 diabetics who have to inject insulin to manage their blood sugars.

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Before diagnosis, a type 1 diabetic whose pancreas is failing will have extremely high blood glucose levels and lose weight fast because they can’t access the sugar that they’re eating without insulin.

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Without insulin the body kicks into (what some call a backup survival mechanism) ketosis which is where the body uses fat for fuel rather than sugar from dietary carbohydrates.

When combined with very high levels of blood glucose, this scenario is called diabetic ketoacidosis and can be a life threatening if left untreated.  This is rare though and only occurs in type 1 diabetics.

After commencing insulin therapy the diabetic regains weight.  The picture below shows “JL” one of the first type 1 diabetics to receive insulin in 1922.  The photo on the left is after diagnosis but before insulin.  The photo on the right is the same child three months after starting insulin injections.

Some type 1 diabetics injecting with needles will get localised hypertrophy where they inject their insulin, particularly if they don’t rotate their injection sites and / or are on a lot of insulin.

Though not recommended for health, some body builders will inject insulin in conjunction with their workouts to maximise muscle growth (warning: insulin promotes both fat and muscle growth).

Another example of how insulin affects body fat is the fact that children born to diabetic mothers are much heavier due to the the insulin circulating in the mothers’ blood stream.   The photos below show my two kids at birth (my wife is a type 1 diabetic and had good control through her pregnancies)…

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snug as a bug

…and now on a high fat diet.

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It’s a bit hard to argue the calories in / calories out theory saying that the in-utero kids should better manage their portion sizes and exercise more!

Carbohydrates raise blood sugars and insulin works to remove the sugar from the blood to store as fat.  In practice it’s impossible to perfectly match the insulin action with the rate of carbohydrate digestion.

While type 1 diabetics are an extreme case, they can be considerd the “canary in the coal mine” of weight maintenance and metabolic health.  To some extent everyone’s body is working to balance the effect of carbohydrates and protein driving up blood sugar and with the pancreas secreting insulin to bring the blood sugar back down.

One thing that’s not well understood is how type 1 diabetics should deal with protein.  Conventional wisdom is that type 1 diabetics should dose with about half the insulin for protein containing foods, however the basis of this is not clear.

With the food insulin index data now maybe we can better understand the insulin requirements of protein containing foods?

[next article…  protein and the foods insulin index… Atkins versus the vegans]

[this post is part of the insulin index series]

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