Blood sugar control in healthy normal persons and in diabetic persons. Even with insulin medication,why ppbs remains high.

[patliputra]

Plasma glucose concentration depends on rate of glucose appearing in circulation ( glucose appearance ) and rate of glucose removal from circulation ( glucose disappearance ). The circulating glucose is derived from three sources-- 1. Intestinal absorption from ingested food. 2. Glycogenolysis 3. Gluconeogenesis .

In non diabetic persons

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In fasting state the blood glucose is derived from glycogenolysis under the influence of glucagon. Basal ( stored ) levels of insulin control glucose disposal . Insulin' s role in suppressing gluconeogenesis and glycogenolysis is minimal due to low secretion of insulin in fasting insulin.

In fed state ( after food ) plasma glucose is derived from ingestion of nutrients. Glucagon secretion is suppressed through the action of ENDOGENOUS INSULIN secretion. This action is facilitated through paracrine route ( communication within the islet cells ). Additionally, insulin suppresses gluconeogenesis and glycogenolysis in the liver and promotes glucose disposal in periphery.

In Diabetic persons

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In fasting state plasma glucose is derived from glycogenolysis and gluconeogenesis under the influence of glucagon. EXOGENOUS Insulin influences the rate of peripheral glucose disappearance and because of its deficiency in portal circulation does not properly regulate the degree to which hepatic glycogenolysis and gluconeogenesis occurs.

After food in diabetics EXOGENOUS INSULIN is ineffective in suppressing glucagon secretion through physiological paracrine route. As a result the appearance of glucose in circulation exceeds the rate of glucose disappearance . THE NET EFFECT IS POST PRANDIAL HYPERGLYCEMIA.

[patliputra]

This post also clarifies the difference in Endogenous and Exogenous Insulins .

[klgksharma]

I have been prescribed Amaryl 1mg for controlling PPBS and Insulin glargine for controlling FBS

[patliputra in reply to klgksharma]

Glargin is a long acting insulin which resembles basal secretion of insulin. Amaryl, a sulphonilurea which stimulates insulin secretion from pancreas. How is your blood sugar status.

[klgksharma]

HbA1c is 6.8, mostly FBS <100, not keeping track of PPBS as no mental strength to give up rice.

[kcpl in reply to klgksharma]

@klgksharma - LCHF is the best way to manage diabetes. No hunger pangs, lower blood sugar, lower diabetes drugs, lower cholesterol drugs and still great numbers. Don't have to make effort to "not eat" -- or starve -- as hunger pangs are almost gone on LCHF. It is the CARBOHYDRATES (and not spices) that causes all the hunger pangs due to spike and crash of blood sugar levels.

PPBS should be the first to monitor.

[patliputra]

Your HbA1c indicates that there is post prandial spike.ppbs is a must ,as it is the most important blood test for diabetics.

[patliputra]

There are two things Hunger eating and Habitual eating. I the first you are forced to eat some thing or it will proceed towards hunger pain. While habitual eating is just a psychological feeling. If you don't eat nothing will happen. So controlling it is not difficult. While hunger pain if it is very frequent has some under lying problem which requires some investigation and proper medical examination.