Had a interesting chat with AI about Diabetes

[MikeO]

My questions were related to first and second phase insulin release and transient hypoglycemia. As always take outside medical explanation with a grain of salt and consult with your Doctor. 

Q1. is the first phase insulin response deficient in type 2 diabetes?

AI response: 

Yes, in type 2 diabetes, the first phase insulin response is often deficient. Normally, when you eat, your pancreas quickly releases a burst of insulin to help regulate blood sugar levels. This initial release is known as the first phase insulin response.

In type 2 diabetes, this first-phase response is impaired or delayed. This means that the pancreas doesn’t release enough insulin quickly enough after eating, which leads to higher blood sugar levels. Over time, this impairment contributes to the development and progression of type 2 diabetes. As the condition progresses, insulin secretion can become further compromised, exacerbating the problem.

Management strategies for type 2 diabetes often aim to improve insulin sensitivity and stimulate better insulin secretion, but the first-phase insulin response might not fully recover even with treatment.

Q2. any thoughts as to how long a delayed first phase insulin response would last?

AI response: 

The duration of a delayed first-phase insulin response can vary significantly depending on several factors, including the individual's overall health, the severity of insulin resistance, and their management of the condition.

In type 2 diabetes, the first-phase insulin response can be delayed for minutes to hours, and it may not fully normalize even with treatment. This delay is part of a broader pattern of insulin dysregulation that can evolve over time. If the condition is managed well with lifestyle changes, medications, or other interventions, some improvement in the first-phase response might be observed. However, it often remains impaired compared to individuals without diabetes.

Long-term, the extent of delay or impairment in the first-phase response can be influenced by factors like:

• Blood glucose levels: Poorly controlled blood sugar can worsen the delay.
• Insulin sensitivity: Better insulin sensitivity can improve the first-phase response.
• Medication adherence: Medications that improve insulin secretion or sensitivity can help.
• Lifestyle factors: Diet, exercise, and weight management play a crucial role.

Regular monitoring and management are essential to assess and address these delays effectively.

Q3. how does this affect the second phase of insulin response?

AI response: 

A delayed first-phase insulin response can affect the second phase of insulin response by creating a more challenging situation for glucose regulation. If the initial burst of insulin is insufficient, the pancreas may struggle to keep up with glucose levels, leading to a higher overall demand for insulin.

As a result, the second phase, which is the sustained release of insulin to handle prolonged glucose elevation, might also be impaired. This can lead to a less efficient regulation of blood sugar levels over time. The ultimate impact is often a greater risk of sustained hyperglycemia and increased difficulty in managing blood sugar levels.

Q4. could this also cause some transient hypoglycemia?

AI response: 

es, a delayed first-phase insulin response can indeed lead to transient hypoglycemia in certain situations. Here's how that can happen:

1. Delayed Insulin Release: If the first-phase insulin response is delayed or inadequate, blood sugar levels can rise after eating because the initial insulin burst needed to quickly manage the glucose from the meal isn't sufficient. This might be followed by a delayed or prolonged second-phase response to manage the sustained glucose levels.

2. Overcompensation: In some cases, if the pancreas eventually releases a significant amount of insulin to manage the elevated blood sugar levels from the delayed first phase, it can sometimes release too much insulin relative to the current glucose level. This overcompensation can lead to a drop in blood sugar, resulting in transient hypoglycemia.

3. Medication Effects: If someone with type 2 diabetes is using insulin or insulin secretagogues (medications that stimulate insulin release), improper dosing or timing can exacerbate these effects. For instance, if these medications cause insulin to be released too early or too much insulin is present after a delayed initial phase, it can lead to a subsequent hypoglycemic episode.

4. Glycemic Variability: Individuals with type 2 diabetes often experience greater glycemic variability. If blood sugar levels spike after meals due to delayed insulin response and then drop too much as insulin finally takes effect, this variability can increase the risk of both hyperglycemia and hypoglycemia.

Managing this involves careful monitoring of blood glucose levels, adjusting medications as needed, and possibly modifying dietary intake or meal timing to balance blood sugar levels effectively.

[Sarah Tee]

So it would be interesting if CGMs could also measure insulin?

[MikeO]

5 hours ago, Sarah Tee said:

So it would be interesting if CGMs could also measure insulin?

I had a thought it would be cool if a CGM could capture other vitals like smart watches do.

[tenef246]

I'm planning on trying a CGM monitor soon

Are there any similar devices that measure insulin levels? 

[MikeO]

1 hour ago, tenef246 said:

I'm planning on trying a CGM monitor soon

Are there any similar devices that measure insulin levels? 

That's great that you are going to try a CGM. They sure give you some insight as to how your blood sugars respond. There is no device available to measure insulin levels. Has to be done from a blood draw at the lab. 

[Sarah Tee]

I don’t think a home insulin monitor is close yet is close yet, but there is one for cortisol that is going to be life-changing for people with Addison’s disease:

https://www.addisonsdisease.org.uk/blog/behind-the-research-u-rhythm-2023

Unfortunately I think it was held up a bit by the pandemic, but it is still a solid project.

[tenef246]

Wow that is amazing. Thanks for sharing about that!

I currently use an OURA ring for sleep, a Garmin watch for heart rate and I’m about to purchase an Aktiia device for blood pressure.

I’ve found that these tracking devices can be very helpful with improving physical health outcomes! 

[MikeO]

1 hour ago, tenef246 said:

I’m about to purchase an Aktiia device for blood pressure.

I would be interested as to how this works out for you. Non invasive solution would be helpful.