Help me understand bounces

  • Thread starter Thread starter Carl & Polly & Bob (GA)
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Carl & Polly & Bob (GA)

Last night I happened to check the board at 3am or so and caught Jamie, Dane and Jupiter in the middle of a 911.

Jupiter dropped to 41, and the next couple hours were pretty much "standard drill" HC gravy and food, test, and lather, rinse repeat. No big jump in numbers, and this morning a very nice low blue AMPS.

Then a 227 shows up. Eight or nine hours after the 41. Bounce? If so, why???

I get the theory. BG drops too low. Kitty's liver panics. Releases glucogon and CR hormones to self-preserve and avoid hypoglycemia.

What I don't get is the time delay.

If self-preservation is the whole point of the panic, why doesn't it happen instantaneously? What good is it, and how is it going to save kitty from hypo if it doesn't happen immediately? Why does it show up all of a sudden eight hours later when it's no longer needed?

I understand that the hormones stick around for a while before the bounce clears. But where was the glycogon when it was needed?
 
I don't know if there's a technical explanation so I'm going to brainstorm.

I think we see the quick, sharp spikes up when a cat is still new to insulin and hasn't been in lower numbers for some time. The more the kitty's body is becoming acclimated to normal BG numbers, the less the body's panic response. Ultimately, we hope the bounces go away. So it makes (perverse) sense that they may be delayed an potentially, not as high.

I'll be curious what others think.
 
I have always wondered about this too... its a good question! I looked at Jupiters SS and sometimes I think he jumps up much quicker, but other times it takes a long time to start seeing the bounce. Could it be because at that point this morning the insulin from last night was really starting to wear off? I have no idea but I would love to be able to understand this too.

I think Jupiter is different from most cats, because his nadir seems to be a lot later in the cycle - but for some reason he went really low way earlier then I would normally expect. This is the 2nd time he dropped low early on in the cycle (on 4/27 he also dropped quickly like he did last night)..

Sometimes his bounces clear quickly and other times it takes day... I also do not understand that.. Why on somedays does it take longer for the bounce to clear then other days?

His cycle on 4/30 confuses me as well because if his body panics and thats why he bounces then why was he in blues and greens all day? He didnt start to bounce for a very long time after his first few low numbers...
 
Interesting discussion Carl. I'd love to hear what others say.

Neko, like Jupiter, often has later nadirs (although I've seen them anywhere from +3 to +13). If you take a look at the last few weeks of Neko's SS, you'll see that she has had wonderful night time cycles, started out great in the AM (except today), then 90% of the time headed for the pinks. The other odd thing I've noticed is that often the worst of her bounce is the start of the third cycle after the low that caused the bounce. There are several other cats on here who save the worst of their bounces for later cycles. It's like their liver gets a reminder and says "OMG - I did what!?".

Neko usually has a later onset to go with her later nadir. That plus a bit of overlap from the previous cycle might explain the timing for when her daily bounces start. Of course, I've also seen her jump 50 points in 1/2 hour after a low without HC, then surf for 6 hours. That sounds like a case of the liver sending out just the right amount of glucogon when needed.

The most frustrating thing about the kind of delayed bounces like Jupiter had today, is that you can't "shoot through the bounce" because you don't know until after you've shot whether the cat will bounce.
 
Over a year ago, I posted a really long post about insulin resistance, and it also explained (from sources I found on the internet) exactly what happens in a human body when hypoglycemia happens, and what the pancreas and the liver do during the process we call "liver training" or "panic"
http://felinediabetes.com/FDMB/viewtopic.php?f=24&t=67645

Here's that part of it:
Another thing that I have repeatedly read here is about "liver panic" and how when the BG goes to low, the liver will dump "glucagon" into the blood to raise the BG. Well,the liver does dump stuff, but not Glucagon. It turns out that glucagon is actually produced naturally by a part of the pancreas called " the islets of Langerhans" (which to me sounds like a wonderful destination for a cruise or vacation, doesn't it?).

Here's a good explanation of what takes place in the blood, pancreas, and afterwards the liver when BG rises or falls:
http://bloodsugardiabetic.com/diabetestreatment/insulin/how-the-body-regulates-blood-sugar/
Blood Sugar Levels Rise

If blood sugar levels increase (e.g. after a meal), the beta cells of the islets of Langerhans in the pancreas produce insulin. The insulin has an effect on various organs of the body, increasing cell permeability to glucose and increasing enzyme activity in the cells allowing the glucose to be taken up and stored.
The liver and muscle tissue converts glucose to glycogen and stores it. This helps reduce the levels of sugar in the blood. In addition, the breakdown of fats in fat cells is inhibited, so that glucose will be used preferentially for energy.

Blood Sugar Levels Fall

The alpha cells in the islets of Langerhans of the pancreas product glucagon. Glucagon is “antagonistic” to insulin, basically having the opposite effect on the organs of the body. Glucagon increases the conversion of stored glycogen into glucose in the liver and muscles thereby increasing blood sugar levels.
Glucagon also increases the uptake of amino acids and glycerol into the liver so that more glucose can be synthesized.


The importance of glycogen as stored energy

Since all of the cells in your body require a continuous supply of energy, it is important that your body stores excess “energy” eaten during meals so that it can be used when food is less plentiful. Excess glucose is converted to glycogen by the mechanisms we saw above.
Glycogen is stored in the liver and the muscles. When your body is active, energy requirements increase and stored glycogen can be converted to glucose to be used as energy. If stored glycogen levels get too low however, cortisol is secreted from the adrenal cortex, and this stimulates the conversion of proteins and fats into glucose so energy levels can be maintained.


So what does the glucagon do?
Glucagon and Insulin
Glucagon increases the amount of glucose in the blood by accelerating the rate at which the liver converts stored glycogen into glucose and releases it into the blood. Insulin decreases the amount of glucose in the blood by transporting glucose from the blood and into the muscle cells. It also stimulates the conversion of glucose back into glycogen so that it can be stored.

It makes the liver dump glycogen, coverted into glucose, into the blood so that it can show up in your next PS reading!
And what happens when there is too much insulin? It does exactly what we don't want it to do:
Other Effects
Insulin also has a few other important roles in the body. Insulin facilitates the storing of excess glucose in the form of glycogen in the liver. Elevated levels of insulin also cause the liver to make more fatty acids. Insulin inhibits the breakdown of fat in adipose tissue for energy. Insulin also allows cells in the body to take up more amino acids, so that they can make more proteins

.
In balance, that's a good thing, and in a non-diabetic, it would do so in amounts that made sense in the body. But if insulin is excessive, and it cause the liver to store more glycogen, then when the BG goes too low, and the pancreas puts out glucagon, and it makes the liver dump the glucose from the glycogen, then the pancreas (and the insulin) is sort of working against itself, isn't it?

To me, it makes it sound like all this stuff, when BGs go low, happens instantly and instinctively. So again, why would it not show up on the meter for hours or even cycles later? I understand some have said or asked if it could be due to the exogenous insulin still "working", and hadn't worn off yet. But if that's the case, then the insulin is doing just what you want it to, right? Holding the BG down. But at a higher than hypo number. So it should be stopping the liver and pancreas from dumping "sugar" into the bloodstream. Unless it's completely worn off and allowing the BG to go up. But you'd have to skip shots (given the depot) for the body to run out of the insulin completely, wouldn't you?
I understand Sienne's point that as the cat goes through Liver Training 101, then you would expect the bounces to happen less often, and to a lesser degree in terms of how high the cat bounces. But I don't see why it would take any longer for a bounce to happen if it is due to the body "triggering" the whole "dump sugar" mechanism. It would seem that it's an all or nothing thing to me. Either the pancreas and liver dump glucose, or they don't. But why would the liver, as Jamie said "...gets a reminder and says "OMG - I did what!?"

There has to be some sort of physiological explanation for what we are seeing, and it must be something different than "the instant hypo bounce" that we see at times....

Thanks for all your input so far!
 
I don't know that all physiological mechanisms, even the protective ones, are all or nothing. I was thinking of an infection, as an example. You can have a "low grade" infection and you don't necessarily spike a fever. The way I'm thinking about the phenomenon is that there has to be a "just noticeable difference." the JND process is not an uncommon one in physiology. There's a point at which there has to be (for lack of a better term) a critical mass for an event to happen. Just think of the degree of sensory overload we'd experience if we responded to every sight, sound, smell, etc. To a degree, we either learn to ignore certain sensation because they're not dangerous or are simply commonplace or those sensations have to be at a certain level to warrant a response. Perhaps bounces work the same way.
 
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