I did some searches for "pancreas" on these boards, and came up with two conflicting accounts.
One post said that, if the pancreas is working, the BG numbers won't go up after eating.
Another post said that, if the pancreas is working, the BG numbers will still go up after eating, just like in non-diabetics.
Color me confused. *LOL*
Anyone else want to chime in here?
When the pancreas has kicked in, they go down after they eat low carb, for instance from 110 (before) down to 65 (after) and it has nothing to do with any shot, the nadir, the shed, or a bounce clearing. I don't suspect Pumbaa is dealing with pancreas action as long as he is still regularly bouncing to pink and yellow or above. He needs to complete Liver training boot camp first before the pancreas has much chance. It may mean holding him to blue or lower for weeks or longer before that happens.
I don't think the pancreas is like a switch that is either turned "off" or totally turned to "on". Sometimes it works only some of the time. I think the way I've seen it stated on the board often is "sputtering pancreas". From the threads I've watched, mostly in PZI, when a cat is getting better, some times the pancreas kicks in, and sometimes it doesn't. But in those threads, where people are encouraged to "feed, then test 30-60 minutes later (and expect a higher number), and then test an hour after that (where a lowered number is expected)", that's just what people do see. It isn't an instantaneous lowering of the BG where you don't see a rise followed by a drop. So I'd have to agree with this:
Another post said that, if the pancreas is working, the BG numbers will still go up after eating, just like in non-diabetics.
I think that what it comes down to is that it is impossible to catch everything that is going on with BG. You'd need an internal BG sensor and an insulin pump reacting to every little change in BG (sort of like a perfectly functioning artificial pancreas and liver) to see when the food makes it rise and when the insulin makes it drop, and how fast that actually takes place every minute of the day. All we can do is poke an ear, get a drop of blood, and run it through a tester that is only accurate +/- 20% with the reading.
In PZI last year, we were lucky enough to get a new kitty and bean who had done phone consults with Dr. Lisa, and we were fortunate to have her post on the board on several occasions. Something she said on one of those threads really stuck with me, and it has to do with the real amount of influence that "we" have over the whole sugar dance. All we can really do is influence what we put into kitty's system every day. How much food, what kind of food, how much insulin, and what type of insulin. We have little to no control over anything that happens once these things are inside kitty's body. Here's a couple of quotes from Dr. P:
We are ALL at a disadvantage because we don't have continuous BG values. I am no smarter than you guys. You are just as smart as me and if we ALL had a BG reading of every minute of every day, we would all know what to do with those numbers.
The bummer is that we don't know where the patient is at every minute of every day and so we just have to go with the data that we have.
Believe me, I completely 'get' the frustration involved with managing any diabetic cat - especially one like Copper - but I just hate to see people ripping their hair out over the dosage of insulin....down to impossible-to-accurately-measure increments of 0.1 or 0.2 units when there are SO many other factors involved in the glucose curve making that level of dosage change pretty darn moot. Yes, it would be great if we really had *that* much control over the disease process but we don't.
(Lori - I am hoping that the last statement will take pressure off of you - not add to it. Copper's body is in charge and we are just along for the ride...doing the best that we can with the ability to affect only a few pieces of the puzzle....ie....diet, insulin, constipation, body weight - in the case of an overweight cat.)
Serum glucose, at any single time point during the glucose curve, represents the sum effects in the *rate* and *amount* and *timing* of:
*Exogenous insulin absorption
*Endogenous insulin production
*Intracellular uptake of exogenous and endogenous insulin
*Insulin degradation and elimination - different for exogenous vs endogenous
*Intestinal glucose absorption
*Endogenous glucose production
*Tissue glucose uptake and utilization
and then throw in the amount of exogenous insulin....excess body fat....inflammation....subclinical infection....etc...etc....
I think that the lower the numbers are overall, the better the chances that the pancreas can start doing what it is supposed to do, and it will "participate" more often as the condition improves. I wouldn't rule out "any" pancreas action taking place even when Pumbaa is at times bouncing all over the place. Maybe it's some input from the pancreas that caused the low numbers that in turn caused the bounces in the first place? It's part of the pancreas that triggers the "liver" action to happen in the first place....
Carl
