State the big ideas of blood sugar regulation
- 1. The primary organs that regulate blood sugar are: PANCREAS, LIVER, ADRENAL GLANDS.
- 2. Never before in the history of mankind, have we had a need to LOWER blood sugar (that is until we started consuming large amounts of refined carbohydrates/sugars)
- 3. Americans/Australians are inundating their bodies with sugar and refined carbohydrates - avg 140pounds(63.5kg) of refined sugar per year.
- 4. Reducing insulin surges through adjusting macronutrient ratios will help the body utilize fats and ketones for energy rather than glucose.
Describe the interaction of the pancreas, liver and adrenals for blood sugar regulation
- The pancreas secretes insulin, and glucagon. Insulin tells your body to use the proteins, fats and carbohydrates you eat for immediate energy, or to put some of that energy into storage, so that you can keep functioning through your day. Insulin works to lower blood sugar levels. Glucagon, also secreted by the pancreas, comes into play when your blood sugar levels drop to low. Glucagon’s job is to raise blood sugar levels.
- If your pancreas has been exhausted by “overcarbsumption” then it can no longer control the amount of insulin floating around in your blood stream, and your blood sugar (glucose) levels raise up. Traditional medicine calls this diabetes, insulin resistance and metabolic syndrome.
- Adrenals are the amazing endocrine glands that sit directly above the kidneys, and control heart rate, body temperature, hormone functions, and our “fight or flight” response. They do so by producing “cortisol.” Cortisol is our bodies glucocorticoid steroid hormone, generally known as the “stress hormone. When your blood sugar levels raise too high, or drop too low; your adrenals send out cortisol signals to the pancreas and liver to release converted glucogen. Glucogen was the end product of that initial insulin signal– the one that said “store some energy for later.”
- When your adrenals have to kick up a response due to high blood sugar levels, they become exhausted.
- So here comes the liver: Carbohydrates give us immediate energy, but are essentially fast acting sugar. Especially in the form of “simple” carbohydrates. Your body knew that it had to store these carbohydrates so that when 10am (or 3pm) came rolling around, you’d need a “pick me up” snack.
- Your liver did this by converting the glucagon to glucogen. Glucogen was then stored as fat in your muscles, and in your liver. The glucogen in the muscles is supposed to be used up in about 90 minutes. But we don’t burn the fat from our muscles like our grandparents did, we have jobs that keep us relatively sedentry. So, that glucogen plugs up the receptors in our muscles and liver, creating fatty livers and weak muscles. Any excess becomes adipose fat, yep, that belly…
Know the processes of :
- glu·co·ne·o·gen·e·sis n. The formation of glucose, especially by the liver, from noncarbohydrate sources, such as amino acids and the glycerol portion of fats.
- Glycogenesis - the synthesis of glycogen from glucose that occurs chiefly in the liver and skeletal muscle.
- Glycogenolysis is the process by which the glycogen present in the liver is transformed into glucose, to be released into the blood.
Describe the blood sugar hormones:
- Insulin is a hormone made by the pancreas that allows your body to use sugar (glucose) from carbohydrates in the food that you eat for energy or to store glucose for future use. Insulin helps keeps your blood sugar level from getting too high (hyperglycemia) or too low (hypoglycemia).
- Glucagon has a major role in maintaining normal concentrations of glucose in blood, and is often described as having the opposite effect of insulin.
- Cortisol Called “the stress hormone,” cortisol influences, regulates or modulates many of the changes that occur in the body in response to stress including, but not limited to: Blood sugar (glucose) levels. Fat, protein and carbohydrate metabolism to maintain blood glucose (gluconeogenesis)
- Epinephrine, more commonly known as adrenaline, is a hormone secreted by the medulla of the adrenal glands. Strong emotions such as fear or anger cause epinephrine to be released into the bloodstream, which causes an increase in heart rate, muscle strength, blood pressure, and sugar metabolism.
Type 1 & Type 2 diabetes
- Hypoglycemia, also called low blood glucose or low blood sugar, occurs when the level of glucose in your blood drops below normal. For many people with diabetes, that means a level of 70 milligrams per deciliter (mg/dL) or less.
- Insulin resistance: The diminished ability of cells to respond to the action of insulin in transporting glucose (sugar) from the bloodstream into muscle and other tissues. Insulin resistance typically develops with obesity and heralds the onset of type 2 diabetes. It is as if insulin is "knocking" on the door of muscle. The muscle hears the knock, opens up, and lets glucose in. But with insulin resistance, the muscle cannot hear the knocking of the insulin (the muscle is "resistant"). The pancreas makes more insulin, which increases insulin levels in the blood and causes a louder "knock." Eventually, the pancreas produces far more insulin than normal and the muscles continue to be resistant to the knock. As long as one can produce enough insulin to overcome this resistance, blood glucose levels remain normal. Once the pancreas is no longer able to keep up, blood glucose starts to rise, initially after meals, eventually even in the fasting state.
- Type 1 diabetes, once known as juvenile diabetes or insulin-dependent diabetes, is a chronic condition in which the pancreas produces little or no insulin
- type 2 diabetes is insulin resistance, meaning their pancreas doesn't produce enough insulin or the body doesn't react properly to insulin.
Explain the damage caused to our bodies by Glycation and the blood sugar impacts of a diet high in refined carbohydrates and low in fats and proteins.
- Glycation is glucose reacting with proteins resulting in "sticky proteins" - these proteins cannot be used by the cells for structure or communication to within the cell or to other cells.
- The process is accelerated by elevated blood sugar levels.
- The proteins covered in sticky sugar become cross-linked and begin to harden. AGES = Avanced Glycation End Processes - these are proteins that have been damaged by sugar - hardening of tissues in organs, arteries, joints, cell membranes, all caused by glycation.
Describe how to evaluate a Sugar burning metabolizer vs a fat burning metabolizer.
- Sugar Burner:
- less able to be satiated
- insistent hunger
- impaired beta-oxidation of fat
- increased carbohydrate cravings & intake
- difficulty burning fat for weight loss.
- Fat Burner:
- burn stored fat throughout the day for energy
- able to effectively oxidize dietary fat for energy
- have plenty of energy on hand
- can rely more on fat for energy during exercise, sparing glycogen for when you need it
- have no change in energy after meals
- sustained energy between meals
Locate and describe test points for blood sugar regulation
- Raglands Test:
- Determine the presence and severity of adrenal dysfunction.
- 1. client lays on back
- 2. place the blood pressure cuff on arm of choice and determine systolic pressure
- 3. pump up cuff again 15mm/Hg higher than systolic pressure
- 4. whilst support their arm, instruct the client to stand quickly
- 5. immediately release the valve to determine the standing systolic pressure within seconds of the client arising.
- 6-10 point rise - excellent
- remains the same - fair
- drops up to 10 points - poor
- 11-20point drop - fail
- more than 20 points drop exhaustion
- PARADOXICAL PUPILLARY RESPONSE
- Indication of adrenal dysfunction
- determine the ability to adapt to light
- Darken the room and wait 15 sec
- instruct the client to look at a fixed point and not blink
- position the light by the clients ear and hold 6-12" from the head
- move the light towards the eye and aim the light at the pupil at 45deg angle
- observe for 20 seconds
- 20sec holds and no pulsing - excellent
- 10sec holds but then starts pulsing - fair
- pulses and becomes large after 5-10secs - poor
- pulses and gradually becomes large over first 10 secs - fail
- failure to constrict or immediately becomes large - extreme exhaustion
- Chapman reflex - adrenals 2"→↑umbilicus
- client on back and lift head - situp
- palp - 2" lateral and superior to umbilicus
- palp with one finger A>P you are feeling for a small pea-like nodule that sit on top of the abdominal muscle - do each side
- Posterior Ilium/Short leg: Adrenals
- Position the client either face up or down, Either gently pull on the legs to help straighten their position or ask the client to push their heels together and release.
- Then holding the clients feet together determine if one leg is shorter than the other by placing your thumbs or fingers on their medial malleolus (anklebones).
- You can compare the seams of the shoes where heels are attached.
- Inguinal ligament tenderness: Adrenals
- ALWAYS ASK PERMISSION BEFORE PALPATING A SENSITIVE AREA.
- The Inguinal ligament runs between the ASIS and the lateral edge of the pubic bone.
- You are palpating the entire ligament by drawing your fingers back and forth across it like a bow on a violin at a 90deg angle.
- Press A>P while doing so.
- If there is pelvic instability , the ligament on one side will be tight and the other flaccid. Palpate both sides for tenderness and tension.
Locate and describe test points for blood sugar regulation
- CHAPMAN REFLEX: PANCREAS 7thL
- Reflex for the Pancreas/Spleen 7th intercostal space on the left, mid mammary line.
- Find the 6th intercostal space and move down and slightly lateral.
- When locating the 7th intercostal space if you move to the xiphoid, you will be below it.
- Single finger palp, A>P.
- Right Thenar pad tenderness: Pancreas
- Draw a circle around the right thenar pad. Directly in the middle of this imaginary circle there should be a slight indentation.
- Probe deeply into this point, palpate for tenderness - often a sharp pain.
- T6/T7 tender close to the spine: Pancreas
- NOT a spinal indicator - reflex located on right side of spine only.
- Locate bottom of the scapula either right or left side, cup it with the palm of your hand, roll your hand upwards and with your palm now flat against the client's back, palpate, right next to the spine(RIGHT SIDE), with your first three fingers P>A.
- You are checking for congestion or tenderness on the right side only - compare with the left side - IF THEY ARE THE SAME TENDERNESS, IT IS NOT AN INDICATOR.
- LIVER 3rd Rib (R)
- DR. Dejarnette's sign: start mid mammary line, right side and count down until you are on top of the 3rd rib(the clavicle counts as the 1st rib).
- On the 3rd rib move laterally slightly to the point where the bone turns to cartilage (chondracostal junction).
- Palpate A>P checking for pain and rigidity - can verify by testing the left - IF THEY ARE THE SAME IT IS NOT AN INDICATOR