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Pediatric Hyperglycemia Protocol

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Hyperglycemic Clamp: A Single Experiment To Simultaneously Assess Insulin Secretion And Insulin Sensitivity In Children † 420

The state of hyperinsulinemia/insulin resistance determines the likelihood that an individual will develop premature atherosclerotic vascular disease. Therefore, various methods to assess in vivo insulin sensitivity have been developed. In adults, it has been shown that the hyperglycemic clamp assesses both insulin sensitivity and insulin secretion in the same individual simultaneously. Our study aimed to determine if in children the insulin sensitivity index derived from a hyperglycemic clamp is a reliable estimate of insulin sensitivity during a hyperinsulinemic-euglycemic clamp. 34 healthy children (age 12.6±0.3 yrs; 18M, 16F; 9 prepubertal, 25 pubertal; 15 Black, 19 White) were studied. Each participated in a 2h hyperglycemic clamp (225mg/dl) & a 3h hyperinsulinemic(40mU/m2/min)-euglycemic clamp in random order. Insulin sensitivity during the euglycemic clamp (IS-EU) was calculated over the last 30 min by dividing glucose disposal rate by steady state insulin concentration. During the hyperglycemic clamp insulin sensitivity index (IS-HY) was calculated over the last 60 min by dividing glucose disposal rate by endogenous insulin levels. During the hyperglycemic clamp insulin se Continue reading >>

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Popular Questions

  1. KOSHIE1

    KETOSIS is a chemical /metabolic state your body is (or isn't!) in. Either your carbs are low enough for your body to be in ketosis, OR NOT. As long as you are in ketosis, your body metabolizes food differently -- it is totally irrelevant whether you are consuming "X" or "Y" number of carbs. In other words, IF you are in ketosis, it doesn't matter how deeply you are in ketosis, or how deeply purple your Ketostix are. You simply ARE or ARE NOT in ketosis.
    Eat too many carbs and your body goes out of ketosis, and changes the way it metabolizes food.
    WHILE IN KETOSIS, you cannot get all the caloric energy out of the food you eat. Fat will only give you 1 (ONE!) calorie of energy, not 9! Protein will give you only 2 calories, not 4; but carbs will still give you the full 4 calories whether or not you are in ketosis.
    So, your Ketostix turn purple because you are in ketosis and producing ketones through your now-inefficient metabolic breakdown of fat. Deeper purple is caused by more ketones, which is caused by eating more fat -- it has absolutely NOTHING to do with changing your body's "level" of ketosis. Remember, you either ARE or ARE NOT in ketosis! THERE ARE NO LEVELS OF KETOSIS, ONLY CONCENTRATIONS OF KETONES, which is entirely dependent upon how much fat you eat.
    So if you are sure you are in ketosis (which you seem to be because your Ketostix are still consistently turning even the palest shade of purple -- which can only happen if you are producing ketones which can only happen if you are in ketosis), then you can only have a limited number of problems (and it isn't ketosis!):
    1. You are simply eating TOO much, too many calories to lose weight! (and it probably is protein).
    2. You are on a plateau, and simply must wait it out.
    3. You are having a "sensitivity" issue that is causing you to retain your weight (probably water). You could be sensitive to anything: milk products, gluten, artificial sweeteners (beware maltitol), medicines, ...
    Three weeks is not an unusually long time for your weight to be stable despite your "best efforts" at losing weight. Review your daily food records and see if there is anything different about the last three weeks. Maybe you can find a clue that way.
    Note: Are you eating maltitol? LOTs of people stall by eating maltitol. "They" say maltitol has "ZERO" effective carbs; but the USDA has research that indicates that maltitol is actually worth "half" its total grams, NOT none of its grams!


    current weight: 206.0



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    177.5

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    145

  2. URMYLF

    Are your calories too high?
    I have noticed that if my carbs are the right level and I'm in ketosis, that if I see how many calories I've eaten, I'm usually around/over 1500.
    According to Atkins, eating protein/fat is supposed to keep you full so you don't want or need to overeat. I must concur! When I overeat because it tastes so good, but I'm not hungry, I see it in the scale. For me, I've learned 1200-1300 is a good place to be, and 70% fat/30% protein is a good ratio for me (the carbs range from 20-35 when I'm losing).
    Eating after dinner also causes me to stall.
    Carrie


    current weight: 192.0



    192

    189.5

    187

    184.5

    182

  3. JUST_JULIA

    Tinamarie, are you actually counting your carbs? You may be eating more carbs than you think. I understand that you can register in ketosis with up to 30 net carbs/day, maybe more, but if you're in the induction phase, you only want to be at 20. I am pretty much at that point too. Also, are you exercising. I tend to lose more weight more quickly when I don't exercise. So if you're exercising and doing everything right, just keep it up and know that doing the right thing will get you to where you want to go. I too have been in ketosis for a while and am not losing weight - I work out at least an hour a day at least 5 days/week, so I know I'm getting in better shape and that the weight loss is going slower than it has been. I just keep doing what I'm doing and I know I will reach my goals - just not by the time I had hoped.

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