Not a huge post here…I just wanted to follow up after Karin’s fantastic look at physological insulin resistance, and some questions about my experience in the comments, I figured I’d just follow up with my blood glucose readings… (since Karin referred to them).
This is after 19 months on a low carb, ketogenic diet…
Hourly blood glucose reading after 19 months on a low carb ketogenic diet.
If you look closely, you’ll see a change on the right side. That was after I cut out coffee (as a test). I drink my coffee black. I’ve read that caffeine can raise blood glucose in some people. Also, stress (which I have a lot of).
Since I don’t have a “before” profile to compare to, this isn’t terribly useful. I mean, I know that in 2011 it was measured at 94 mg/dl, and a year later, it was measured at 103 mg/dl. This was not the direction I expected things to go.
My A1C has always been 5.5. That never seems to move. I’ll try reading my blood glucose again this week or next and see if there’s been change in the last few months.
Resources
- High Blood Sugar In Ketogenic Dieters! Plus A Special Surprise (Hint: Genotypes And Metabolism)!, Layton, Karin (katkinsk). Ketopia, Feb 2013.
- Physiologicial Insulin Resistance, O’Neill, Michael (mjoneill). Ketopia, Dec 2012.
PaleoFastUK on February 22, 2013 at 9:11 am said:
Hi..yes serum ketones is the way to go. If you detect them in urine it means actually you are not using them efficiently as fuel. They should not be there in your urine when in deep healthy ketosis. But yes I heard the ketosticks are dear! You could maximise their usefulness and economise by first looking at your blood glucose. Say over a 12-14 hour period you find consistent peaks/troughs (and by consistent I mean you need to perhsp monitor gluc over a few days) choose one of each and then you could measure the serum keton levels at your chosen glucose peak time (prediction ketons might be low) and gluc trough (prediction they might be higher).
I think I am going to buy both glucometer and ketometer as well. I am curious to see what daily 20 hour fasts do to my values. I am still contending with skeptical colleagues who predict all sorts of mischief happening in my system. Actually I feel wonderfully stable….I’ll post this also on your site….
I always tell them that someone who loves food and cooking like I do would not spend all day without eating (although I no longer see it that way now after almost 6 months!) if I didn’t really feel great with it. I love and I hope I can carry this on for the rest of my life! I think I might be an insulin hypersecretor, one of these people who secrets too much insulin at the time of eating. Remeber your post on biphasic insulin secretion? Well I had been aware of that for a while and some experts (and I think I agree with them) think that the first insulin peak which is called a neurological i.e. it is a reflex of food injestion independently of the carb content of food, this peak is what in msot people but especially in some of us causes that strong urge to eat. PArt of teh mechanism could be that as you have jsut started eating this early insulin peak lowers your blood gluc and tells the brain to get on with eating. In some of us and I count myself in this urge to eat after the first bite is very strong and amost primitive. You can imagine if i eat three or four meals a day I experience this powerful urge each time and it is tiring and unpleasant to resist. Ignorant of my problem I struggle with it for a lifetime but now that i know eating once a day (and high fat med protein food) is a true blessing for me. I can even enjoy the urge because I feel I ahve earned my food all day even though my job is office based i pretend I am foraging. I love it but understnad that people for who food does not trigger such strong urge then they don’t see at present the advantage of deacresing meal frequency. Keep me posted and I’ll get sorted and hope to publish my measurements so we can compare! 🙂
“PArt of teh mechanism could be that as you have jsut started eating this early insulin peak lowers your blood gluc and tells the brain to get on with eating. In some of us and I count myself in this urge to eat after the first bite is very strong and amost primitive. You can imagine if i eat three or four meals a day I experience this powerful urge each time and it is tiring and unpleasant to resist.”
PaleofastUK
I find this very interesting..and a thought I had myself regarding BG remaining high.
I think there will be much new information coming out about BG over the next years.
MY own FBG and BG levels have also risen over the past year..-did not measure before that.
A thought very similar to what I have quoted you on..remains in my mind, that the raised BG is somewhat of a thermostat or regulator for a keto adapted person. The raised BG purpose is exactly that..to regulate further CARB consumption..specifically.
If you go with the premise that the natural purpose of carbs is to lay on weight for a lean season..and then are in the ketogenic cycle of the year/season..it makes sense that the signal should be “”stores are full” .
Does anyone know if elevated BG alone is harmful? or only as a bundle wth other symptoms.
I think of Peter Attia and his thoughts on diabetes NOT being caused by obesity. Of course at this time insulin resistance itself..seems to be the trigger..but I’ll bet this will result in even more questions. A fascinating time. wonderful discussion..thanks!!
Dear Michael as promised here I am. I start with an apology in case you had come across this before. So I don’t know much about your diet and exercise regime but your hyperglycaemia could be easily explained by ketogenic insulin reistance. This is the ‘healthy’ form of insulin resistance. The threshold of dietary carbs at which this is triggered varies from person to person but generally below 50g many people develope muscle insulin resistance (the liver form is the pathologic one happens when we eat too many carbs). Anyway it may also depend on how efficient your protein gluconeogenesis is and how inefficient your brain is at using ketones. The body defends the brain over and above any other body tissue so if for any reason it feels that glucose must be secured insulin resistance is the mechanism (so it will also depend on how much protein you include at each meal etc). The ketogenic insulin resistance is totally reversible and you could easily test this with your glucometer. Just have one healthy carb meal (couple of bananas, handful of dried fruit and even a small potato or sweet potato. Measure your blood gluc before and for a couple of hours afterwards. Your hyperglycaemia should subside. I am curious.
Hope this helps
Paleofast
OOOOoooops Of course you have written an entire post on physiological insulin resistance….sorry. I think best thing to try is increase carbs a little eating so called natural healthy starches and see if this sorts you out.
Ha! No problem. I think I’m going to investigate coffee, then follow this protocol:
I’ve done a week of glucose readings already, and gave up coffee half way through. I noticed a nice drop in blood glucose after quitting, but I didn’t put 2 + 2 together, and it was a small sample and could have just been random.
If I still maintain high fasting blood glucose, I’ll then switch to 150g/carbs a day for 3 days and see what my glucose does. That’s the standard protocol (from what I’ve read, anyways) for a Glucose Tolerance Test when the subject is a low carb/ketogenic dieter. If we take a GCC without first upping our carb intake, we’ll fail.
I would expect that 150g of carbs is higher than necessary as a sustained way of eating, but at least it establishes an upper limit.
I’ll definitely keep you posted on how this progresses. In the mean time, thanks for sharing this information with me. Even though I already covered physiological insulin resistance, I’m always looking for new information on it and I really you reaching out to me when you learned something about this phenomena.
HI Michael yes sorry again for rediscovering the wheel for you. I think it is fascinating that at the two extremes the body responds in similar way although the organs involved are different.
But it makes perfect sense and despite the negavite connotation because of pre-diabetes in the case of liver resistance, the insulin resistance you may be experiencing is a healthy one.
Gluconeogenesis from protein in your case and that of other ketotic hyperglycaemic people (I might be amongst them even though I don’ know yet) might also be a factor. It is like an uncoupling if biochemical pathways.
A question about teh role of coffee. I thought coffee causes insulin release…so one possible prediction could be that if you remove the coffee your hyperglycaemia may get worse or on second thoughts it might improve if the insulin receptors are allowed to recover from so called receptor fatigue (I take it you relish your daily coffees?).
Depending on your macronutrient proportions now you could try the pemmican 80% fat diet with much less protein and see if that re-sets the system. I am also twigging things as I go along…what an amazing journey! Will stay tuned 🙂
Here’s some starting info on why I want to rule out Coffee… For most people, it’s not a problem. But who knows for me?
Today is March 16, 2014 are you still following a LC/Keto diet? If so what is your general blood glucose reading a year later?
Hi Patti!
Indeed I am still following a low carb diet. Alas, I have not measured blood sugar, so I don’t have additional info to share in that regards. For as long as I measured, it pretty much stayed consistent with what was reported above.
-Michael
Hi Michael,
Thank you for responding to my question. It seemed so odd to me that when I started my keto diet two months ago my fasting blood sugar with the Precision Xtra strip in the morning ranged between 85 and 90, now it is 105 or even sometimes 116. YIKES!!! So it is good to know that I may be one of those people with physiological insulin resistance.
Patti
Have you had your Blood Lipid Panel taken? What are your numbers? LDL? I have been eating a keto diet and exercising a lot for 6 months. I didn’t have weight to lose just tired of eating high carb for 40 years. I tested my LDL and it just about doubled 125 to 212. My HDL 100 and Triglycerides 46. Crazy good their. My blood glucose levels are just like yours. I’ve measured my ketones via blood and I’ve always been around .5. After a long bike ride (4 hours), my ketones are 1.7 and by BG is 70. But typically my fasting BG is around 105 and during the day 115. I thought by BG would drop in the 80s when on leto. Based on my high LDL, I’ve gotten my thyroid tested. I’m waiting for the results to come back in a few days. Any other thoughts? Coritsol?
Hi Chris, this is a wild shot hoping you would respond after all this while 🙂 Wondering if you found out any more background or reasons behind your LDL readings. Could you please share any follow ups? I have noticed my LDL shoot up too after following Keto for 2.5 months now. Triglycerides are low as they should be and HDL is in healthy range. I found out that the normal LDL tests lab do gives an inaccurate picture of real LDL levels and CVD risks. It is the particle size of LDL that seems to be more important. The labs (both labcorp and quest diagnostics) now have these advanced tests. I am going to get those done soon and I can report on them.
Krish
I did get my LDL particle size tested and they were all the healthy size. I was relieved but I guess that was to be expected. I was alittle nervous about my fasting glucose level rising but I.did read that was expected to some dgree. I was swimming in the mirning and jogging at lunch time. Then long bike rides on weekends so its was alot of exercise. That may have played a role in those numbers. Ive stopped striving for ketosis and do eat carbs but im always in the edge. Weight was never my issue just wanted to experiment with not bonking on long bike rides and wanted to stop craving carbs. I did a strick keto for 1.5 years. As I said im on the edge now. Some days no carbs some 50 g some 150g. I have not had my blood tested in a couple years. Im glad you reached out. Dont worry about your ldl count. Give it time. You are right about cvd and ldl levels. I had a Stanford cardiologist tell me that I should be on statins. Ironically my other hospital called and said I needed to exercise more to.reduce my cholesterol. Keep me posted on your experience and feel.free to ask anything.
Adrenal fatigue?
BTW, I started eating more carbs after my blood was drawn for the thyroid test. I was at 50g total carbs before. I’m trying to get to 100g now to see if that will lower my LDL.
Michael, I’m in the same boat. I’ve lost 40-43lbs over the last year on a low carb, ketogenic diet. My recent FBG readings went up from 70-80 (3-6 months earlier) to 90-110. Ketones dropped down to .4-.5 range. Last week I started fasting (eat 1 meal / day at noon). The ketone measurements went up to 1.5-2.5, and FGB came down to 80-90. I believe fasting is the way to go. Keto without fasting means => low blood ketones => increased need for sugar by the brain => more frequent eating, where sugars are derived from protein & insulin resistance by the muscles. At least that’s my theory. Please try fasting. Breakfast is not the most important meal of the day, it’s easier to skip while your blood ketones are maximally high. Best.
I am having higher FBG in the morning (from 80 to now 100) since being on the high fact/low carb/keto diet. In researching it, I found this mention of it being perfectly normal. http://ketopia.com/high-blood-sugar-in-ketogenic-dieters-plus-a-special-surprise-hint-genotypes-and-metabolism/
I would also have thought it would go lower, but it does not. Hope this helps.
Wow I made a comment exactly one year ago about physiological insulin resistance. I stopped doing the keto diet sometime in May of last year. I don’t know, I just found my car driving me to WholeFoods and buying tons of white rice and french fries at the hot food bar. I did that for about a month, I could not get enough carbs into my diet. About that time I had read about or saw a video on youtube about physiological insulin resistance being a precursor to insulin resistance. Meaning I was causing my body to go towards being diabetic. This is my body not anyone elses. For me, keto is not the way. I know Jimmy Moore has been very successful at Keto as well as Maria Emmerich, but I don’t necessarily think it is for everyone. Yes my weight is up 10 pounds, but I don’t have those periodic sugar binges I was dealing with on Keto. Also, I had slowed down on urinating, in fact I found it very hard to urniate.
I hope someone can still weigh in on this. I started a zero carb diet a week ago. I was so sick of my constant sugar cravings and binges despite being sugar, gluten, and grain free, I still craved it like a fiend. Since being on a diet of just meat, I’ve had very little issue. Very, very light carb flu, still have plenty of energy, lost some weight, not thinking about food as much, things seem to be good. I tested with a blood monitor and found my ketones were 3.3 yesterday. This morning I tested my fasting glucose and it was 132. I’m not diabetic. I have never had issues with blood sugar whenever it has been tested. This really shocked me. Is this likely to improve or do I need to get out of ketosis?
This is a good podcast on Keto diets by paleomom. http://paleoparents.com/podcast/tpv-podcast-episode-140-the-danger-of-ketogenic-diets/ Some people don’t benefit from keto diets.
@Andrea: You cannot go diabetic overnight or over a week. It’s best to monitor your Fasting Blood Glucose (FBG) everyday and come to a firmer conclusion. Low carb does raise your *mildy* *over a long time period*. Mine was 70-90, then it went up to 95-110 over a 1 year period. Adapting to using fat as an energy source might be messing up with your body temporarily. I would keep a close eye on FBG. 132 isn’t lethal or anything. My $.02. I’d also consult a physician (hopefully someone who’s knowledgable about low carb metabolism… few are).