The Dawn Phenomenon – T2d 8
The occurrence of high blood sugars after a period of fasting is often puzzling to those not familiar with the Dawn Phenomenon. Why are blood sugars elevated if you haven’t eaten overnight? This effect is also seen during fasting, even during prolonged fasting. There are two main effects – the Somogyi Effect and the Dawn Phenomenon. Somogyi Effect The Somogyi effect is also called reactive hyperglycaemia and happens in type 2 diabetic patients. The blood sugar sometimes drops in reaction to the night time dose of medication. This low blood sugar is dangerous, and in response, the body tries to raise it. Since the patient is asleep, he/she does not feel the hypoglycaemic symptoms of shakiness or tremors or confusion. By the time the patient awakens, the sugar is elevated without a good explanation. The high blood sugar occurs in reaction to the preceding low. This can be diagnosed by checking the blood sugar at 2am or 3am. If it is very low, then this is diagnostic of the Somogy Effect. Dawn Phenomenon The Dawn Effect, sometimes also called the Dawn Phenomenon (DP) was first described about 30 years ago. It is estimated to occur in up to 75% of T2D patients although severity varies widely. It occurs both in those treated with insulin and those that are not. The circadian rhythm creates this DP. Just before awakening (around 4am), the body secretes higher levels of Growth Hormone, cortisol, glucagon and adrenalin. Together, these are called the counter-regulatory hormones. That is, they counter the blood sugar lowering effects of insulin, meaning that they raise blood sugars. The nocturnal surge of growth hormone is considered the primary cause of the DP. These normal circadian hormonal increases prepare our bodies for the day ahead. That is, glucagon tells the liver Continue reading >>
Ketone And Glucose Levels Both Up
Ive started a strict keto diet 10 days ago which is a followup on a 3 week period of gradually lowering carbs in my diet. I do not have diabetes, allergies or any other sickness. Im 5 10" (177cm) and weigh 154 pounds (70kg). My blood tests 10 days ago when I started my keto journey was: Question 1: On day 3 on the strict program I clocked a 4.2 mmol/L ketones in my blood. I measure blood at home. Since that Ive constantly clocked 3+ levels with the 4.2 as the highest. Even in a fasted state, meaning before breakfast I clock 3+ levels. What does this mean? What Ive read for most people even to get to a 1mmol/L state takes a lot longer. I strength train 5 times per week. Question 2: This morning (12 hours without food) I tested my glucose levels as well as ketones and the numbers are 6.2 mmol/L (114 mmg/dL) and a 3.8 mmol/L ketones in my blood. Should I be concerned about the high glucose levels as I eat max 25grams of carbs per day? Also this would mean that I have a very high energy count in my blood (6.2+3.8) which is maybe not optimal for the benefits Im looking for, like transforming my metabolism into a fat burner instead of a carb burner. Or maybe my glucose monitor is fooling me? I use menarini diagnostics monitor Early morning is when cortisol rises highest and cortisol raises blood glucose. 114 mg/dl fasting blood glucose is well into the pre-diabetic range (100-125) but if it only occurs in the morning it is less of an issue. If your are strength training elevated blood glucose, especially before bed, will blunt the growth hormone response reducing the muscle building effect of exercise. And chronically elevated blood glucose leads to hyperinsulinemia and insulin resistance. A loss of insulin receptors also blunts the anabolic effects of GH/IGF-1 as IGF-1 also Continue reading >>
How You Can Have High Blood Sugar Without Carbs
How You Can Have High Blood Sugar Without Carbs Can you have high blood sugar without carbs? Well, its important to look at common beliefs about high blood sugar first. High blood sugar is bad. Carbohydrates raise blood sugar. Therefore carbohydrates are bad. The theory is simple, and yet incredibly flawed. The truth is, you can have chronically high blood sugar even while religiously avoiding every starch and sugar in sight. Low-carb forums are littered with posts asking a very relevant question: Why is my blood sugar so high when Im not eating any carbs? The answer is simple, yet often overlooked. The Hormone that Raises Blood Sugar: No Carbohydrates Required If the body were an engine, glucose would be its fuel. Most people think glucose only comes from carbohydrates (sugar and starch), but protein can also be turned into glucose when there arent enough carbs around to do the job. This is called gluconeogenesis, and its performed by one of the major stress hormones cortisol. When you have high cortisol levels (from diet, lifestyle, etc.), the cortisol rapidly breaks down protein into glucose, which can raise blood sugar levels considerably. For some folks, this results in chronically high blood sugareven if they are on a low-carb diet. The trouble is, cortisol isnt just breaking down the protein you eat. Its doing something far more destructive. The body is quite a smart machine, and it has no problem taking detours to get energy if necessary. If your body isnt getting the energy it needs from your diet, it has a back-up source: its own tissue. It sounds kind of cannibalistic, eating your own lean body tissue for energy. I mean, I seriously doubt any one of you would relish cutting off a chunk of your leg for dinner. I know I wouldnt. But every time your body uses c Continue reading >>
High Fasting Blood Sugar On Keto?
The more I coach people through a ketogenic lifestyle, the more I become familiar with small nuances that can affect different peoples experience. For example, there are a number of people who experience high fasting blood sugar upon waking in the morning. These individuals would express that they were following a ketogenic diet and were in a fasted state so it doesnt make sense to have elevated blood sugar. What you are going to find out in this article is that this effect may actually be much more normal than you think. In fact, it may not even be an issue. That being said, for some people it may actually be a sign of something undesirable going on with their metabolism. This article will help you troubleshoot what is likely to be causing your high fasting blood sugar. When someone has elevated fasting blood sugar and is NOT following a ketogenic lifestyle, it is likely that they are suffering from insulin resistance. Insulin resistance is characteristic of pre-diabetes and diabetes , as well as metabolic syndrome. This is when your cells stop listening to insulins signals to let glucose into the cell and instead allow glucose to continue circulating in the blood. This is often due to a high sugar diet that constantly bombards insulin receptors to the point where they become desensitized. Think Little Boy Who Cried Wolf, but with your cells. This is called pathologic insulin resistance as it is considered a disorder and increases your risk of many different diseases . In diabetics, there are 2 common ways that high fasting morning blood sugar arises. The first reason is the Dawn Phenomenon and this impacts individuals who are following a ketogenic lifestyle as well. Overnight as we sleep between the hours of 2-8am a slurry of hormones including cortisol, growth hormo Continue reading >>
The High Blood Glucose Dilemma On Low Carb (lc) Diets
If you are on a ketogenic or very low carb (VLC) diet (e.g. with 50-100gr carb/day and/or eating ketone producing MCT oils such as coconut oil), you may have a dilemma of having high Blood Glucose (BG) despite eating LC: If you are keto adapted, that is, your body is using ketones and even though you have sufficient insulin (say >5 microU/ml) your body tries to keep your BG higher than necessary, e.g. above 100-110 mg/dl. That is your BG set-point is always high. If you try to lower the set-point to say 80s, by water Intermittent Fasting (IF), then your body starts to convert your muscles into glucose to keep its high BG set-point. So, you may have a slightly lower BG, but you lose some muscle mass. Having a high set-point has many other problems, e.g. if you eat something with a little bit more carb, say a small fruit, your BG shoots up to 130s and stays there for hours. This may be due to something called "Physiological Insulin Resistance (PhIR) by Petro Dobromylskyj. He wrote many good articles about it -???thanks Petro--in his blog Hyperlipid. Apparently, PhIR is a normal reaction of the body and quite different from Pathological Insulin Resistance (PaIR). It seems that the main difference between PhIR and PaIR is that insulin is at a normal level in the former and abnormally high in the latter. (PaIR is obviously type2 diabetes.) If I understand correctly, PhIR is kind of IR only in the muscle tissue, that is only the muscles do not react to insulin and NOT use glucose even though it is available. However, if you are eating too much protein, the liver may also be considered IR, because it tries to keep the BG high by converting proteins to glucose, even though BG is already too high, that is, it also may not be responding to insulin. (I think working muscles can us Continue reading >>
Why Your “normal” Blood Sugar Isn’t Normal (part 2)
Hi, I just found this site and would like to participate. I will give my numbers, etc. First, my last A1c was 6.1, the doc said it was Pre-diabetes in January of 2014, OK, I get it that part, but what confuses me is that at home, on my glucometer, all my fastings were “Normal” however, back then, I had not checked after meals, so maybe they were the culprits. Now, I am checking all the time and driving myself crazy. In the morning sometimes fasting is 95 and other times 85, it varies day to day. Usually, after a low carb meal, it drops to the 80’s the first hour and lower the second. On some days, when I am naughty and eat wrong, my b/s sugar is still low, and on other days, I can eat the same thing, and it goes sky high, again, not consistent. Normally, however, since February, my fbs is 90, 1 hour after, 120, 2nd hour, back to 90, but, that changes as well. In February, of 2014, on the 5th, it was horrible. I think I had eaten Lasagne, well, before, my sugars did not change much, but that night, WHAM-O I started at 80 before the meal, I forgot to take it at the one and two hour mark, but did at the 3 hour mark, it was 175, then at four hours, down to 160, then at 5 hours, back to 175. I went to bed, because by that time, it was 2 AM, but when I woke up at 8:00 and took it, it was back to 89!!!! This horrible ordeal has only happened once, but, I have gone up to 178 since, but come down to normal in 2 hours. I don’t know if I was extra stressed that day or what, I am under tons of it, my marriage is not good, my dear dad died 2 years ago and my very best friend died 7 months ago, I live in a strange country, I am from America, but moved to New Zealand last year, and I am soooo unhappy. Anyway, what does confuse me is why the daily differences, even though I may Continue reading >>
How The Ketogenic Diet Works For Type 2 Diabetes
Special diets for type 2 diabetes often focus on weight loss, so it might seem crazy that a high-fat diet is an option. But the ketogenic (keto) diet, high in fat and low in carbs, can potentially change the way your body stores and uses energy, easing diabetes symptoms. With the keto diet, your body converts fat, instead of sugar, into energy. The diet was created in 1924 as a treatment for epilepsy, but the effects of this eating pattern are also being studied for type 2 diabetes. The ketogenic diet may improve blood glucose (sugar) levels while also reducing the need for insulin. However, the diet does come with risks, so make sure to discuss it with your doctor before making drastic dietary changes. Many people with type 2 diabetes are overweight, so a high-fat diet can seem unhelpful. The goal of the ketogenic diet is to have the body use fat for energy instead of carbohydrates or glucose. A person on the keto diet gets most of their energy from fat, with very little of the diet coming from carbohydrates. The ketogenic diet doesn’t mean you should load up on saturated fats, though. Heart-healthy fats are the key to sustaining overall health. Some healthy foods that are commonly eaten in the ketogenic diet include: eggs fish such as salmon cottage cheese avocado olives and olive oil nuts and nut butters seeds The ketogenic diet has the potential to decrease blood glucose levels. Managing carbohydrate intake is often recommended for people with type 2 diabetes because carbohydrates turn to sugar and, in large quantities, can cause blood sugar spikes. If you already have high blood glucose, then eating too many carbs can be dangerous. By switching the focus to fat, some people experience reduced blood sugar. The Atkins diet is one of the most famous low-carb, high-p Continue reading >>
The Ketogenic Diet And Insulin Resistance
We recently touched on how you can use the ketogenic diet to control symptoms of diabetes such as elevated glucose and triglycerides. In this article, we examine research showing the impact that the ketogenic diet has on levels of the hormone insulin, a key regulator of blood sugar in the body. What is Insulin’s Role in the Body? Before we look at the research, we need to know our main players. Insulin is a protein-based hormone produced by beta-cells located in the pancreas. The pancreas, which is located under the stomach, also produces enzymes that aid with digestion. Insulin’s primary purpose is to regulate the metabolism of fats and carbohydrates. The digestive system breaks down carbohydrates, such as sugars and starches, into a molecule called glucose. This compound can be used by cells to produce energy through a process called cellular respiration. Insulin allows cells in the body absorb glucose, ultimately lowering levels of glucose in the blood stream. After a meal is consumed, blood glucose levels increase and the pancreas responds by releasing insulin into the blood. Insulin assists fat, liver, and muscle cells absorb glucose from the blood, resulting in lower levels of blood glucose. Insulin stimulates liver and muscle tissues to store excess glucose as a molecule called glycogen and also reduces glucose production by the liver. When blood sugar is low, the hormone glucagon (produced by alpha-cells in the pancreas) stimulate cells to break down glycogen into glucose that is subsequently released into the blood stream. In healthy people who do not have type II diabetes, these functions allow levels of blood glucose and insulin to stay in a normal range. What Is Insulin Resistance and Why Is It a Problem? Unfortunately, for many Americans and other peopl Continue reading >>
Monitoring Ketone And Blood Glucose Levels On A Low Carb Diet
By Mary T. Newport M.D. While it is not necessary to measure ketone levels, many people who make the change to a low carb, ketogenic diet and/or use ketone salts would like to have some positive proof that their ketone levels are, in fact, elevated. When transitioning from a higher carb to a low carb, ketogenic type diet, it can take several days to begin to see an increase in ketone levels and the ketone level may continue to rise for two or three weeks before it levels off. The ketone level can fluctuate somewhat throughout the day and can vary considerably from person to person. Using ketone salts, such as Prüvit KETO//OS® or KETO//OS Max, as a supplement can give you a jump start on getting into ketosis and increase ketone levels within 30 to 60 minutes of taking the product. Using coconut oil and MCT oil as part of the diet can help increase and sustain ketone levels as well. There are several ways available to measure ketone levels in urine, blood or by using a breath analyzer. When blood levels of ketones become elevated, the excess ketones will filter out of the blood into the urine. Urine ketone test strips were originally developed for diabetics to help determine if they are going into diabetic ketoacidosis when the blood sugar is elevated. There are a number of companies that sell urine test strips that change color when ketone levels are elevated – usually the deeper the color, the higher the ketone level. This will not tell you what your actual blood ketone level is but can give you a rough idea of whether you are in ketosis or not. However, one of the drawbacks to using urine test strips is that they only measure the ketone acetoacetate and not beta-hydroxybutyrate, which tends to be much more elevated than acetoacetate during ketosis. Also, Prüvit ke Continue reading >>
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How To Easily Track Your Glucose Ketone Index (gki) On Your Ketogenic Diet
Tracking ketone levels is a large part of success on the ketogenic diet. It helps you know how far you are into ketosis and where we might need to make changes. But did you know that there’s an even better way to step it up a notch? The glucose ketone index is a simple calculation that allows you to find out how ketosis works best for you individually. Without it, you could be in full, high-level ketosis yet still not getting the full benefits. In this post, we’ll be looking at how to easily track your glucose ketone index for different aspects of health along with your ketogenic diet. Basics of the Glucose Ketone Index Here’s what you need to know about the glucose ketone index (GKI): Researchers have used the index in studies on the ketogenic diet, fasting, and more. Additionally, it has been used for tracking changes and progress regarding weight loss, athletic performance, management of metabolic diseases like type 2 diabetes, and even cancer treatment. Now that we’ve covered the basics of what the GKI does, let’s talk about how you can use tracking it to your advantage. Tracking Your Glucose Ketone Index What’s so special about the glucose ketone index is that it lets you track both glucose and ketones at the same time, taking into account how they work together. It’s a way to know your optimal state for addressing all sorts of health conditions. Tracking this number benefits you over simply measuring ketone levels. That’s because even if you’re deeply in ketosis, you could still have high blood glucose levels that throw things off and affect your health. Essentially, it gives you a more full picture of your metabolic health. The numbers you can expect to target depend on your intentions for being in ketosis. Is your goal weight loss, better overa Continue reading >>
Getting To Know Ketones
People with diabetes, particularly those with Type 1 diabetes, have been at least vaguely aware of the word ketones for a long time. With the recent resurgence of popular interest in low-carbohydrate diets, however, just about everyone seems to be talking about ketones these days. But does anyone really know what ketones are? Are they a danger to your health (as in diabetic ketoacidosis), or a sign that you have lowered your carbohydrate intake enough to cause weight loss (as some people who follow low-carbohydrate diets believe)? What are ketones? Ketones are end-products of fat metabolism in the body. That is, they are formed when fat is burned for energy by the muscles. Chemically, they are acids known as ketone bodies, and there are three types: beta-hydroxybutyric acid, aceto-acetic acid, and acetone. But you don’t have to be a chemist to understand what role they play in the body. To get to know ketones, it’s helpful to understand how your body burns fuel. A simple analogy is that of an automobile. For a car engine to run, the engine must burn fuel (gasoline), and when the fuel is burned, exhaust (carbon monoxide) is created. The carbon monoxide is the end-product of gasoline combustion. Your body also has an engine that must burn fuel to operate. The engine is muscle, and the fuel is fat, carbohydrate (glucose), and, in certain conditions, protein. When fat is burned, the “exhaust” is ketones, and when glucose is burned, the “exhaust” is lactic acid. Fat is more desirable as a fuel than glucose because there are more calories in a gram of fat (9 calories per gram) than there are in a gram of glucose (4 calories per gram), so you get more energy per gram of fat burned. In a sense, you could call fat a high-test fuel. But there is one catch to burning f Continue reading >>
Ketogenic Diet For Type 2 Diabetes: Does It Work?
Type 2 diabetes is a condition affecting blood sugar levels that can be managed by following a healthful diet and maintaining a healthy weight. People who are obese can reduce their risk of developing diabetes by eating a balanced, nutritious diet. Following a diet that is full of vitamins and minerals and low in added sugars and unhealthful fats can help people to lose some of the extra weight. People who lose 5-10 percent of their body weight can lower their risk of developing diabetes by 58 percent. For people with diabetes or people with pre-diabetes, losing the same amount of body weight can help provide a noticeable improvement in blood sugar. For some people, the ketogenic diet is an effective way to control their diabetes. It has been shown to lower blood glucose levels as well as reduce weight. Contents of this article: What is the ketogenic diet? Foods containing carbohydrates, such as bread, pasta, and fruit, are the body's main fuel source. The body breaks the food down and uses the resulting sugar (glucose) for energy. A ketogenic diet is a high-fat, very low carbohydrate diet. It was initially developed and recommended for children with epilepsy. The diet recommends that people eat 30 grams (g) of carbohydrates or below per day. The goal is to eat 3 to 4 g of fat for every 1 g of carbohydrate and protein. Impact on blood sugar levels Because the ketogenic diet restricts carbohydrates, there is not enough sugar available for the body to use as fuel, so it resorts to using fat. The process of breaking down fat is called "ketosis," and it produces a fuel source called ketones. A ketogenic diet helps some people with type 2 diabetes because it allows the body to maintain glucose levels at a low but healthy level. The reduced amount of carbohydrates in the diet Continue reading >>
Are Exogenous Ketones Beneficial For Blood Sugar?
Are Exogenous Ketones Beneficial For Blood Sugar? Posted by:Dr. Brian Mowll onAugust 13, 2018 Type 2 diabetes and obesity have reached epidemic (read: ridiculous) proportions in the past few decades. If left unmanaged, type 2 diabetes can damage vessels that supply blood to vital organs and can also lead to an increased risk of heart disease and stroke. But a new study published in the Journal of Physiology has shown that a ketone supplement can lower blood sugar levels. 1 While more studies will need to be conducted, the findings suggest a future method to control blood sugar spikes for those with diabetes. This is potentially great news. Youve probably heard of these weird sounding supplements before. If you follow health or diet trends, you know a lot of people are making all kinds of claims about them. But what the heck are exogenous ketones and why should you care? Exogenous ketones come in different forms and are used for several different reasons including fat burning, reducing ketosis symptoms, enhancing physical performance and mental performance. Ketones are actually made by the body in absence of carbohydrates and they are typically made from stored fat. Your body can run on three different types of ketones they are acetoacetate, beta-hydroxybutyrate , and acetone. Since Beta-hydroxybutyrate is the active form that can flow freely in the blood, and is used by ALL your tissues, that is the form that most exogenous ketone supplements are formulated from. Ketones are organic compounds that result whenbody fatis broken down for energy. While this may not sound like a bad thing, for people with diabetes, especially Type 1 diabetes, high levels of ketones in the body can be toxic. Should you develop ketones, you need to know how to identify symptoms, how to check Continue reading >>
Video: What Eating “high-fat” Or “keto” Does To Your Blood Sugar
What happens to your blood sugar when you eat fat? The steps you need to stabilize your blood sugar and increase your fat-burning hormones (by following a Fat Fueled, keto eating style). Up until I found keto (high-fat, low-carb living) I was in the “eat every 2-3 hours in order to control blood sugar” camp. What I didn’t know, was that the constant eating; generally of carbohydrates, was exactly what was causing my blood sugar irregularities – constant “hangry” feelings, hypoglycemia, insulin resistance, and more. After a couple of weeks of eating Fat Fueled, keto, I no longer struggled with hypoglycemia. It was as if my sugar lows just… disappeared. And I’m not the only one that’s experienced massive changes to blood sugar shortly after shifting to a Fat Fueled, keto life. I invited Dietitian Cassie on the show today to help explain exactly what happens to our blood sugar when we eat fat – the ins and outs of insulin resistance, actions that affect blood sugar, how to use carb-ups to heal insulin resistance and much more. Today’s keto video encourages us to use dietary fat as our ally, to rely on it to support balanced blood sugar, thriving hormones and a healthy body. For video transcription, scroll down. Highlights… What foods affect blood sugar How dietary fat affects your blood sugar If combining carbohydrates and fat is a good thing How fat cells are created How to get into fat-burning mode Signs and symptoms of insulin resistance and insulin sensitivity How cortisol (and a poor sleep) affects your blood sugar How carb cycling and carb refeeding can help bust through insulin resistance How to heal yourself from insulin resistance Resources… Watch the video: When to know it’s time to carb-up (and how to do it) Step-by-step guide on goin Continue reading >>
The Interplay Of Exercise And Ketosis Part I
The interplay of exercise and ketosis – Part I I embarked on a self-experiment last weekend to see if I could better understand the interplay between the different types of exercise I do and ketone production (beta-hydroxybutyrate, or B-OHB, to be specific). To be clear, nothing I do with a sample size of one “proves” anything, but sometimes self-experiments can help you formulate hypotheses and, if nothing else, understand how your body works. Consider the parable of the black sheep. If you see even a single black sheep in the field, depending on your field of training, you can draw conclusions: Three scientists were on a train and had just crossed the border into Scotland. A black sheep was grazing on a hillside. The biologist peered out of the window and said, “Look! Scottish sheep are black!” The chemist said, “No, no. Some Scottish sheep are black.” The physicist, with an irritated tone in his voice, said, “My friends, there is at least one field, containing at least one sheep, of which at least one side is black some of the time.” My point is, even a self-experiment of one can be good for something. To test the relationship between exercise and ketosis I decided to examine my blood levels of glucose, B-OHB, and lactate immediately before and after three different types of workouts on three successive days. This interplay is complex and no one knows “everything” about it, including the world’s experts (which I am not pretending to be). I’m going to try to balance a fine line in this post – I want to be rigorous enough to explore the ideas with substance but not too detailed to put you to sleep. I hope I am able to balance these forces adequately. If any of you are not familiar with the work of Jeff Volek and Steve Phinney, b Continue reading >>