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 Fasting Blood Sugar Might Still Be High On Low Carb
It’s not too uncommon to have slightly high fasting blood sugar on low carb and keto diets. Is this a problem? It depends on your insulin levels, as outlined by Dr. Ted Naiman below. If you’re insulin sensitive, and have slightly higher fasting blood glucose, it’s likely just fine. More The dawn phenomenon – why are blood sugars high in the morning? Insulin Advanced low-carb topics Diabetes Dr. Naiman Earlier with Dr. Naiman All earlier posts about Dr. Naiman Continue reading >>
Top 10 Reasons You’re Not Losing Weight
These are the top 10 reasons you’re not losing weight on a low carb diet. A great FREE printable for the fridge and an easy reminder to stay on track. Just click on the image below to save the PDF for printing. UPDATE – watch the quick video below. No compatible source was found for this media. Top 10 Reasons You’re Not Losing Weight Eating LCHF Too Many Carbohydrates – are carbs starting to sneak back into your diet? Be honest and start tracking everything using KetoDietApp. A little treat here and there adds up. Some are more carb sensitive (or insulin resistant) than others. I know that my carbs have to be around 50g/day to be feeling great and in control of my appetite. Lower than that and I will lose a little bit of weight, above that and I know my weight loss will stall. I generally go between 35-70g/day without too much tracking because I have done it for so long. Too Much Fruit – yes I use berries on my breakfast and desserts, but that is it. I allow my children to eat fruit (without gorging) as they are fit, healthy and in the normal weight range. For me, the sugar and fructose in fruit is too much. Sure, enjoy it as a treat and eat only low carb nutritent dense berries. See fruit as an occasional sweet treat. Packed with fibre, antioxidants, nutrients……… “If you are overweight, fruit is not your friend” Too much Dairy – my biggest downfall is milk. I love my lattes and flat whites. Now milk is great, full of protein and calcium, but it also contains about 5% carbs. A latte can range from 9g to 15g carbs depending on the size you choose. Most dairy such as milk, cream and yoghurt contains approximately 4- 5% but you are more likely to drink a large glass of milk, eat a bowl of yoghurt or drink a large latte than eat 250g of full fat cheese Continue reading >>
Ada’s Latest Low-carb Stance Is Severely Flawed, Says Longtime Low-carb Advocate Dr. Bernstein
Diabetes Health Pioneering low-carb diet advocate Dr. Richard K. Bernstein has responded to the American Diabetes Association’s recent support for low-carb diets with a critique of several of the ADA’s most cherished notions. In a recent “Ask Dr. Bernstein.com” tele-seminar presented to callers and listeners, he cited the ADA’s 2008 guidelines for doctors, disputing the association’s recommendations on several fronts: He said that the ADA’s definition of a low-carb diet as one with 130 or fewer grams of carbohydrates per day “is four times higher than what I recommend and makes it impossible to maintain [blood glucose] control.” He disputed the ADA’s contention that an A1c of less than 6 for people with diabetes increases the risk of hypoglycemia. “The risk is only to people taking the industrial insulin doses that the ADA recommends for covering their high-carbohydrate diets. Regarding the ADA’s recommendation that adults with diabetes shoot for blood sugar levels of 70 mg/dl to 130 mg/dl before meals and 180 mg/dl after meals – with even higher levels allowed for children – Dr. Bernstein said, “Children are not entitled to normal blood sugar levels? And neither are adults.” Those guidelines, he said, “were created by non-diabetics to be imposed upon diabetics.” Dr. Bernstein called the association’s recommendation that people with diabetes regularly see podiatrists to have their foot calluses debrided with a scalpel “the most dangerous thing you can do to a diabetic.” He said that 100 percent of the diabetic amputees he has ever interviewed in his university-based wound care clinic told him that their amputations arose from infections caused by an attempt to remove a callus – whether at the hands of a podiatrist, a family me Continue reading >>
Power: Fasting Vs Low Carb – Fasting 26
What’s the difference in power between fasting and LowCarb High Fat (LCHF)? Sometimes it feels like arguing whether Batman or Superman is more powerful (Superman, of course). But they’re both superheros, and the point of both these dietary superhero regimens is to lower insulin. This stems from a rational examination about the causes of obesity and type 2 diabetes. You need to understand the aetiology of obesity (the underlying cause) if you are to have any hope of treating it. For decades, we have laboured under the false assumption that excessive calories caused obesity. However, overfeeding and underfeeding studies clearly proved this hypothesis wrong. If calories caused obesity, then overfeeding calories should cause obesity. It did, but only in the short term. Long term, weight went back to normal. Underfeeding calories on the other hand, should lead to permanent weight loss. But it did not. The failure rate of this Caloric Reduction as Primary strategy is an abysmal 99%. Using a more rational model of obesity as a hormonal disorder (mainly insulin, but also cortisol) leads to the hypothesis that increasing insulin should lead to lasting weight gain. Decreasing insulin should lead to weight loss. And guess what? It worked just as advertised. (See the Hormonal Obesity series for a full description). So, if we understand that excessive insulin causes weight gain, then the treatment is quite clear and just really damned obvious. You don’t need to decrease calories, although there is some overlap. You need to decrease insulin to cause weight loss. Both LCHF diets and fasting accomplish this goal. Refined carbohydrates are the biggest stimulus to insulin, so reducing carbs reduces insulin. Protein, especially animal proteins also raise insulin, so keeping protein Continue reading >>
Low Carb - But High Sugars - Advice Please!
Diabetes Forum The Global Diabetes Community Find support, ask questions and share your experiences. Join the community Low carb - but high sugars - advice please! I wonder if I could get your thoughts. I'm T1, and had a bad hypo last year - following this I decided to go on a low carb diet, to limit the amount of insulin in my system at any one time. I'm much happier doing this, and can't now imagine going back to a high carb diet. I made the transition to low carb fairly slowly, and I did lose about 8kg in body weight (possibly as I wasn't really replacing the lost carb calories with protein/fat) - however, for the last 4/5 months, my average daily carb intake has been about 45-65g, and my weight loss seems to have now plateaued, as it's been fairly constant over this time. The low carb diet has certainly help control my sugar levels, with far less swing in the highs and lows, and generally confined to a narrower range - however, in the last month or so, I've found that I need much more insulin than normal, to maintain sugars in a good range. My long-standing ratio of 1u/10g carb just isn't working (by a long way), and sugars are frequently in the 12-15 range. Even if I take a 3 unit correction dose, the sugars might only reduce by say 2 or 3 mmol. This is very unusual for me - having been diabetic for around 15 years, I'm of course familiar with all the different factors that can cause insulin resistance or sensitivity, and clearly there are periods where you're going to be more or less sensitive than usual - but as my sugars have been high for around a month, I have to say I'm quite confused by this. I contacted my specialist diabetic dietician, who tells me that this is apparently a known issue with low carb diets - she tells me that people do quite often need to Continue reading >>
- Could going low-carb help you fight off diabetes? The usual advice for Type 2 is to eat plenty. But now a number of patients and doctors are leading a growing rebellion
- How Low Can You Go? Expert Advice On Low Carb Diets and Diabetes
- Low Carb vs. High Carb - My Surprising 24-day Diabetes Diet Battle
Why Low-carb Diets Aren’t The Answer
What raises blood sugar? The simple answer is carbohydrates. So why not just yank them out of your diet like weeds in your garden? Why not quash blood sugar by swearing off bread, pasta, rice, and cereal? Been there, done that. The low-carb craze is on the downswing, and that’s a good thing because over the long haul, very low carb diets simply aren’t good for you, as you’ll discover in this chapter. That doesn’t mean it’s not smart to cut back on carbs—but don’t go crazy. When low-carb diets first became popular, they seemed to be a breath of fresh air after the low-fat (and high-carb) diets that preceded them. Remember low-fat cookies, lowfat snack cakes, and low-fat everything else? With low-carb diets, suddenly people could load up on bacon and still lose weight as long as they were willing to eat hamburgers without buns and pretty much give up sandwiches and spaghetti. People were amazed at how effective these diets could be. Weight loss could happen very quickly, sometimes within days. And amazingly, it often seemed to come with added health benefits, including lower cholesterol, blood pressure, and triglycerides (blood fats linked to heart attacks.) The most extreme kind of low-carb diet was pioneered by the late Robert Atkins, M.D., whose first book, Dr. Atkins’ Diet Revolution, came out in 1972. It promised quick and long-lasting weight loss and prevention of chronic disease, all while allowing high-fat steak and ice cream. Since then, other, more moderate low-carb diets have allowed small amounts of carbohydrate-rich foods, but they still cut out most grains as well as starchy vegetables and even fruit. The Downsides of These Diets The Atkins diet and the many other low-carb diets that followed in its footsteps have turned out to be less effect Continue reading >>
Ketones & Low Carb Diets
WRITTEN BY: Alexi Melvin Note: By providing a place for the community to share real life experiences we hope you find inspiration and new ways of thinking about management. We encourage you to approach these offerings as you would a buffet — review the options, maybe try a few new things and come back for what works best for you. Bon Appetit! Check out our library of resources on Food. Testing for ketones is something that I am sure every person with Type 1 remembers doing shortly after diagnosis – constantly matching the color on that little square at the end of the urine stick to the color grid on the bottle. We all are taught that ketones can result from high blood sugar or illness, but what I have recently experienced has illuminated another cause of ketones – cutting out carbs. It wasn’t until about three years after my Type 1 diabetes diagnosis that I had even considered the idea of a lower carb diet. I loved pasta. Pasta with butter and parmesan cheese had been a staple of my diet since I was old enough to eat solid foods. I loved hot dogs, paninis, the occasional pizza night and Starbucks pastries for breakfast. And really – who doesn’t regularly crave carbs? The first few years of my T1D life were relatively seamless, albeit largely due to that lovely “honeymoon period.” I could eat as many carbs as I wanted and my blood sugar levels seemed to cooperate nicely no matter what I did or how often I snacked. And then suddenly, I started noticing the dreaded spikes and subsequent drops. It was getting more difficult to avoid the high blood sugars after those meals filled with complex carbs. One day my mom made grilled salmon – something new. My blood sugar behaved like a champ. “I wonder what would happen if you cut out carbs completely,” my mo Continue reading >>
Diabetes & Ketogenic Diet: Can You Manage Your Diabetes On A Ketogenic Diet?
In this article we will cover what a Ketogenic diet is and if you can manage your diabetes while on this diet. Ketogenic diet for diabetics is a highly controversial topic, but we will break down everything here for you! As a Certified Diabetes Educator (CDE), I have to tell you from the start I will have a biased view here. Sorry, but I feel that I need to be completely honest right up front! I will however, present all the evidence that is available currently on the subject. As a CDE, I have been taught to follow the American Diabetes Association Dietary Guidelines for Americans which is low in carbohydrates, high in fiber, with fresh vegetables, fruits and whole grains. The Ketogenic Diet this article will be discussing is much lower in carbohydrates, in order to promote the state of nutritional ketosis, or the fat burning state for weight loss. What is a Ketogenic Diet? The Ketogenic Diet is a low carbohydrate diet, consisting initially of less than 20 carbohydrates per day. Not per meal, yes, you heard me correctly, per day. It is not for the faint of heart and yes I am writing from experience. Of course I have tried it! Hasn’t everybody in America at some point who has wanted to lose weight? Does it work you ask? Of course it does! The problem is how long can you keep it up? Your body uses the carbohydrates you eat for energy, so if we restrict how many carbohydrates we eat, the body has to get its fuel source from fat. A byproduct of this fat burning state are ketones which are produced; this is called nutritional ketosis. You can determine if you are in this fat burning state by purchasing urine ketone testing strips from your local pharmacy. The Ketogenic Diet with Diabetes Some precautions must be made clear; this diet is not appropriate for people with any Continue reading >>
Low Carb Vs. High Carb - My Surprising 24-day Diabetes Diet Battle
Twitter summary: What I learned from doubling my carb intake: the same average blood sugar, but four times as much hypoglycemia, more work, stress, & danger. As a teenager, I ate a high carb diet that included lots of Goldfish crackers, white sandwich bread, pasta, and white potatoes. It was tasty, but it put my blood sugars on a wild roller coaster every single day. Things turned around in college when I learned about nutrition, got on CGM, and spent time with health conscious friends. I soon realized that eating less than 30 grams of carbs at one time was a complete gamechanger. I’ve stuck with that approach ever since. But is this lower carb method actually better for my blood sugars, or have I just been fooling myself? To find out, I took on a somewhat terrifying self-tracking experiment: 12 days of my usual, lower-carb diet, which averaged 146 grams of carbs per day (21% of daily calories). My carbs were primarily from nuts, seeds, vegetables, and a bit of fruit. 12 days of a higher-carb, high whole-grain diet, which averaged 313 grams of carbs per day (43% of my daily calories). My sources of carbs were NOT junk food: plain oatmeal, whole wheat bread, quinoa, wild rice, and fruit. Neither of these was unrealistic. My lower-carb diet was nowhere near Atkins level (20 grams per day), and the higher-carb diet was consistent with the “average” 45% carb diet in people with diabetes (according to ADA). Even though this was a one-person (n=1) experiment, I wanted to be as scientific and fair as possible: eating whole, unprocessed foods in both periods; counting and tracking every single gram of carbohydrate (LoseIt! app); wearing CGM 24/7 and downloading the glucose data to document what happened (Dexcom G5 and Clarity); taking insulin before meals (5-15 minutes pr Continue reading >>
How Low Is Low Carb?
Many agree: People with diabetes should eat a low-carb diet. Last week we looked at what “carbs” are. But what is meant by “low?” How much carbohydrate should you eat? The Dietary Guidelines for Americans, 2010, (PDF) recommend that healthy people get 50–65% of their calories from carbohydrates. A study posted on the American Diabetes Association (ADA) Web site agrees. For a woman eating a below-average 2,000 calories a day, 50–65% would be 250–325 grams of carb a day. The Dietary Guidelines call for “a balanced diet that includes six one-ounce (28.3 g) servings of grain foods each day.” This would mean 170 grams of carbohydrate from grains alone each day. And the average American diet includes many other carb sources. Most men eat closer to 3,000 calories a day, so their numbers would be higher. Sixty percent of 3,000 would be 1,800 calories, equivalent to 450 grams of carbohydrate each day. Anything less than the recommended range is sometimes considered “low-carb.” Most popular low-carb diets, like Atkins, South Beach, Zone, and Protein Power, are much lower, from 45% of calories down to 5%. Many diabetes experts recommend somewhat lower carb intakes than ADA does. On our site, dietitian Jacquie Craig wrote, “Most people need between 30–75 grams of carbohydrate per meal and 15–30 grams for snacks.” So that sounds like between 120 and 300 grams a day. Dr. Richard Bernstein, an MD with Type 1 diabetes and a long-time advocate of the low-carb approach to diabetes, suggests much lower intakes. He says eat 6 grams of carbs at breakfast, and snacks, 12 grams each at lunch and dinner. So that would be about 40 grams of carbs per day. If 12 grams per meal sounds like a small amount, it is. It’s about the amount in an average slice of bread. An Continue reading >>
Dear Mark: Does Eating A Low Carb Diet Cause Insulin Resistance?
157 Comments Despite all the success you might have had with the Primal way of life, doubts can still nag at you. Maybe it’s something you read, or something someone said to you, or a disapproving glance or offhand comment from a person you otherwise respect, but it’s pretty common when you’re doing something, like giving up grains, avoiding processed food, or eating animal fat, that challenges deeply-and-widely held beliefs about health and wellness. It doesn’t really even matter that you’re losing weight or seem to be thriving; you may still have questions. That’s healthy and smart, and it’s totally natural. A question I’ve been getting of late is the effect of reducing carb intake on insulin sensitivity. It’s often bandied about that going low carb is good for folks with insulin resistance, but it’s also said that low carb can worsen insulin resistance. Are both true and, if so, how do they all jibe together? That’s what the reader was wondering with this week’s question: Hi Mark, I’ve been Primal for a few months now and love it. Lowering my carbs and upping my animal fat helped me lose weight and gain tons of energy (not too shabby for a middle-aged guy!). However, I’m a little worried. I’ve heard that low carb diets can increase insulin resistance. Even though I’ve done well and feel great, should I be worried about insulin resistance? Do I need to increase my carb intake? I always thought low carb Primal was supposed to improve insulin function. Vince Going Primal usually does improve insulin sensitivity, both directly and in a roundabout way. It improves directly because you lose weight, you reduce your intake of inflammatory foods, you lower systemic inflammation (by getting some sun, smart exercise, omega-3s, and reducing or dea Continue reading >>
Is Your Fasting Blood Glucose Higher On Low Carb Or Keto? Five Things To Know
This past spring, after 18 months of great success on the keto diet, I tested my fasting blood sugar on my home glucose monitor for the first time in many months. The result shocked me. I had purchased the device, which also tests ketones, when I was diagnosed with pre-diabetes in the fall of 2015. As I embarked on low-carb keto eating, I tested my blood regularly. Soon my fasting blood sugar was once again in the healthy range. I was in optimal ketosis day after day. Not only that, I lost 10 lbs (5 kg) and felt fantastic — full of energy with no hunger or cravings. Before long I could predict the meter’s results based on what I was eating or doing. I put the meter away and got on with my happy, healthy keto life. When my doctor ordered some lab tests this spring, I brought the meter out again. While I had no health complaints, excellent blood pressure and stable weight, she wanted to see how my cholesterol, lipids, HbA1c, and fasting glucose were doing on my keto diet — and I was curious, too. To check the accuracy of my meter against the lab results, on the morning of the test I sat in my car outside the clinic at 7:30 am, and pricked my finger. I was expecting to see a lovely fasting blood glucose (FBG) of 4.7 or 4.8 mmol/l (85 mg/dl). It was 5.8! (103 mg/dl). What? I bailed on the tests and drove home — I didn’t want my doctor warning me I was pre-diabetic again when I had no explanation for that higher result. The next morning I tested again: 5.9! (104). Huh??? For the next two weeks I tested every morning. No matter what I did, my FBG would be in 5.7 to 6.0 (102 to 106 mg/dl), the pre-diabetic range again. One morning after a restless sleep it was even 6.2 mmol/l (113 mg/dl). But my ketones were still reading an optimal 1.5-2.5 mmol/l. I was still burnin Continue reading >>
- Postprandial Blood Glucose Is a Stronger Predictor of Cardiovascular Events Than Fasting Blood Glucose in Type 2 Diabetes Mellitus, Particularly in Women: Lessons from the San Luigi Gonzaga Diabetes Study
- Got pre-diabetes? Here’s five things to eat or avoid to prevent type 2 diabetes
- Got pre-diabetes? Here's five things to eat or avoid to prevent type 2 diabetes
High Blood Sugar In Ketogenic Dieters! Plus A Special Surprise (hint: Genotypes And Metabolism)!
A while ago Michael and I were discussing future article topics. There are truly a plethora of avenues to go down in this area of research and there is no lack of things to research and comment on. But even though I have a couple of pretty cool MCT articles sitting around on my desk, I want an interesting topic. I want something new. Something challenging. Besides, everyone is drinking the MCT koolaid these days. It’s become passe. (Also, it upsets my stomach and I have a personal vendetta against it. So there.) What’s new? There has to be something new! Michael pointed me to one of his old articles on physiological insulin resistance as an idea. I brushed it off at first. Dismissed it as a quirk. But then I thought about it. WHY does blood glucose rise in response to a low carb diet? It truly is an interesting question. What does it say about low carb diets if they induce an almost diabetic effect on circulating glucose? Thus my research began. This short abstract confirmed that it is normal for people on low carb diets to experience a rise in blood glucose levels. Because it’s a non-open journal (shame!), there’s a one-sentence explanation given: A decrease in first-phase insulin secretion may partially contribute to the short-term LC/HFD-induced increase in postprandial plasma glucose levels. First phase insulin secretion? There’s a first phase? So… There’s more than one phase to insulin secretion? I had no idea. Call me ignorant but I had no idea until this point that there was more than one phase to insulin secretion. This article delves deeper into the signaling involved in (what I learned is called) biphasic insulin secretion. The first phase of insulin secretion lasts approximately 10 minutes, and the second phase of insulin secretion picks up afte 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 >>