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 >>
Where Is My Blood Glucose Coming From? I'm Eating Very Few Carbs.
Where is my blood glucose coming from? I'm eating very few carbs. Where is my blood glucose coming from? I'm eating very few carbs. I've only been dealing with a diabetes or pre-diabetes diagnosis for three months. I had my first A1C in January and it came back at 6.6. A surprise to me and my doctor since I am thin. (I'm about 5' 6" and was no more than about 130 then.) I immediately put myself on a very low carb diet and increased my daily exercise. So for three months my diet has been fish, cheese, leafy green vegetables, okra (I read that it might be good to lower BG), and nuts (almonds and peanuts). I found I still craved yogurt, so I found a brand that has a bit of flavor and only 12 grams of carbs. Sometimes I would eat one cup a day. Occasionally two cups. Then when I read that chia was supposed to help lower BG, so I added 1/4 of a cup of those to my yogurt. After three months, my weight has gone from maybe 125-130 to 116. So I am definitely losing weight, whether I need to or not. I had my second A1C this week; it is at 6.2. I thought it would be better since I'm eating very few carbs. I don't do blood monitoring right now, so I don't know what might cause spikes. But I thought that if I had very few carbs, there wouldn't be a problem. I read about someone who was eating a low carb diet and had an A1C for 5.7. He wanted to bring that down, so he went on a very low carb diet, and three months later his A1C was still at 5.7. So then he decided to monitor his blood every hour for a day and at no point did his glucose go above normal levels. So he figured maybe his red blood cells stick around longer than usual and have given him a false high. I have also read one's body will also make its own glucose. So if you are on a very low carb diet, you may still be gettin 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 >>
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 >>
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 >>
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 >>
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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 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 >>
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 >>
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 >>
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 >>
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 >>
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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 >>
No Carb, Low Carb, Or Moderate Carb – Which Is The Best Diabetic Diet?
Is a no carb, low carb or moderate carb diet best as a diabetic diet? This is a question I’m asked almost daily, and today I will try to answer it by sharing my experiences with diets containing varying levels of carbs. Before I jump into the different diets, let’s get the obvious answer out of the way which is “it depends”. The diet that is best for you will always, to a large degree, depend on your goals and activity level – the diabetic diet that works for you might not work for me, and vice versa. If you are trying to build strength and muscles, you shouldn’t follow the same diet as when you are trying to lose weight. In the same way, someone who runs every day has different dietary requirements to someone who sits in an office all day and doesn’t exercise. Now that we have that out of the way, let’s get into the details of the different diets! The moderate carb diet The general recommendation for a non-diabetic person is to get 40-60% of their daily calories from carbs. If you eat 2,000 calories a day, that’s between 200 and 300 grams of carbs a day. For people with diabetes, this is generally too many carbs, but I do get pretty close to this when I am trying to build muscles. During my last building phase, I averaged about 200-250 grams of carbs a day, but I was also lifting heavily 5-6 days a week. As long as I stick to low glycemic carbs (except right after my workout), I can eat that many carbs and still have very tight blood sugar control. The fun thing about this diet (aside from eating a lot of tasty carbs) was that I managed to lean out slightly while adding some nice muscle mass. However, I wouldn’t consider this a weight loss diet by any means. Most people, myself included, won’t be able to “keep it clean” all of the time, and th Continue reading >>
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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 >>