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 >>
Low-carb Caveat
There was a little girl, Who had a little curl, Right in the middle of her forehead When she was good She was very good indeed But when she was bad she was horrid. So goes the familiar poem by Henry Wadsworth Longfellow, and so goes most of our low-carb diets I suspect. When we are in diet mode and are deeply committed, we are very good indeed, but when we break and hit the carbs (and this includes yours truly) we are horrid. A paper in this week’s JAMA presents data confirming what I’ve long suspected: carb bingeing now and then could actually cause worse free radical damage than regularly eating more carbs on an ongoing basis. The paper titled Activation of Oxidative Stress by Acute Glucose Fluctuations Compared with Sustained Chronic Hyperglycemia in Patients With Type II Diabetes shows that patients with diabetes who have fluctuations in their blood sugars incur more free radical damage than those with high but not fluctuating blood sugar levels. Before we get into the nitty gritty of the paper, I will step back a little and go over some of the biochemistry involved so that the data will be more understandable to those who might not have a technical background. First, let’s look at how blood sugar is measured. The standard way is to draw blood (usually after the patient has fasted for 12-14 hours) and test it for a blood sugar level. Although this is the way that diabetics were monitored for years, it’s not a particularly accurate means of managing patients with diabetes. The fasting blood sugar test itself is reliable, but it only tells what the blood sugar is at the precise moment the blood was drawn–not what it was the week before or the day before or even the hour before. The typical drill was that diabetic patients would come to the office, have their 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 To Lower Your Blood Sugar Naturally
Processed foods like cookies, cakes, and candy (and even starchy plant foods like rice, beans, and potatoes) can cause rapid increases in blood sugar levels. After one meal containing these foods, blood sugar can get so high that insulin can’t keep up. Side effects like fatigue, blurred vision, headaches, trouble concentrating, and frequent urination can result. If you consume high-carbohydrate foods every day, you increase your risk of type 2 diabetes — the medical diagnosis for having chronically high blood sugar levels that are caused by diet and lifestyle. (This is different from type 1 diabetes — a condition where the body produces little to no insulin.) Over 422 million people have diabetes worldwide, and their high blood sugar levels are destroying their bodies. To know if your blood sugar levels are chronically high, many doctors will check your A1C levels. A1C stands for glycated hemoglobin, which is formed when blood sugar attaches to hemoglobin (the oxygen-carrying protein in red blood cells). A1C tests measure the percentage of your hemoglobin that has blood sugar attached to it. If blood sugar levels have been high for the past 3 months, then more hemoglobin will be glycated. Thus, A1C testing provides an accurate measurement of how high your blood sugar has been over the past two to three months. An A1C level of 6.5 percent or higher on two separate tests indicates that you have diabetes. An A1C between 5.7 and 6.4 percent indicates pre-diabetes. Below 5.7 is considered normal. Earlier in this article, we explored how you can raise your blood sugar. Just eat cookies, cakes, rice, potatoes, and other high-carbohydrate foods, and you will be on the fast track toward diabetes. Following this logic, won’t eating fewer carbohydrates lower your blood sug Continue reading >>
5 Reasons For High Fasting Blood Glucose Other Than Low Carb Or Keto
Many people are probably wondering why is their fasting blood sugar higher on low carb. As a matter of fact, dozens of paleo and ketogenic forums have discussions on this topic. Some of the information with unsubstantiated claims is that low-carb diet might trigger diabetes. Some people even quit their keto diet since they had high FBGs, i.e., fasting blood glucose. However,you should not jump into conclusions, there are 5 things you should know. 1. Glucose Meters Can Give False Readings You should bear in mind that technical reasons can lead to higher sugar readings. The US Federal Drug Administration, i.e., FDA allows home sugar monitors to have a variance of 15 percent in the results. This means that one reading of 100 mg or dl may be as high as 115 and as low as 85 which is a big variation. The software engineer, Dave Feldman, said that he had a huge variation in the results. Although he expected high blood sugar due to his long-term keto eating low in carbs. Therefore, now whenever he gets a result he was not expecting, he does 3 readings within few minutes and averages the obtained result. According to other researchers, false readings might occur because of other reasons . Reasons like pricking a finger for blood with a hand which has minute traces of food or sugar (for example just touching fruit). In addition, dehydration can increase results. Therefore, it is crucial to wash the hands before testing. However, you should bear in mind that certain soaps have additives such as honey which can distort readings. Other factors which may lead to lower or higher readings are environmental conditions such as high altitudes. And also strips which are too cold or too hot. Therefore, when you get an unexpected high reading , do one more. 2. Understand Cortisol and Its In 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 >>
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 >>
Asknadia: Is My Low Carb Diet Causing A False Pre Diabetes Diagnosis
Dear Nadia, When you are loosing weight on a low carb diet, does this artificially inflate my pre-diabetes glucose test? Paula Corin Linnwood WA Dear Paula, Pre-diabetes statistics have been in the news for several years with great concern for our national population. It is great that you are staying on top of your health and paying attention to your diet to be one less number in the growing diabetes population. The annual increase in pre-diabetes diagnosis is growing at an alarming rate. In 2010, 79 million people were diagnosed with pre-diabetes. Two year later, in 2012, this number grew to 86 million people . The Center for Disease Control and Prevention reports within a five year period, 15-30% of the people diagnosed with pre-diabetes will be be diagnosed with type 2 diabetes. This translates into anther 12.9 to 25.8 million people who are coming up through ranks with a diabetes diagnosis from 2012. What is Pre-diabetes Pre-diabetes is when your blood sugar test reads higher than normal but not high enough to be diagnosed with diabetes. Does a Low Carb Diet Give You a False Pre-diabetes Diagnosis If you take a glucose tolerance test and are eating under 300 carbs a day for three days prior to the test; yes you can get a false diabetes or pre-diabetes diagnosis. Typically when you eat food, the GLP-1 hormone in your body simulates the secretion of the insulin hormone to convert food into energy. With a low carb diet your body secrets less insulin and turns to your reserves to metabolize the fat for energy. Why You Get a False Pre-diabetes Diagnosis A low carb diet will create a slow uptake of insulin which shows a false elevated glucose. It metabolizes your fat reserves. Dr Richard Bernstein, a famous low carb diet advocate and a person with type 1, tells me we can 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 >>
Will Low-carb Diets Cause Blood Sugar Levels To Drop?
Video of the Day If you're accustomed to eating a very high-carb diet and suddenly switch to a very low-carb diet, you could experience rather dramatic drops in your blood sugar during the first few days or weeks of your transition. This low blood sugar can cause notably uncomfortable side effects and intense cravings. Carbs and Blood Sugar Your body converts consumed carbohydrates into glucose, a type of sugar. When the glucose enters your bloodstream, it leads to an increase in your blood sugar level. The pancreas produces insulin in response to spikes in blood sugar, which helps your body store the sugar for energy. This insulin release subsides when your cells absorb the sugar and your levels stabilize. In a healthy body, the surge of blood sugar and insulin is relatively moderate and keeps you evenly motoring through your day. When you eat lots of carbohydrates, your body's blood sugar remains consistently high and your system constantly pumps out insulin. This chronic elevation of blood sugar and release of insulin causes inflammation, an increase in fat storage and an inability to burn stored fat. Chronically high blood sugar levels increase your risk of disease, including heart disease and type 2 diabetes. You crave carbohydrates regularly for energy, because your body isn't efficient at using stored fat for fuel. How a Low-Carb Diet Impacts Blood Sugar If you regularly consume a large amount of carbohydrates, especially refined ones like white bread and soda, you may experience a notable drop in blood sugar when you drastically reduce your carb intake. In the first week of carb reduction, your body will seek to maintain your high sugar intake. You'll crave carbohydrates and may even feel weak because your body hasn't yet become efficient at burning fat for fuel Continue reading >>
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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 >>
Is Low-carb Eating Really Better For Blood Sugar?
A review of popular low-carbohydrate diets finds that while restricting carbs can reduce blood sugar in the short run, evidence in support of long-term benefits is lacking. While very low carbohydrate diets (LCD) promise to cut blood sugars, a review of popular LCDs finds that while very low-carb eating can reduce blood sugar in the short run, little evidence exists to show long-term benefits. The study, published online in the Journal of the American Osteopathic Association, reports that while LCDs may be “slightly better than low fat diets for weight and triglycerides management” they are “not superior for the management of blood glucose, blood pressure, or cholesterol levels.” However, researchers note that physicians should be aware that “available evidence for LCDs is limited because of variable definitions, lack of long-term studies, and lack of patient adherence.” Diets considered ranged from very low carb—less than 20 to 60 grams per day—to less restrictive diets that averaged about 130 grams per day. The American Diabetes Association says diets should be tailored to individual needs, but recommends starting at 45-60 grams of carbohydrates per meal. “Patients can likely follow a version of the low carbohydrate diet for longer than the studies suggest, but we don’t know the health effects of a very low carbohydrate ketogenic diet of less than 20 grams of carbs per day,” says Heather Fields, MD, an author of the study and a doctor of integrative medicine at the Mayo Clinic in Phoenix, Arizona. “With so few people adhering to a truly ketogenic diet long term [more than a year], we will likely never be able to study the health effects in a meaningful way.” Dr. Fields finds that if type 2 patients have not had success with a plant-based, who 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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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 >>
Why Do My Blood Sugars Rise After A High Protein Meal?
Complex issues often require more detail than you can pack into a Facebook post. One such area of confusion and controversy is gluconeogenesis and the impact of protein on blood sugar and ketosis. Some common questions that I see floating around the interwebs include: If you are managing diabetes, should you avoid protein because it can convert to glucose and “kick you out of ketosis”? If you’ve dropped the carbs and protein to manage your blood sugars, should you eat “fat to satiety” or continue to add more fats until you achieve “optimal ketosis” (i.e. blood ketone levels between 1.5 and 3.0mmol/L)? Then, if adding fat doesn’t get you into the “optimal ketosis zone”, do you need exogenous ketones to get your ketones up so you can start to lose weight? This article explores: the reason that some people may see an increase in their blood sugars and a decrease in their ketones after a high protein meal, what it means for their health, and what they can do to optimise the metabolic health. You’re probably aware that protein can be converted to glucose via a process in the body called gluconeogenesis. Gluconeogenesis is the process of converting another substrate (e.g. protein or fat[1]) to glucose. Gluco = glucose Neo = new Genesis = creation Gluconeogenesis = new glucose creation As shown in the table below, all but two of the amino acids (i.e. the building blocks of protein) can be converted to glucose. Five others can be converted to either glucose or ketones depending on the body’s requirements at the time. Once your body has used up the protein, it needs to build and repair muscle and make neurotransmitters, etc. any “excess protein” can be used to refill the small protein stores in the blood stream and replenish glycogen stores in the liv Continue reading >>
