High Blood Sugar One Hour After Eating Tested Again 10 Mins Later Dropped to Very Low
This past leap, after eighteen 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 outcome shocked me.
I had purchased the device, which also tests ketones, when I was diagnosed with pre-diabetes in the autumn of 2015. As I embarked on low-carb keto eating, I tested my claret regularly. Soon my fasting blood sugar was one time again in the healthy range. I was in ketosis day after 24-hour interval. Non but that, I lost 10 lbs (5 kg) and felt fantastic — total 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, salubrious 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 force per unit area and stable weight, she wanted to meet 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 forenoon of the test I sat in my auto outside the clinic at 7:30 am, and pricked my finger. I was expecting to run into a lovely fasting blood glucose (FBG) of 4.7 or iv.8 mmol/l (85 mg/dl).
Information technology was 5.eight! (103 mg/dl). What? I bailed on the tests and drove home — I didn't want my md warning me I was pre-diabetic again when I had no explanation for that college result.
The next morning I tested again: five.9! (104). Huh???
For the adjacent 2 weeks I tested every morning. No matter what I did, my FBG would exist in 5.7 to vi.0 (102 to 106 mg/dl), the pre-diabetic range again.
One morn after a restless slumber information technology was even 6.2 mmol/l (113 mg/dl). But my ketones were still reading 1.5-2.5 mmol/l. I was still burning fat, not glucose. When I tested my blood afterwards meals, my glucose hardly moved at all. My charts, which I enter at SugarStats, were almost a straight line, with the FBG the highest reading of the day, 12 to 14 hours after any food at all.
What was going on?
Many people inquire: "Why is my fasting blood glucose higher on low carb?" Dozens of ketogenic and paleo forums have discussions on the outcome. Some of the information flames fears, using unsubstantiated claims, that a low-carb diet could trigger diabetes rather than contrary it. Some posters in forums fifty-fifty say they've quit the keto diet because their college FBGs scared them so much.
Only have no fear. We have researched the medical literature and consulted with leading experts. Hither'south what you demand to know:
1. Relax, information technology is normal — call it "adaptive glucose sparing"
"We definitely run into that in people who are doing low carb long term, the majority will find that their fasting claret glucose becomes their highest value of the day," says Dr. Sarah Hallberg. "They are not really having issues with blood sugar. They are doing really well. But if you are looking at a log of 24 hours of blood glucose you lot will see a high first matter in the morning time and then a steady decline throughout the day, with no big excursions [in glucose levels] even afterward meals."
The scientific proper name is "physiologic insulin resistance" and it's likely a good affair — unlike "pathologic insulin resistance."
As regular visitors will know, the "pathologic" kind of insulin resistance is caused by college and college levels of insulin — hyperinsulinemia — trying to strength glucose into our cells. That insulin resistance is a prominent feature of blazon 2 diabetes, polycystic ovary syndrome (PCOS) and other chronic weather condition.
So let's call physiologic insulin resistance instead "adaptive glucose sparing," a name that has been proposed past many to reduce the confusion. Dr. Ted Naiman describes it equally muscles that are in "glucose refusal mode."
Prior to converting to the ketogenic diet, your muscles were the major sites to soak up and use glucose in the blood for energy. On a long-term keto diet, however, they at present prefer fat as fuel. So the muscles are resisting the activeness of insulin to bring sugar into cells for energy, saying, in essence: "Nosotros don't desire or need your sugar anymore, so motility information technology along." Hence, the slightly elevated, but more often than not stable, glucose circulating in the blood.1
Where is that glucose coming from when you lot swallow no sugar and merely leafy veggie carbs in your nutrition? Your liver, through gluconeogenesis — the creation of glucose from not-saccharide sources such as lactate, glycerol, and glucogenic amino acids from proteins. It is a natural protective process that got homo sapiens through hundreds of thousands of years of feasts and famines.
"There is no essential requirement for dietary carbohydrate because humans possess a robust capacity to suit to low-carbohydrate availability," says Dr. Jeff Volek. In the liver of a keto-adapted person, he notes: "ketone production increases dramatically to displace glucose every bit the brain's primary energy source, while fatty acids supply the majority of energy for skeletal muscle. Glucose production from non-carbohydrate sources via gluconeogenesis supplies carbons for the few cells dependent on glycolysis [using saccharide for energy.]"2
Why are blood sugars highest in the morning? It'southward the dawn phenomenon, when cortisol, growth hormones, adrenaline and the enzyme glucagon pulse to the liver to get you up and moving for the mean solar day — spurring gluconeogenesis for the cells that need glucose.
"It'south your body making you breakfast," notes one post that discusses the common phenomenon — except that when your muscles are fat-adapted, they don't desire it.three
The HbA1c test estimates the average glucose level in the blood over the previous 3 months past counting the number of glucose molecules stuck on ruby blood cells. On a low-carb nutrition the HbA1c will almost always exist lower than the fasting blood glucose suggests, showing that good glucose control, or type two diabetes, is not an issue for that individual.4
2. Insulin is depression — an of import departure
Only testing fasting blood glucose without testing fasting insulin tells yous very lilliputian. That's because 2 people could accept exactly that aforementioned fasting blood glucose levels and have very dissimilar circulating insulin levels.5
It is all most the relationship between glucose and insulin and how they work in concert. This is called the homeostatic model assessment of insulin resistance or HOMA-IR. The proper noun is a mouthful, but information technology simply means that the body is always trying to keep its essential systems in residue or in an equilibrium — chosen homeostasis. Insulin is working confronting glucose in an attempt to continue blood sugar levels stable, a.k.a in homeostasis.6
In one individual — for example someone with pre-diabetes, type two diabetes, or PCOS — insulin may over time be pulsed out in higher and higher amounts just to keep the blood sugar relatively stable. While fasting blood glucose could withal be in the normal range, it is taking increasing amounts of insulin to proceed it there. Equally insulin resistance develops, and insulin becomes increasingly ineffective to bring claret sugars down, blood sugars volition somewhen rising too loftier.
In a second individual — someone who has been on the keto diet for a number of months and is now burning fat for energy — much lower amounts of insulin are existence pulsed past the pancreas to keep the glucose stable. You have at present, therefore, improved your insulin resistance and simply need small amounts of insulin to proceed glucose in check.
Dr. Naiman's graph shows, if you know your fasting blood glucose and your fasting insulin, the HOMA-IR equation can tell you how insulin sensitive or insulin resistant you are. If your fasting blood saccharide is 5.7 mmol/L (103 mg/dL) and your insulin is high, too, over 12 μU/mL, you are insulin resistant and may be on your style to type 2 diabetes. If your blood sugar is 5.7 mmol/L but your fasting insulin is under 9 μU/mL, you are insulin sensitive and may be in "glucose refusal" mode from a low-carb diet.
Most doctors practice non yet check for fasting insulin with a fasting blood glucose examination. You usually accept to ask for information technology.7
3. Understand cortisol and its impact on blood glucose
We all live stressful lives, but some of us have a harder time reducing or releasing our stress. That fact may play out in restlessness, poor sleep, indisposition, or feelings of anxiety or abiding tension. Cortisol is the stress hormone that mediates the "fight or flying" physiologic response. And it has a direct bearing on our glucose levels.
"Prolonged cortisol stimulation volition enhance blood glucose levels," notes Dr. Jason Fung, who wrote an entire affiliate on the stress hormone in his 2016 bestseller The Obesity Code.8 In it he describes how cortisol, released from the adrenal glands, sends a bulletin to the body to release glucose to prepare for a perceived threat, spurring gluconeogenesis in the liver. In prehistoric times, that surge of glucose energy was unremarkably used up fighting or fleeing from the threat. But in current days, often that stress goes unreleased, the free energy not used, which tin can lead to prolonged higher glucose levels (and higher insulin levels to try to bring it downward.)
US nurse Kelley Pound, a depression-carb diabetes educator who blogs at the site LowcarbRN, wore a continuous glucose monitor to see how various foods and stimuli impacted her blood glucose throughout the 24-hour interval. She discovered that even while eating low carb, it was stress that had the biggest impact on her readings, far more than than any depression-carb food. "My blood glucose will boilerplate twenty-30 points higher on mornings where I have not gotten at least 7 hours of sleep," said Pound, who decided to focus on stress reduction as a central part of diabetes management. "Working so hard to keep blood glucose controlled with diet, only to have it go haywire with stress, is defeating my goals."
I, as well, discovered the aforementioned stress bear on, peculiarly with slumber. Since this spring, I am doing yoga in the early evening, focusing on other stress reduction activities (painting and playing my guitar at night rather than scanning Facebook or watching the news) and wearing earplugs and an center shade to help ensure a better night sleep. Doing and so drops my FBG back into the normal range the next morning.
Drinking a glass or two of wine at night can lower readings, too, because the liver metabolizes the alcohol start before turning to gluconeogenesis, simply I don't want to potable daily.
iv. Glucose meters can give false readings
While physiologic reasons crusade higher glucose readings, technical reasons tin cause them, too. The Usa Federal Drug Administration allows home glucose monitors to have a variance of 15% in results. That ways a reading of 100 mg/dl might actually be as low every bit 85 mg/dl or as high as 115, a huge variation!ix
Dave Feldman, the software engineer who has cracked the Cholesterol Code, has blogged about his glucose meter variance, charting and taking pictures of his ii glucose meters, measuring the aforementioned drop of blood. While he was expecting his blood glucose set up signal to be college considering of his long-term depression-carb keto eating, he was surprised by the sometimes huge variation in results. He notes that whenever he gets an unexpected result, he takes iii readings, all within a few minutes of each other, so averages the effect.
Other researchers accept noted that imitation readings can exist acquired by pricking a finger for claret with hands that accept minute traces of sugar or food (only touching a piece of fruit.) Dehydration raises results, too. Y'all should e'er launder your hands before testing, simply some soaps have additives like beloved or a fragrance that can linger on fingers and distort readings. As well, strips that are too hot or too cold, or other environmental conditions like loftier altitudes, tin can produce higher or lower readings. Fifty-fifty different lots of strips can produce unlike results on the same meter.
Now, like Feldman, whenever I go an unusually loftier reading, I take some other reading. Information technology is often many points lower.10
5. A word nearly LADA – Latent Autoimmune Diabetes in Adults
If all of the information in this mail does not assistance you sympathize your rising claret glucose on the low-carb diet, and your blood glucose continues to ascent college and higher, non simply in the morning but at other times of day, there may be a potential upshot of latent autoimmune diabetes in adults (LADA), likewise sometimes called type 1.v diabetes.11
Both Dr. Hallberg and Dr. Fung say they see LADA regularly among their patients who may have been misdiagnosed with type ii diabetes and have LADA instead.
LADA is like type i diabetes in that antibodies are attacking the insulin-producing cells of the pancreas, but it arises in adulthood, non in babyhood or adolescence. Diabetes researchers annotation that LADA also has features of type ii diabetes, but the patients unremarkably are thinner and progress to needing insulin faster because their insulin-producing beta cells have been attacked by antibodies. The highest rates of LADA are found in Northern Europe, with up to 14% of those with type ii diabetes actually having information technology.12
"I test serum C-peptide and insulin in everybody in my Intensive Dietary Direction program," notes Dr. Fung. "I re-check them over time and it often takes 6 months to 1 year to clinch the diagnosis. I would suspect about 5-x% of my blazon 2s are actually LADA."
Dr. Naiman has similar experiences and routines.13
Fortunately, merely like blazon one or type two diabetes, the low-carb keto diet is a successful way for individuals with LADA to keep their blood sugar as stable as possible. If they need to eventually inject insulin, low-carb eating enables them to use the to the lowest degree amount of insulin necessary to keep loftier blood sugars in cheque. "It may not boring progress of the beta cell destruction, only low carb is a very successful therapeutic strategy to reduce reliance on medication," notes Dr. Fung.
Determination
Later doing all this research on fasting glucose levels in low-carb keto eating, I am no longer worried about my morning highs. Now with a greater focus on stress reduction and ameliorate sleep, they are routinely in the normal range anyway, while I continue to be in ketosis and love my keto diet and keto life.
And by the way, when I finally went for the my lab test, I got great results. My lipids and cholesterol were first-class and my HbA1c was a healthy 5.3%. "Keep doing what you lot are doing," my medico said. "You lot are the picture of robust health."
—
Anne Mullens
Source: https://www.dietdoctor.com/low-carb/fasting-blood-glucose-higher
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