Testing for Insulin Spikes while Aiming for Ketosis?

KnitOrMiss

So, I was reading a brilliant article today that @Dragonwolf posted elsewhere, and in a referenced article, talking about becoming keto-adapted as far as exercise and all that, the article referenced it being key to make sure to test after meals for insulin spikes.

I have a blood insulin meter that was assigned to me by a doctor who was convinced that I was diabetic despite great blood levels due to reactions I was having to all foods, but I was never really trained on how to properly use it as far as testing times, etc. I tested before a meal or after a meal, but never consistently.

So, I hope that explains some background, my real question is this. To determine what kind of insulin spike I do or do not have after eating a meal (particularly thinking of my lunch lately, which is a little over 10 carbs total, but less than 10 net), do I need to test my blood sugar before eating, and then also after for a range? If so, how far before and how far after?

I know that my fasting BG has been 88-90 for years now, and as I remember, my BG during my "food narcolepsy moments (long explanation here" was always around 120-125, which I was told was completely in a normal range for food consumption. I know that I do not have diabetes or hypoglycemia, and all of my food crash reactions are pretty much gone completely since starting LCHF almost a month ago, but I really don't know what I'm looking for. In particular, I'm wanting to keep an eye our for a carb meal threshold. I'm not specifically aiming for keto at this time, mostly LCHF, but if keto serves my body better, I can go for that, it just means some more adjusting.

So any advice as far as when to test (as I said, I'm pretty much focusing on lunch as my test meal, as I've been fairly steady on that meal for a week or so no, with no noticeable impact to me), before and after, if needed for understanding insulin spike, as well as any advice on my diary - with the caveat that you will see a lot of repeating and not much choice at the moment due to extremely limited funds at the moment - so I'm just doing the best I can do, etc. My endocrinologist had suggested a starting point of 25% carbs, but I found that keeping my carbs that high still caused cravings, so I dropped it even further (I think I'm coming in at 10% or under regularly) and kept proteins in the 20% range, and filled in the rest with fats (I think my running average since I started logging here over week ago is 7-10% carbs, 15-23% protein, and the balance in fats)... This seems to keep me full and satisfied, next to no cravings.

Last night, I tried just having a glass of tea with cream, and a small amount of sweetener (just to counter the tanins) satisfied me completely, without need for my 5-10 chocolate chips I'd been eating every few days... So I think making sure my fats are fully in balance after each meal interval seems to make me feel better.

Appreciate thoughts, feedback, and advice.

Thanks in advance everyone!

Dragonwolf

I assume you mean blood glucose meter. If you truly mean insulin meter, then get me the information on that sucker, because I have yet to find one that actually measures insulin. I will personally drive down to OK if I have to to pick up something that actually does insulin, since as far as I can tell, those don't exist.

Anywho, from my understanding of test times from my diabetic family, here's what you generally want around meals:

1. Shortly before a meal. For purposes of data, exact timing doesn't really matter (usually, timing matters more for insulin medication, which doesn't apply here), but is necessary to get your baseline "fasting" number.
2. 1 hour after a meal. Semi-optional, but can catch faster increases from simpler sugars. May be useful for informational purposes.
3. 2 hours after a meal. The usual post-meal measurement. Theoretically, this should be the highest reading, but type of carbohydrates can change whether this is really the highest and how long it takes to reduce from there.
4. 3 hours after a meal. Optional measurement. This is useful for seeing how long it takes for your blood sugar to return to fasting levels. This should be about the same as your pre-meal/fasting reading, or close. If it's still over 100, then something isn't quite right.

Of course, you also have the morning fasted number that can give you a solid reading of what your "8+ hours sans food" number is.

Hope this helps!

KnitOrMiss

Yes, *smh* I did indeed mean a Blood Glucose Meter. Sorry. I'd be excited for Insulin meter too! I just feel lost in this, and I have limited strips at the moment. I'm also no longer a patient of the doctor who "issued" me the meter, and so I don't know how I would go about getting additional strips. They have to be prescribed, right? I just still have the sample strips that came with it, less than 10 left.

So if I'm looking specifically for a spike, I'd test before for baseline, then 1 hour or 2 hour? Maybe 1 hour for a rush/spike? Or 1.5 hours for the best of both worlds? Before, when I was having my issues of passing out after eating, it was around 45 minutes, give or take a few, when it would hit. So, at that 1 hour point sounds like the range? I can do this a few times, to get different days, to average out, but I'm hoping to only test twice, once before, once after...

And I don't have a fasting number since I started LCHF, but it's only been a month, so I can't imagine it being hugely different, though who knows. I just got overly frustrated with not having any instruction other than test for baseline, then test when problem is present. No standard hours, or suggestions of time or anything... I guess I could ask my endocrinologist specifically what he suggests, but I don't know if he'd be the doc to ask.

Dragonwolf

KnitOrMiss wrote: »

Yes, *smh* I did indeed mean a Blood Glucose Meter. Sorry. I'd be excited for Insulin meter too! I just feel lost in this, and I have limited strips at the moment. I'm also no longer a patient of the doctor who "issued" me the meter, and so I don't know how I would go about getting additional strips. They have to be prescribed, right? I just still have the sample strips that came with it, less than 10 left.

So if I'm looking specifically for a spike, I'd test before for baseline, then 1 hour or 2 hour? Maybe 1 hour for a rush/spike? Or 1.5 hours for the best of both worlds? Before, when I was having my issues of passing out after eating, it was around 45 minutes, give or take a few, when it would hit. So, at that 1 hour point sounds like the range? I can do this a few times, to get different days, to average out, but I'm hoping to only test twice, once before, once after...

And I don't have a fasting number since I started LCHF, but it's only been a month, so I can't imagine it being hugely different, though who knows. I just got overly frustrated with not having any instruction other than test for baseline, then test when problem is present. No standard hours, or suggestions of time or anything... I guess I could ask my endocrinologist specifically what he suggests, but I don't know if he'd be the doc to ask.

The strips don't require a prescription (none of the glucose monitoring stuff does), though it usually makes it cheaper out of pocket, since insurance would cover such expenses. If you have an HSA or FSA account, you should be able to charge the strips to that. Other than that, you can get them at the pharmacy, from Amazon, or even directly from the manufacturer. (Unfortunately, glucose meters are very much a "razor and blades" type of product -- the meters and starter kits are cheap, and they gouge you on the strips and lancets.)

If you're going to only do two readings, the generally recommended ones are before meal and 2 hours after. However, since your issues showed up at 45 minutes, I'd say test there, too. I know you don't want to test more than once after, but the more you can test, the more data points you'll have to work with and the better the picture will be.