Fasting Blood Sugars
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genmon00
Posts: 604 Member
Hello wonderful Low Carbers!
This question is for the diabetics specifically T2D's. A little background, I've been LCHF since May 2016. At the time my FBS was 120-140 (thats with taking Metformin 2000 mg a day, Actos and Januvia) and my A1C was 7.5. After about 2 months on LCHF my FBS dropped to 70-80's and A1C 5.2. The Dr okd for me to just take Metformin. I was not yet including fitness in my journey. Ok so in the last month, i have purposefully increased my carbs to 50-60 net. And my FBS are now 105-115 each morning (i havent been able to check post meals). This is kinda freaking me out. Due to scheduling my fitness regime is almost non existentent ( i miss it so!). Has anyone experienced this? I feel like I have an increased sensitivity to carbs now. Any insight is appreciated!
This question is for the diabetics specifically T2D's. A little background, I've been LCHF since May 2016. At the time my FBS was 120-140 (thats with taking Metformin 2000 mg a day, Actos and Januvia) and my A1C was 7.5. After about 2 months on LCHF my FBS dropped to 70-80's and A1C 5.2. The Dr okd for me to just take Metformin. I was not yet including fitness in my journey. Ok so in the last month, i have purposefully increased my carbs to 50-60 net. And my FBS are now 105-115 each morning (i havent been able to check post meals). This is kinda freaking me out. Due to scheduling my fitness regime is almost non existentent ( i miss it so!). Has anyone experienced this? I feel like I have an increased sensitivity to carbs now. Any insight is appreciated!
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Replies
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Just a few thoughts. First, if scheduling has caused you to not exercise, your stress levels are likely higher. Stress increases cortisol which increases BG.
Second, according to Dr Adam Naly, it is not uncommon for someone who is IR to have FBG a bit over 100 after becoming fat adapted. He said his morning FBG is consistently around 105, but his A1c is 5.2. The more important measure is the PP reading as that will tell you how well your body is processing what you eaten. I would suggest finding a way to fit this testing into your schedule.
Third, why did you up your carbs, and with what foods and how have you spread them out? If you are taking them in mostly in one meal, then that will cause some problems as will taking them in via straight sugar. According to Dr Bernstein, your body does not process carbs as well first thing in the morning so breakfast should be the lowest carb meal of the day. He suggests 6 g for breakfast and 12 g each for lunch and dinner. That is only 30 total, so maybe double if you think 60 is where you want to be.4 -
Increased carb intake and increased bg... seems like what I would've expected honestly.0
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Thank you @cstehansen! Yes, I have been experiencing a heck of a lot more stress since I was changed to my new work schedule and i miss my workouts very much. Its a daily battle trying to find time. I always heard to eat my most carb heavy meal in the AM so thats interesting about what Dr Bernstein said, I'm definitely going to experiment with that. I upped my carbs because 20 g feels too restrictive to me and Im not aggresively trying to loose weight. Im going to bring my glucometer to work and set a timer to remind me to check. Thank you for sharing this wisdom!0
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Sunny_Bunny_ wrote: »Increased carb intake and increased bg... seems like what I would've expected honestly.
Lol yes logically yes i should not be surprised but such a big jump? Its still very low carb just not keto. I think stress is probably the culprit. And my home situation is a big source of angst but unfortunately nothing i could about it at this time.1 -
Sunny_Bunny_ wrote: »Increased carb intake and increased bg... seems like what I would've expected honestly.
Lol yes logically yes i should not be surprised but such a big jump? Its still very low carb just not keto. I think stress is probably the culprit. And my home situation is a big source of angst but unfortunately nothing i could about it at this time.
With IR, a big jump isn't surprising at all. You have a situation where system overreaction is the norm. The way to suppress the overreaction is very low carb.
I don't necessarily think the higher fasting bg will result in higher A1c though. It could and I definitely think having fewer carbs in the morning is a good idea. Something else to consider though is that your consistent 105 isn't crazy high. I don't have a diagnosis of IR and I really don't suspect I had/have it at all. Even if I did before going keto, it would've been in the early stages and minor and even after over a year of very very low carb, I have had morning bg of 100 a couple times and the times I have checked it out of pure curiosity are probably less than a dozen total... so, having a slight rise in the morning isn't necessarily a sign that there's a problem. Especially since cortisol rises to wake us from sleep and the morning bg should be the highest of the day.
I don't think aiming for the higher carb amount is necessarily a problem but it may slow down the reversal of the IR. As long as you're able to stick I it long term and A1c is in a healthier range I think you're on the right track. Please don't stress it too much. I know it's very important to you to get control of the diabetes and I am no expert and I don't even have it myself so I understand that my thoughts here may not hold as much weight as others that have first hand experience, but I personally believe that we should aim for good progress and be a little tough on ourselves as far not bending our own rules too much, but at the same time we need to be realistic and can't expect perfection from ourselves either.
There are other ways to influence the reversal of IR like intermittent fasting, water fasting and even just following the Dr Bernstein idea of having the higher carbs at dinner.
Our bodies can take a lot of abuse and be quite forgiving. Which allows us a little trial and error while figuring out/trying out different things to figure out not only how to be healthier but how to do it long term. We don't need perfection. We just need something to be consistent that we can build upon for long term results.
Honestly, I commend anyone with IR for attempting any level of low carb because I fully understand the carb "addiction" as someone that doesn't have that extra complication driving it. It's hard to change. You've done great this far. You're still experimenting so cut yourself a little slack if things take a sidestep in the process. You seem fully committed to your long term health and that's the biggest hurdle in my opinion.2 -
Thank you @Sunny_Bunny_ ! I love this woe and honestly I under estimated my issues with food. Sometimes when I feel like all I hear is NO to other areas of my life that out of my control, I want to HELL YES to things I can control, like what I put in my mouth...I mean I seriously considered buying some cigarrettes the other day (when I had the blow out with my family) and I have not smoked in several years and did not have any desire for it. Just another way to say "KITTEN OFF" to what I "should" be doing..sorry...I feel like I'm in therapy lol...Anyhoo, I am SO grateful for this forum and all of you very supportive and non judgemental people. I know you have my back lol3
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How are you timing your metformin? It might be that if you were to take 500-1000 of the XR right before bed, you'd see a lower FBG.
(I think it takes 4-6 hours for Metformin XR to reach peak blood levels, but I'll bet there's a bit of variation among the 20+ generics on the market.)1 -
I'm T2, though I don't take metformin,so I have no experience there, but if you went from 20 g carbs a day to 60g and haven't offset that with any exercise, the jump you experienced is very much in line with what I would experience.
A 30-40 g carb increase might not sound like a lot, but your body had likely adjusted to its new normal and you doubled and tripled your carb intake, that's a big dietary change.
Where are your carbs coming from? That will make a huge difference too. I would recommend sticking with high fiber veggies as they will have a much lower impact than bread, potatoes, fruit, etc (even in very small portions).
I took the opposite approach this winter. I had increased my carb intake from 20 to 40g over the summer as I was doing quite a few long hikes every week. That basically equated to a big salad with lots of veggies for breakfast or lunch and a bowl of veggie soup or stew at night, all low carb veg. But I've cut back down below 20 g most days now that the weather has changed as I'm not exercising as frequently, the exercise makes a massive difference and as a diabetic you need to adjust your diet accordingly just as you would if you changed your meds.
And fully agreed with the above re exercise and stress!2 -
After 5 or so months keto, my FBG went back up. It is usually back in the prediabetic range now. Some mornings it dips lower but I have no idea why it is always high. My highest reading of the day usually. I can eat no carbs at night, skip dinner, eat carbs at night and eat in the evening and it makes no real difference to my BG. It's annoying.
I don't know if my morning BG went up because I was fat adapted or because I stopped losing weight. All I know is that the omly way to be sure that my FBG is normal is to not eat for 24 hours, but I don't do that often.
I'm not on metformin but I sometimes think I should be... I just hate to start another drug.1 -
After 5 or so months keto, my FBG went back up. It is usually back in the prediabetic range now. Some mornings it dips lower but I have no idea why it is always high. My highest reading of the day usually. I can eat no carbs at night, skip dinner, eat carbs at night and eat in the evening and it makes no real difference to my BG. It's annoying.
I don't know if my morning BG went up because I was fat adapted or because I stopped losing weight. All I know is that the omly way to be sure that my FBG is normal is to not eat for 24 hours, but I don't do that often.
I'm not on metformin but I sometimes think I should be... I just hate to start another drug.
Metformin is good stuff. Before starting, I would go to one of those places that relines old gas tanks or fills in chips in porcelain ball-and-claw foot tubs and get your GI system ready for the onslaught. (Of course, you might be among the many who can tolerate whichever generic your pharmacy carries with OEM.)3 -
After 5 or so months keto, my FBG went back up. It is usually back in the prediabetic range now. Some mornings it dips lower but I have no idea why it is always high. My highest reading of the day usually. I can eat no carbs at night, skip dinner, eat carbs at night and eat in the evening and it makes no real difference to my BG. It's annoying.
I don't know if my morning BG went up because I was fat adapted or because I stopped losing weight. All I know is that the omly way to be sure that my FBG is normal is to not eat for 24 hours, but I don't do that often.
I'm not on metformin but I sometimes think I should be... I just hate to start another drug.
Metformin is good stuff. Before starting, I would go to one of those places that relines old gas tanks or fills in chips in porcelain ball-and-claw foot tubs and get your GI system ready for the onslaught. (Of course, you might be among the many who can tolerate whichever generic your pharmacy carries with OEM.)
And that's the other reason that I have put it off. I'm a celiac and I had decades of GI issues. I was finally diagnosed and have had a few years of normalcy... I don't want to lose that.
Weird what gets important to you as you age. I always said I was not going to grow into one of those people who discusses their BMs and meds... Oops.
But what is OEM?1 -
After 5 or so months keto, my FBG went back up. It is usually back in the prediabetic range now. Some mornings it dips lower but I have no idea why it is always high. My highest reading of the day usually. I can eat no carbs at night, skip dinner, eat carbs at night and eat in the evening and it makes no real difference to my BG. It's annoying.
I don't know if my morning BG went up because I was fat adapted or because I stopped losing weight. All I know is that the omly way to be sure that my FBG is normal is to not eat for 24 hours, but I don't do that often.
I'm not on metformin but I sometimes think I should be... I just hate to start another drug.
Metformin is good stuff. Before starting, I would go to one of those places that relines old gas tanks or fills in chips in porcelain ball-and-claw foot tubs and get your GI system ready for the onslaught. (Of course, you might be among the many who can tolerate whichever generic your pharmacy carries with OEM.)
And that's the other reason that I have put it off. I'm a celiac and I had decades of GI issues. I was finally diagnosed and have had a few years of normalcy... I don't want to lose that.
Weird what gets important to you as you age. I always said I was not going to grow into one of those people who discusses their BMs and meds... Oops.
But what is OEM?
Ah. Original equipment
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Thank you @cstehansen! Yes, I have been experiencing a heck of a lot more stress since I was changed to my new work schedule and i miss my workouts very much. Its a daily battle trying to find time. I always heard to eat my most carb heavy meal in the AM so thats interesting about what Dr Bernstein said, I'm definitely going to experiment with that. I upped my carbs because 20 g feels too restrictive to me and Im not aggresively trying to loose weight. Im going to bring my glucometer to work and set a timer to remind me to check. Thank you for sharing this wisdom!
As for what Dr Bernstein said, always remember there is no one size fits all. Hr is T1, also, so that could be different. The best advice I can give is to learn the things which help others and try each to see what works for you (n=1 experiments). Everything I have seen in research that shows success is only successful for some percentage below 100. It may be high like 85%, but that still means it was not successful for 15%.
The high am reading is called the "dawn phenomenon" and is VERY common especially for diabetics. That's why I suggested the PP readings. If those are elevated, then there may be an issue that needs to be addressed. If it is only the am fbg reading, then you likely don't need to worry about it at all unit gets really high.
If you can't do formal exercise, I would suggest trying to figure out a way to squeeze in a 10-15 minute brisk walk after lunch and/or dinner. That is something that has a high success rate for eliminating PP spikes.3 -
Read a lot of good info here. I'm a diabetic and here's a question Why can't I bring down my b/s I have a flu bug for a week and a 1/2 and the lowest I've seen is 8.5 in that time. The last week keeping carbs under 70 but no change.
Help.0 -
LinCharpentier wrote: »Read a lot of good info here. I'm a diabetic and here's a question Why can't I bring down my b/s I have a flu bug for a week and a 1/2 and the lowest I've seen is 8.5 in that time. The last week keeping carbs under 70 but no change.
Help.
From my understanding (and I am not a doctor) here are a few thoughts:
The flu may actually be keeping your BG higher because it is a stressor on your body. Getting healthy again for a week or two and then checking would be what I would suggest to get a better baseline.
What carbs and the timing of the carbs would be the next thing I would check. 70 is not a lot, but if it is mostly all in one meal and in the form of simple sugars, that is much different than spread fairly equally between 3 meals and made up of complex carbohydrates.
The third thing is overall caloric intake. I find that if I eat above maintenance even a little bit, my BG is elevated regardless of what I eat. That includes the times I splurge like on Christmas Eve and went to a nice Brazilian steakhouse and ate nothing but meat with a little bit of cheese and greens. Total carb intake was very low, however, the volume I ate was well above maintenance levels and as a result, my BG was elevated more than normal the next morning and really the whole next day.2 -
To make matters even worse, Dr. Bernstein also likes to point out that you can feed a diabetic a bowl of pebbles, and even that will trigger an anticipatory release of glucagon and a corresponding rise in BG.
So it's not just calories but also volume. Sheesh!1 -
^^^can we have a BOO button!
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Being sick will definitely raise blood sugar due to cortisol.
My T1D daughter has had major blood sugar spikes from just the stress of watching a scary movie!
Last January she was in ICU for 3 days with DKA after an 18 wheeler almost ran her off the road. She didn't crash at all. Just the scare threw her blood sugar so out of control that she couldn't get it to come back down. She took dose after dose of insulin and nothing worked.
The year before that she had a bacterial infection that wouldn't have taken an average person to the doctor, but she spent 4 days in ICU.
Stress is a HUGE factor for blood sugar, weight loss, everything. Even small but constant stressors that we don't even think of as stress.1 -
LinCharpentier wrote: »Read a lot of good info here. I'm a diabetic and here's a question Why can't I bring down my b/s I have a flu bug for a week and a 1/2 and the lowest I've seen is 8.5 in that time. The last week keeping carbs under 70 but no change.
Help.
Hi @LinCharpentier Being sick will raise most diabetics' blood sugar. It puts added stress in the body, which is never a good thing for a diabetic. I've been able to stop taking insulin by eating a very low carb diet, but I still keep a few insulin pens around in case I get sick. Even if I eat nothing but broth when I'm sick, my blood sugar still goes way up.0
