Blood Sugar Question
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chaoticdreams
Posts: 447 Member
So I've been low carb 25 g or less now for just under 3 months on keto. My blood sugar has gotten heaps and bounds better (type 2)...... but my fasting glucose is still not quite great. I fast 20-23 hours a day Mon through Friday, last meal before 7/8 pm most nights. By lunch my BG is still in the upper 120's. Now, I understand dawn phenomenon, and I get that's why it's high likely, but should I be worried that it takes almost 18 hours of fasting to go down into the mid 90's/lower 100's? Due for an a1c next month, but the Doc is not going to be pleased with my meter readings.
Also noticing that when the BG is high my blood ketone level is .3. I quit chasing ketones after a month back into this, so I'm not really worried about that, but should I be? That is not really high enough for nutritional ketosis. I'm keeping protein 100g or less daily (average about 70) and I"m not really all that active right now. Working on trying to find an exercise plan that fits my schedule. My weight loss has stalled for 2 weeks now, but I think that's hormone related and not really due to this. Been losing weight with little issue until recently and my diet hasn't changed. The only artificial sweeteners I consume daily are equal tablets (not the powder packets) and stevia, neither of which have ever affected my BG in the past and considering it goes down as the day progresses, I don't think it's doing so now.
I mean 127 is awesome compared to the 200 it was 3 months ago, but isn't that still really high for fasting? Should I be concerned at all or just keep calm and low carb on?
Also noticing that when the BG is high my blood ketone level is .3. I quit chasing ketones after a month back into this, so I'm not really worried about that, but should I be? That is not really high enough for nutritional ketosis. I'm keeping protein 100g or less daily (average about 70) and I"m not really all that active right now. Working on trying to find an exercise plan that fits my schedule. My weight loss has stalled for 2 weeks now, but I think that's hormone related and not really due to this. Been losing weight with little issue until recently and my diet hasn't changed. The only artificial sweeteners I consume daily are equal tablets (not the powder packets) and stevia, neither of which have ever affected my BG in the past and considering it goes down as the day progresses, I don't think it's doing so now.
I mean 127 is awesome compared to the 200 it was 3 months ago, but isn't that still really high for fasting? Should I be concerned at all or just keep calm and low carb on?
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Replies
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It took be about a year to get my fasting BG below 100. I just kept the carbs under 50 grams daily and finally got an A1C test and it came back 5.0 after nearly 3 years of LCHF.
I look at my trend lines instead of absolute numbers. As long as I am moving towards better health and better labs I do not stress.
We are all different and starting from different states of health.9 -
I am having the same issue with my fasting blood sugar's. My A-1 C is 5.0 but my fasting blood sugar is now going up to 125 and it's taking a lot of fasting to get it under 100. I'm not quite sure what's going on either because I eating very very healthy way. I hope that just keep working at it and then the fasting blood sugar's will normalize1
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Been keto 4 months and have found if I eat too much protein, it will affect my BG reading that next morning.2
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How long have you had type 2 diabetes? Are you taking any type of medicine for it or just trying to manage with diet?2
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According to a site I just read, "fasting can actually raise cortisol levels. So in someone with blood sugar regulation issues, fasting can actually make them worse." I'm glad you asked this question. I'm going to have to see if my fasting bg is higher when I fast. I don't do it very often, just a couple of times a week. Mostly my "normal" fasting bg is below 100.
This is the site I read this on. I don't know if it's woo or not. https://chriskresser.com/intermittent-fasting-cortisol-and-blood-sugar/3 -
Glucose reading are a puzzle. Sometimes you just get a high one for no apparent good reason.
There does not seem to be a "one size fits all" set of recommendations with many things like protein and sweeteners. It takes trying and checking the glucose to see.
For me the LC has been like a miracle. When I was diagnosed, I had an A1C of 12.8. After less than a year of LC and metformin (1000 mg generic twice a day), my A1C was 5.5. My doctor changed the metformin to 1000 mg once a day, and I am staying with the <20 g carbs a day. MySugr claims my predicted A1C is 5.4, and my 90-day average is 108.
I have lost weight (which helps things), but the LC has made that fairly easy for me compared to other weight loss attempts over the years. The T2D diagnosis gave me a lot of incentive, but I credit the LC diet with having really transformed my health in a couple of areas.4 -
For the ladies among us, remember that menstrual cycles can affect glucose readings.3
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Sabine_Stroehm wrote: »For the ladies among us, remember that menstrual cycles can affect glucose readings.
Really? I did not know this. It's definitely close to SW. Thanks!GaleHawkins wrote: »It took be about a year to get my fasting BG below 100. I just kept the carbs under 50 grams daily and finally got an A1C test and it came back 5.0 after nearly 3 years of LCHF.
I look at my trend lines instead of absolute numbers. As long as I am moving towards better health and better labs I do not stress.
We are all different and starting from different states of health.
Yeah, I'm not taking a flying leap off the train this time and am perfectly happy these days. I'm hoping things just continue to get better; that seems to be the case with most. You are definitely an inspiration!midwesterner85 wrote: »How long have you had type 2 diabetes? Are you taking any type of medicine for it or just trying to manage with diet?
I was diagnosed just over two years ago. Initially I was on metformin, went low carb and my a1c went down to 5.4 after 5 months? Somewhere around there, so my Dr. agreed that I was doing great managing with diet and took me off. Well... that didn't go well since I didn't stick with things. He was still optimistic in November about the WL again and my numbers at that time were pretty good even after just a month of keto, so after getting fussed at, he still didn't re-up my prescription. I see him again in January. I didn't mind metformin and am half way considering asking to be put back on regardless since it seems to help with a lot of other things too.Jigglypuff00 wrote: »According to a site I just read, "fasting can actually raise cortisol levels. So in someone with blood sugar regulation issues, fasting can actually make them worse." I'm glad you asked this question. I'm going to have to see if my fasting bg is higher when I fast. I don't do it very often, just a couple of times a week. Mostly my "normal" fasting bg is below 100.
This is the site I read this on. I don't know if it's woo or not. https://chriskresser.com/intermittent-fasting-cortisol-and-blood-sugar/
Thanks! I'm not fasting as long today due to our Christmas work party so I'm going to do some testing. I'd also read that fasting was bad on the BS because the body tends to want a certain amount of glucose in the blood while fasting and that amount is normally higher for diabetics. As you said, so much woo out there it's hard to really know.
Maybe it's just going to be wonky for a while and I just need to give it more time. I feel great! I don't think it's protein. It could be I guess, but most days it's under 100 grams, on average in the 70's.
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For now, it might be worthwhile to get back on metformin. Metformin inhibits glycogen release, so it would help if you are seeing a dawn phenomenon-type response while fasting (the cortisol issue @Jigglypuff00 mentioned). It also might be worthwhile to trend BG for a few days to see if you are seeing a rise several hours after fasting or if you are still running high from the previous meal. In the case of the latter, there is possibly more going on.
How much weight do you have left to lose?2 -
55 lbs
I was really kinda surprised he didn't put me back on met in November since he was very gung ho about it before. I don't think it's running high from my nightly meal, usually by bed time it's in normal after meal levels and dropping. I'm definitely having dawn phenomenon issues though. Only a few more weeks till I see him again and I'll bring up the met then.
On a happy note, at least he's very pro low carb/keto. His entire office was on a low carb diet in November.2 -
Assuming bedtime is at least 3 hrs. after dinner and you are testing even higher after fasting for several more hours; I can't see any other explanation aside from dawn phenomenon / glycogen release issues.
The metformin should definitely help, and you might find that getting closer to your goal weight makes some difference as well... but in the meantime, stay low carb and look at taking metformin again.0 -
@chaoticdreams - It's possible that the doctor may not have seen the more recent note in your chart about having taken you off Metformin, and he still thought you were on it, from when he remembers putting you on it. Unless you specifically discussed you not taking it, doctors sometimes miss small notes about that - because they do keep most of their T2D patients on Metformin, even as they improve...and he distinctly remembered putting you on it originally, etc. Sadly, they only have a few moments to review the case and refresh their minds on each specific patient given the hundreds they see in any given day/week/month... It's always a good idea to go back over ANY concern you have, just to double check both your memory and your doctor's memory...2
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Jigglypuff00 wrote: »According to a site I just read, "fasting can actually raise cortisol levels. So in someone with blood sugar regulation issues, fasting can actually make them worse." I'm glad you asked this question. I'm going to have to see if my fasting bg is higher when I fast. I don't do it very often, just a couple of times a week. Mostly my "normal" fasting bg is below 100.
This is the site I read this on. I don't know if it's woo or not. https://chriskresser.com/intermittent-fasting-cortisol-and-blood-sugar/
I would agree this is a possibility. It is not one size fits all. And, you have to look at longer term markers. I know when I eat 3x a day, my in between meals drops lower. When I fast for 2 or more days, my BG can stay around 105 the whole time and then 2-3 hours after my first meal drop down into the low 90's.
Whether I fast or not, my A1c has stayed consistent, so the more frequent bumps from eating (although not very high given how low my carb intake is) seems to be counterbalanced by lower lows when I eat more frequently to the point that the average stays the same.
Fasting (IF or longer term) can be very helpful for some, but, like nearly everything else, it isn't for everyone.3 -
ok so my doctor told me she is happy if my fasting blood sugar is under 140 , so my 115 to 136 has been amazing , my A1c was 9.2 and my daily sugars were 200 to 300 , so this low carb , high fat and protein has been amazing , I have a lot to lose too. So i won't be trying to hit 100 or less , unless she says later I should . I am eating under 20 carbs a day . I am real excited to see my new A1c in april .6
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tammyfranks2 wrote: »ok so my doctor told me she is happy if my fasting blood sugar is under 140 , so my 115 to 136 has been amazing , my A1c was 9.2 and my daily sugars were 200 to 300 , so this low carb , high fat and protein has been amazing , I have a lot to lose too. So i won't be trying to hit 100 or less , unless she says later I should . I am eating under 20 carbs a day . I am real excited to see my new A1c in april .
Stay the course. Since my doctor took me off the metformin in January, my glucose numbers have been creeping up. By that I mean 120(ish) on rising and 130's after meals. This has been discouraging for me, but I will see what the next A1C is. I am doing this with diet alone and no meds for now. It might be time for me to go back on metformin at the next appointment. I will have to see.3 -
tammyfranks2 wrote: »ok so my doctor told me she is happy if my fasting blood sugar is under 140 , so my 115 to 136 has been amazing , my A1c was 9.2 and my daily sugars were 200 to 300 , so this low carb , high fat and protein has been amazing , I have a lot to lose too. So i won't be trying to hit 100 or less , unless she says later I should . I am eating under 20 carbs a day . I am real excited to see my new A1c in april .
Hmm. Not about your great progress (nice going!), but about your doctor's "happiness" threshold.
The risk of many diabetes-related complications starts to climb around BG=140 (heart trouble, kidney disease, nerve damage...). So I would want my doctor to give me a good reason - other than the doctor's guess as to what I can handle psychologically - as to why such a high base level would make her happy.....
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agree w/ @RalfLott. Docs and American Diabetes Assoc. set that threshold much too high. You do need to understand if A1C is over 7% you are still at a high risk for severe, life-threatening diabetic complications. I found out an old friend has full kidney failure. She said, but I did what the doctor told me and kept A1C < 7%. That's not enough.
@tammyfranks2 I know you need to have achievable goals and that may be all that your doctor thinks you can do at the moment. It is a huge step in the right direction to go from 200-300 down to 115-136! Congratulations for achieving that! It does lower your risk, but you are still at risk. Don't accept 140 fasting as an end goal. Ask your doctor what blood glucose levels will keep you from getting sick?chaoticdreams wrote: »I mean 127 is awesome compared to the 200 it was 3 months ago, but isn't that still really high for fasting? Should I be concerned at all or just keep calm and low carb on?
From all I have read, fasting should lower blood glucose, and longer fasting will lower it more. But also, you didn't become diabetic overnight and that problem won't just go away tomorrow. You have made a substantial improvement in just a few months and your doctor should be very happy with that.
Keep up the good work! It may take a few more months of diligent low carb diet to reach normal fasting blood sugar, but it should be achievable with low carb, moderate protein diet.
I started at A1C of 11.7% and was immediately put on insulin. It took months to get low enough A1C to stop insulin, and I am currently at 6.4% without insulin, taking Xigduo. my goal is to get off all meds this year and maintain a totally normal A1C level of <4.8%.
I'm watching Dr. Bernstein Diabetes University (look for the 121 episode playlist). It has been full of really interesting information. Some of the episodes only apply to insulin dependent Type 1, but there is so much that I needed to know and my doctor didn't care enough to tell me.
https://www.youtube.com/watch?v=WFNGdKSXx64&list=PLs_TA02I6IvV6-1s2pL4BPhvMo0Ck_lcY 6 -
@catherineg3 -
Lots of good points, especially the encouraging observation that blood glucose will continue to drift down over time. FF 6 or 12 months while following the same manageable LC blueprint and things might look pretty rosy!2 -
Love Dr. Bernstein! I'm halfway through his "Diabetes Solution" book and have learned so much! I highly recommend his info.2
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@tammyfranks2 - progress is progress. You didn't get high BG overnight, and for many of us, it takes a while to get it down. I have been low carb for almost 2 years and keto since August 2016. I had an initial stair step down but then held steady at an A1c of 6 and morning BG around 110.
I have tinkered here and there and lately, I have gotten several readings below 100 in the morning including an 80 this morning. I am hoping this is another stair step drop, but too early for me to tell yet.
I dropped almost all dairy except ghee, butter, HWC and very very small amounts of cheese. I also cut out nuts. It will suck if I have to keep both of those out of my diet long term, but, if that was the catalyst for this latest drop, it is what it is.
Hang in there and remember this is a marathon and not a sprint. If you want proof this works, just check out the latest results from Virta Health at the 1 year mark of the 5 year study - https://www.virtahealth.com/research4
