A few doubts regarding low carb and blood glucose

[D@n1el]

Hi,
I am a lean prediabetic (BMI = 20,2), my exams show no insulin resistance (HOMA-IR = 1.00) but they do suggest beta cell dysfunction (HOMA-Beta = 44.26). I am not taking medication now, my doctor said we should first try to get it all under control with lifestyle changes. I am going to the gym 5 times a week, and I am jogging 40 minutes at 10 km/h (= 6.21 mph), 3 times a week. A radical change.

So I've become interested in low carb and intermittent fasting diet, mainly by reading Dr. Fung's work and dietdoctor.com. I've been eating 20g-40g of carbs a day (usually <30g of carbs, +-120g of protein, +- 150g of healthy fat). I've been doing this for more than a month, and I was able to combine it with 16:8 fasting every day (eTRF, I eat between 5am and 1pm).

I've noticed some cool changes: clearer mind, better sleep (I was suffering from maintenance insomnia, not anymore), more energy. I don't think too much about food anymore, and I have absolutely no cravings for carb. I do get signs I might be on ketosis: sweet breath, very mild muscle cramps, better focus, satiety, acetone smelling urine.

Since about two weeks ago, I've noticed my fasting glucose is somewhat higher, systematically.
I get 105 mg/dL (5.8 mmol/l), even 108mg/dL (5.9 mmol/l). Before that, and during the initial stages of low carb, intermittent fasting and physical activity, there were days I would finally get "normal" fasting glucose levels, like 90 mg/dL (4.99 mmol/l). Before low carb and fasting, I would get 101 mg/dL (5.6 mmol/l).

I suppose this is more or less normal, I've read about "adaptive glucose sparring" and Dr. Fung states that fasting may raise blood glucose.

But I do have some doubts. Here they are (sorry for the long introduction!):

1) Is Low Carb supposed to help glucose control in my case (lean body, no apparent insulin resistance, signs of beta-cell dysfunction) ?

2) If I persist with Low Carb and 16:8 intermittent fasting (not a burden at all to me, I enjoy it!), is it likely that I will have better long term results?

3) I have no intention of losing much more weight. If I get enough fat so I keep it stable, will I still get the benefits I need (glucose control) from low carb and intermittent fasting?

What I do fear is that I might making my situation worse. I suppose not, but just checking anyway.

Thanks!

 

[HSSS]

To the best of my knowledge type 2 (and prediabetes is prediabetic of type 2) would involve insulin resistance almost by definition. Lack of such and beta cell deficiency would more likely be attributed to something like LADA. I might be totally wrong and would be interested what others think.

that said low carb will likely help keep your remaining beta cells less stressed and prolong any honeymoon period possibly significantly if it is LADA and help it ifs type 2. And if you enjoy it then it’s a win all round. Long term will depend of the cause of your issues. Yes adding fats, and for some protein, is how to maintain or even gain whilst keeping carbs low and maintaining the benefits.

 

[jjraak]

A good point, @HSSS

As for the o/p query re numbers.

Even as a TOFI.. (thin on the outside, fat on the inside)
the fat you can't get rid of, because of the T2
Still gets stored in places you don't want or need it.. The internal organs.

As I understand it, stop putting in more carbs, and the body then gets a chance to transport out the excess already within..aka glucose and internal fats.

Perhaps that explains why the carb input v fbg doesn't always match up to our expectations.
(Yours btw. Look really good )

Add in the DP liver dump to match what our bodies 'expect' us to need to start the day
(Based on its previous experience of our diets, which is now changing).. It's no wonder it's the last number to fall into line.

 

[Mbaker]

Great results.

Low carb does help blood glucose control. You might want to place some focus on post prandial rises, at 30, 60, 90 and180 minutes, I like mine to be less than 1.5 mmol, some others 2.0.

Sticking to the programme and tweaking only 1 item at a time is a good idea, whilst documenting what you did (I wish I did this more in the early stages).

I believe once you are fat adapted i.e. not hungry and can do either 1 or 2 meals a day through choice, wholr animal based protein should be the focus, as you get enough fat from this and you will burn body fat easily. I believe it is important to focus on visceral fat removal.

You are clearly very fit running the times you do. In your shoes I would pull back a little and do the same volume (time wise) and put more into resistance training. You will then get more free up take of glucose via the non insulin pathway of Glut 4 receptors within the muscle; focusing on the legs is key, but I do a mixture of power lifting and every muscle group resistance.