Breaking Out of Insulin Resistance

[Triceraptors]

Hello guys, after consultation with endo and a couple of nights in the hospital, he concluded that over around 3 weeks period, where I was mostly eating very low carb and/or very little calories, I have induced severe insulin resistance in my body.

Here is what was done: c-peptide was low, but according to him, it is low because I was in fasted state and I was not eating carbs for weeks. I failed OGTT spectacularily which resulted in concerns about diabetes. The endo did the tests and I had normal fasting, hba1c and all antibodies known to mankind were negative against pancreas for type 1 diabetes. The behavior during OGTT was constant rise in blood sugar, up to 14 mmol/l at two hours. Then in one hour it dropped to 5.2 and 30 mins later I ended up hypoglycemic at 3.8. My cortisol is very high as well.

When I eat even not that much carbs, say a banana, I go straight to hyper again over 2 hours. I still get most of my calories from fat and protein. My endo told me to visit dietician in order to sort out my eating disorders and do gradual refeeding because it can drop electrolytes to dangerous levels and require an ambulance. Basically, it seems like my body repress insulin and also does not produce it that well being in VLC state. It is a bit scary, I don't know how to break out of this safely. I assume my pancreas is not shot because antibodies are all at 0 hence it is not type 1 or LADA. Is it safe assumption? Also, I am rather skeletal nowadays, and cannot possibly suffer type 2 diabetes from chronic insulin resistance, especially with lowish c-peptide. The endo thinks my pancreas is in hibernation and I am alive because of glucogenesis and my ketones in urine are **** high (3+, 4+).

How can I leave this messed up state? I feel really weak on this diet, I wake up wide awake after 3 hours of sleep and cannot sleep (high cortisol). I experience high postprandials after meals and am afraid of dumping more carbs into me because of possibility that insulin is not working AND muscles are rejecting glucose as well, which could lead to severe hyperglecemia as it did on OGTT.

Any experience in breaking this? Am I safe to assume that endo determined I really don't have diabetes accurately? For reference, my blood glucose thorough the night was 3.8, 4.1, 4.4, 5.2, 4.8 and hba1c is 4.9. I have no antibodies, all liver and kidney tests are perfect.

I have discovered that this guy https://high-fat-nutrition.blogspot.co.uk/2014/05/eat-as-much-starch-as-you-wish.html claims (CTRL-F "OGTT") his 75g glucose goes to 14 mmol/l because of insulin resistance and adaption to VLC diet.

Can you guys help me to safely break through this? I feel horrible, my cortisol is high, my mood is ****, I have headaches and cannot sleep well. Also constantly hungry and leaking ketones all over the place. It is pissing me off and I hope it is indeed not diabetes and physiological insulin resistance.

 

[ziggy_w]

Hi @Triceraptors,

I am so sorry reading that you are so upset and anxious.

Do you mind sharing some information? Were you diagnosed with diabetes? Or did you embark on a low-carb diet for other reasons?

Personally, I have been eating low-carb for the last two and a half years and my stats are similar to yours (haven't done an OGTT, cortisol, antibody, and c-peptide test, though, but would expect to get very similar results). My GP, who is also is an endo, isn't concerned, however.

What you are observing is the normal reaction to a low carb diet (maybe except for the cortisol, which - I expect - might decrease again as your body adapts to this type of diet. Initially, changing your metabolism, puts a lot of stress on your body and you are only 3 weeks in).

A very low-carb diet induces ketosis (that's why you have high urine ketones -- also because your body isn't fully adapted to using these ketones yet), the pancreas gets used to producing less insulin (last meal effect), so it initially produces less insulin in response to a high-carb load. However, given your low blood sugars only one hour after ingesting a high glucose load indicate that your pancreas is alive and kicking. So in my opinion (and I am not a doctor, or at least not one in medicine), you have nothing to worry about.

Would it be possible for you to consult another doctor -- one who is familiar with low-carb or ketogenic diets?

Probably -- if you were to continue on this low-carb diet, some of the issues with waking after three hours and feeling weak might resolve. However, if you really want to stop eating this way, my suggestion would be to increase your carbs gradually to transition more gradually. I am quite sure you have done any permanent damage to your metabolism (just my opinion, though).

 

[Triceraptors]

Hi @Triceraptors,

I am so sorry reading that you are so upset and anxious.

Do you mind sharing some information? Were you diagnosed with diabetes? Or did you embark on a low-carb diet for other reasons?

Personally, I have been eating low-carb for the last two and a half years and my stats are similar to yours (haven't done an OGTT, cortisol, antibody, and c-peptide test, though, but would expect to get very similar results). My GP, who is also is an endo, isn't concerned, however.

What you are observing is the normal reaction to a low carb diet (maybe except for the cortisol, which - I expect - might decrease again as your body adapts to this type of diet. Initially, changing your metabolism, puts a lot of stress on your body and you are only 3 weeks in).

A very low-carb diet induces ketosis (that's why you have high urine ketones -- also because your body isn't fully adapted to using these ketones yet), the pancreas gets used to producing less insulin (last meal effect), so it initially produces less insulin in response to a high-carb load. However, given your low blood sugars only one hour after ingesting a high glucose load indicate that your pancreas is alive and kicking. So in my opinion (and I am not a doctor, or at least not one in medicine), you have nothing to worry about.

Would it be possible for you to consult another doctor -- one who is familiar with low-carb or ketogenic diets?

Probably -- if you were to continue on this low-carb diet, some of the issues with waking after three hours and feeling weak might resolve. However, if you really want to stop eating this way, my suggestion would be to increase your carbs gradually to transition more gradually. I quite sure you have done any permanent damage to your metabolism (just my opinion, though).

I was not diagnosed with diabetes. The endocrinologist said none of the parameters show I am diabetic. I fell into low-carb accidently, then got some sweet taste in my mouth, ketones, loss of weight and got scared so took out all carbs for at least 2 weeks, and did not each much as well. Quite stupid, but I was anxious as hell. I was discharged from the hospital endo and another doctor telling me that this is severe insulin resistance induced by this lifestyle and I need a dietician to help me safely go back to normal metabolism.

He said that my OGTT was that insane because of muscles rejecting glucose and pancreas being lazy. By the way, I did not write it out clearly. My OGTT was bad. It shot up to 13.8 after 2 hours, then came down on its own to normal after around 3.5 hours. This is what scared me and the endo. This is why he put me into hospital for monitoring and he seems to be convinced this is not diabetes but insulin resistance.

I want to stop this madness and come back to eating my carbs. Reason why I quit them was concerns of diabetes and according to the endocrinologist, it is not my problem. Also, my c-peptide was lowish but it seems it matters only if fasting blood glucose is high, main was like 3.9 at a time.

I hope my doc is not wrong.

 

[ziggy_w]

Hi @Triceraptors,

Sorry, I misunderstood. Yes, what you were experiencing in my opionion is probably physiological insulin resistance, which can be reversed. Also, as you are not diabetic, there is really no need to severely cut carbs.

Try not to be too anxious -- I am sure everything will work itself out and you should be back to normal in a few weeks.

 

[andcol]

You are in starvation mode. You body stops processing glucose so that it can be diverted for the brain. That is why your OGTT was all over the place and your ketones are super high. When you drop the carbs you have to replace them with something else and you didnt as you also went on a fast.

 

[Triceraptors]

Hi @Triceraptors,

Sorry, I misunderstood. Yes, what you were experiencing in my opionion is probably physiological insulin resistance, which can be reversed. Also, as you are not diabetic, there is really no need to severely cut carbs.

Try not to be too anxious -- I am sure everything will work itself out and you should be back to normal in a few weeks.

No, it is my fault for writing incoherently. Yes, I am currently reading about it and it seems that this unintentional experiment clearly shown that low-carb is an absolute bane to my body. Now, whenever I eat a little bit of carbs, my blood glucose spikes up and makes me feel ******. I want this reversed because it is horrible.

You are in starvation mode. You body stops processing glucose so that it can be diverted for the brain. That is why your OGTT was all over the place and your ketones are super high. When you drop the carbs you have to replace them with something else and you didnt as you also went on a fast.

Yes, eventually I did replace them with heavy protein and fat intake. However, I am definitely not at even 1500 calories a day and still am afraid of putting too much carbs into the body because of glucose build up in blood. Not sure how to resolve it safely. Any thoughts?

 

[Freema]

Hello guys, after consultation with endo and a couple of nights in the hospital, he concluded that over around 3 weeks period, where I was mostly eating very low carb and/or very little calories, I have induced severe insulin resistance in my body.

Here is what was done: c-peptide was low, but according to him, it is low because I was in fasted state and I was not eating carbs for weeks. I failed OGTT spectacularily which resulted in concerns about diabetes. The endo did the tests and I had normal fasting, hba1c and all antibodies known to mankind were negative against pancreas for type 1 diabetes. The behavior during OGTT was constant rise in blood sugar, up to 14 mmol/l at two hours. Then in one hour it dropped to 5.2 and 30 mins later I ended up hypoglycemic at 3.8. My cortisol is very high as well.

When I eat even not that much carbs, say a banana, I go straight to hyper again over 2 hours. I still get most of my calories from fat and protein. My endo told me to visit dietician in order to sort out my eating disorders and do gradual refeeding because it can drop electrolytes to dangerous levels and require an ambulance. Basically, it seems like my body repress insulin and also does not produce it that well being in VLC state. It is a bit scary, I don't know how to break out of this safely. I assume my pancreas is not shot because antibodies are all at 0 hence it is not type 1 or LADA. Is it safe assumption? Also, I am rather skeletal nowadays, and cannot possibly suffer type 2 diabetes from chronic insulin resistance, especially with lowish c-peptide. The endo thinks my pancreas is in hibernation and I am alive because of glucogenesis and my ketones in urine are **** high (3+, 4+).

How can I leave this messed up state? I feel really weak on this diet, I wake up wide awake after 3 hours of sleep and cannot sleep (high cortisol). I experience high postprandials after meals and am afraid of dumping more carbs into me because of possibility that insulin is not working AND muscles are rejecting glucose as well, which could lead to severe hyperglecemia as it did on OGTT.

Any experience in breaking this? Am I safe to assume that endo determined I really don't have diabetes accurately? For reference, my blood glucose thorough the night was 3.8, 4.1, 4.4, 5.2, 4.8 and hba1c is 4.9. I have no antibodies, all liver and kidney tests are perfect.

I have discovered that this guy https://high-fat-nutrition.blogspot.co.uk/2014/05/eat-as-much-starch-as-you-wish.html claims (CTRL-F "OGTT") his 75g glucose goes to 14 mmol/l because of insulin resistance and adaption to VLC diet.

Can you guys help me to safely break through this? I feel horrible, my cortisol is high, my mood is ****, I have headaches and cannot sleep well. Also constantly hungry and leaking ketones all over the place. It is pissing me off and I hope it is indeed not diabetes and physiological insulin resistance.

very thin persons can also have servere insuline resistance...it is not only connected to obesity.. , I think I would advice you to try to deliberately gain muscles... it has helped med tremendously .... to get my blood glucose lower muh faster... and also has given me the possibillity to eat a lot more carbs, well not as many as I am many times tempted to eat .. but quite a lot more carbs than most type 2´s ... I think I have gained around 4 kg of muscles...
my personal theory is that muscles that are never used or hardly used also do not work as well when it comes to the symbiosis with the rest of the body by exchanging the different substances ; hormones macronutrients and vitamins and minerals... I think that getting muscles into optimal function and use do help the whole body..

https://bottomlineinc.com/health/medications/are-statin-drugs-destroying-your-muscles

 

[ziggy_w]

No, it is my fault for writing incoherently. Yes, I am currently reading about it and it seems that this unintentional experiment clearly shown that low-carb is an absolute bane to my body. Now, whenever I eat a little bit of carbs, my blood glucose spikes up and makes me feel ******. I want this reversed because it is horrible.



Yes, eventually I did replace them with heavy protein and fat intake. However, I am definitely not at even 1500 calories a day and still am afraid of putting too much carbs into the body because of glucose build up in blood. Not sure how to resolve it safely. Any thoughts?

Maybe, you could start with smallish portions of carbs which are processed more slowly, e.g. lentils, chick peas. Adding fat to the carbs slows down the increase in blood sugar levels even more -- thus leading to much lower, but longer peaks. Also, protein has a very similar profile on blood glucose (low and prolonged increase in blood sugar levels). This would probably lead to much more stable blood sugar levels and make you feel less "******".

If you decide to try this, let us know how it works for you.

 

[Triceraptors]

Maybe, you could start with smallish portions of carbs which are processed more slowly, e.g. lentils, chick peas. Adding fat to the carbs slows down the increase in blood sugar levels even more -- thus leading to much lower, but longer peaks. Also, protein has a very similar profile on blood glucose (low and prolonged increase in blood sugar levels). This would probably lead to much more stable blood sugar levels and make you feel less "******".

If you decide to try this, let us know how it works for you.

I am getting some of those and will see what happens. Thank you for advice.

 

[lucylocket61]

what dietary advice has your endo given you?

 

[Triceraptors]

what dietary advice has your endo given you?

"Eat normally". My normal used to be at least 150-200 grams of carbs a day. Otherwise, he said dietician is going to be very useful to gradually "refeed" myself safely. I am still in doubts about this whole thing. Internet has variety of opinions about whether people become more insulin resistant or not. According to endo, who did a Phd on fasting as well, seems he is convinced this is the case.

 

[lucylocket61]

"Eat normally". My normal used to be at least 150-200 grams of carbs a day. Otherwise, he said dietician is going to be very useful to gradually "refeed" myself safely. I am still in doubts about this whole thing. Internet has variety of opinions about whether people become more insulin resistant or not. According to endo, who did a Phd on fasting as well, seems he is convinced this is the case.

I suggest that you do as the endo has said and eat normally, as in, what a normal non-diabetic person would eat. Any tweaking can come later, when you are back to health.

 

[Diakat]

How about addressing your eating disorder with a professional as the endo suggested? We are not medics and cannot advise.

 

[Triceraptors]

Assuming this is correct data: http://freetheanimal.com/2014/03/reiterate-elevated-ketone.html

That explains a lot of my experiences.

 

[Triceraptors]

Does this sound correct?

"
Your body is undergoing gluconeogenesis excessively. xEva just mentioned the seemingly paradoxal effect of increasing carbohydrate intake on LOWERING blood sugar. This has to do with the fact that carbohydrates increase insulin and incretin hormones, which shuts of gluconeogenesis and transports glucose out of the blood. Fueling your body with greasy-protein (Ketogenic diet) forces your body to start synthesizing its own glucose. It does this by increasing catabolic-hormones like cortisol, glucagon, GH, catecholamine's and other hormones that turn protein into glucose. These hormones in excessive amounts also reduce insulin sensitivity, reducing the transport of glucose out of the blood.
"

My cortisol is very high even at day time. I was told my doctors that a bunch of such hormones repress insulin and severely reduce ability to transport glucose from the blood stream which means a build up of dangerous levels of glucose.

 

[ickihun]

Sounds like you have caused insulin resistance due to fasting, like the endo is saying.
I feed my insulin and injected insulin so i can convert into glucose as if i dont my body absorbes insulin but needs more insulin to convert even just a little bit of nourishment.
I dont over feed and add more insulin.
I have done severe diets in the past.
I am only well on 100-150g of carbs daily. My body likes that level the best.
I dont have everyone's answers to their bodies understanding of why its not doing this right.
My endo believes the right diet is definitely the key to helping with insulin resistance. My underactive thyroid too. My tsh improved on 100g carbs only.
However i am diabetic thou.

I'm guessing if you started eating 100g of carbs you would see exactly what your metabolism is doing.
A no carb diet must be life changing.
Does @NoCrbs4Me have a no carb diet with a successful metabolism?
I think nocrbs4me definitely eats thou. I dont think he fasts?

However just remember this is a diabetes forum rather than a keto forum.

 

[ickihun]

Cortisol is high due to your body fighting to survive. This is telling you your current diet isnt helpful. That is why your anxious. Your body is on high alert. Currently.

 

[Triceraptors]

This long post seem to tell exactly my experiences: http://www.longecity.org/forum/topi...lucose-after-low-carb-keto-diets/#entry715853

Except the guy did not do something crazy like OGTT and end up in ER.

 

[NoCrbs4Me]

Does @NoCrbs4Me have a no carb diet with a successful metabolism?
I think nocrbs4me definitely eats thou. I dont think he fasts?

I don't fast. While not quite "no carbs", my diet is pretty close to no carbs. I don't know haw successful it is - my blood glucose levels are in the normal range but I've still got some excess fat. When I do have something carby I seem to have a near normal response - i.e. my blood glucose rises, peaks after about an hour after eating the carbs, then drops back down to pre-meal levels about 2 hours after eating.

 

[lindisfel]

Why the heck would someone go on a low carb diet if they did not have a blood glucose anomaly like type 2 diabetes or Reactive Hypoglycemia? Perhaps I would do it if I developed a masochistic complex. Then again I know it stops my repeated hypos after meals.
People should not complain when they persecute themselves, they get no sympathy.
. D.