Can your HbA1c keep going down?

[SunnyExpat]

Just like to point out that this may be true in the context of low carb/moderate fats diet, but those on ketogenic diet and striving to be keto adpated would view this a little differently...because they believe that eventually even the brain will be keto-adapted.
http://www.ketotic.org/2012/05/keto-adaptation-what-it-is-and-how-to.html

"When glycogen runs out, you start producing ketones, and some are excreted in the urine. This is easy to measure, and some keto dieters use it to know if they are hitting a low enough level of carbohydrate restriction. This also marks the beginning of the second stage of keto-adaptation. Ketones are now becoming available for fuel, but they haven't yet risen to their stable adapted level. There is an interesting interplay between ketone use in the muscles and the brain. When ketone levels are low, the muscles tend to use them directly for fuel, but as levels increase, the muscles use them less, turning to fat for fuel instead. The brain, on the other hand, uses ketones proportionally to their concentration in the blood. This means that at low levels of ketones, the brain's supply is not much affected, because the muscles intercede, but above some threshold, the brain's supply rapidly becomes much higher. At this point, the brain can rely on ketones, and since it is no longer susceptible to running out of fuel, the need to eat frequently throughout the day to maintain mental function disappears. The muscles in turn now rely on fat: they finally have access to a virtually unlimited supply of energy, which is particularly valuable for athletes."

I've seen that before.

I've always wondered, where do athletes store the ketones?

Most sports, the body has reserves so when blood sugar goes low, the liver dumps, and can be quickly replenished, then in turn replenished from a high energy food.
Ketones are converted from fat, so does that mean any sudden impact sport has a massive dip while the body converts fat into ketones again, to 'restock' the blood as it were?

So although there may be a massive stockpile of fat reserves to draw on, how does it help, unless it's for a low impact sport, that doesn't require much impact.
Ie, is it ok for a marathon runner, but no use for a power lifter?

 

[Oldvatr]

Yes, indeed. Keto diets have been used since 1922 for control of siezures in children, and although much of the evidence is anecdotal and not covered by RTC studies, there is evidence that a NC diet is possible. I include an article I found that gives a nice well presented discourse on this
http://www.neurorexia.com/2013/03/2...ular-neuroscience-look-at-the-ketogenic-diet/

ETA; Another somewhat technical article, but informative:
http://jissn.biomedcentral.com/articles/10.1186/1550-2783-1-2-7

Having thought about this for a while, I still think there is a lower limit below which we should not allow our bgl to drop. I can understand Zero Carbs is theoretically possiblem but v. difficult to achieve. However, for ketosis to occur, we need the amino acids to regulate the process. These essential bodies are synthesised from protein, so protein needs to be remaining in our diets. That said, the gluconeogenesis process will kick in and synthesise protein into glucogen, and this will lead to an HbA1c that is nonzero. I think it would be exceedingly dangerous to cut both carbs and protein to the extent that ketosis will no longer occur, I believe this is termed starvation.
The other aspect of zero carbing is that there is serious loss of sources of many micronutrients that we get from our carbs, and these minerals and vits may need supplementation if we drop our carbs too low. We also get dietary fibre from carbs, so that too would need supplementation as well.
I still maintain that there is a practical lower limit to HbA1c. Note, in this discourseI have ignored the use of hypoglycemic medication that can artificially drop bgls too low, but this is a transient condition that should not greatly influence a 3 month average. None the less, while such medication is in place, then carb intake will be needed. As a T2D this is an option for me to consider, but not if I was insulin dependant.

 

[annalaix]

Congratulations on your success, I don't know the answer but maybe you can incorporate some carbs back into your system. healthy carbs of course! Good luck.

Anna.

 

[Lizzie2]

Congratulations on your success, I don't know the answer but maybe you can incorporate some carbs back into your system. healthy carbs of course! Good luck.

Anna.

Thank you. I was really surprised - and relieved because I think I need some sort of carbs - at how many carbs I'm actually eating - they're just from better sources.

 

[Sid Bonkers]

Hi @Lizzie2 my hba1c has gone from 42 to 36 in the last 18 months however I was told by my DN that once a diabetic always a diabetic!
@Sid Bonkers when I told my DN that I was testing my BG with a meter her response was 'why do you want to give yourself sore fingers?' - some much for honesty!!

I would have said that it didnt give me sore fingers it just told me what different foods did to me bg levels but Ive always found that a good working relationship with my health care team based on truth and trust is always best, but that could just be me

 

[Sid Bonkers]

It's ok Sid, no porkies at all...

That all sounds good to me, I just have one test a year now too

 

[kokhongw]

Ie, is it ok for a marathon runner, but no use for a power lifter?

That's a good question. From the way most keto adapt advocate puts it. I tend to think that is the case. Seem more advantageous for endurance sports.

 

[TomGreen101]

I don't count carbs but estimate them for calculating NovoRapid units before meals and snacks. So far it's been very good.
Yes once a diabetic, always a diabetic.
To me you have a choice, to curb your food choices or medicate to keep your BG in line. I chose to medicate and eat what I like.
I use Accu Chck Mobile but am testing the new Accu Chck Connect . It wordlessly downloads your test results and sends a text message to whom ever you like. So far I'm very impressed. The reports need some tweaking but are very good.
I've tested at least a dozen meters and I really like the Connect