Why Do I Have Glucose Spikes?

[PrancingPony]

Keeping it short. I used keto diet to lose weight and was doing fine. One day I decided it to be enough but I kept losing weight nonetheless. I went to a doc about it and he tested me for diabetes. I had normal fasting and A1c. He sent me for a GTT which I failed and it prompted him to send me to an endo. The endo repeated GTT and I failed it. He tested for type 1. One item that stood out was a bit below normal c-peptide but I had normal blood glucose at a time of measurement. I was sent to a hospital under his supervision to observe how my blood glucose works. I was discharged with diagnosis of being healthy.

I was told to reintroroduce carbs and see what happens. I observe glucose spikes going to 10+ mmol/l for the past two weeks, where I have read that it takes a while for the pancreas to wake up. Does this mean I am meant to continue this and see if it changes or two weeks was enough and I am actually harming myself and there is something else going wrong? As I said, the only measurement that was bad is c-peptide. I do not think it is insulin resistance since my insulin is low on keto diet, which probably means I need very little insulin to keep the BG normal. It is when subjected to glucose load, when I see weird spikes.

Any scientific advice is appreciated. My last a1c was 4.6%.

 

[DCUKMod]

Keeping it short. I used keto diet to lose weight and was doing fine. One day I decided it to be enough but I kept losing weight nonetheless. I went to a doc about it and he tested me for diabetes. I had normal fasting and A1c. He sent me for a GTT which I failed and it prompted him to send me to an endo. The endo repeated GTT and I failed it. He tested for type 1. One item that stood out was a bit below normal c-peptide but I had normal blood glucose at a time of measurement. I was sent to a hospital under his supervision to observe how my blood glucose works. I was discharged with diagnosis of being healthy.

I was told to reintroroduce carbs and see what happens. I observe glucose spikes going to 10+ mmol/l for the past two weeks, where I have read that it takes a while for the pancreas to wake up. Does this mean I am meant to continue this and see if it changes or two weeks was enough and I am actually harming myself and there is something else going wrong? As I said, the only measurement that was bad is c-peptide. I do not think it is insulin resistance since my insulin is low on keto diet, which probably means I need very little insulin to keep the BG normal. It is when subjected to glucose load, when I see weird spikes.

Any scientific advice is appreciated. My last a1c was 4.6%.

Hi there PrancingPony - Did you carry on with your keto diet, right up to the GTTs you did? If you did, that could have been a contributory factor in your failing to pass it, because your body could have been "caught out" by the carb hit.

Our systems work to habit to an extent, so our digestive systems generate the amount of enzymes it's been used to, to cope with the usual diet, and it can take a few days for it to sort that out.

When are you actually seeing those spikes, in relation to when you are eating?

Some people do take some time to balance out their weight loss when following an LC or keto diet. I was one of those. It took several weeks to get my balance right.

I wouldn't like to comment too much on your C-Peptide test as I don't have much wisdom to offer you.

 

[PrancingPony]

Hi there PrancingPony - Did you carry on with your keto diet, right up to the GTTs you did? If you did, that could have been a contributory factor in your failing to pass it, because your body could have been "caught out" by the carb hit.

Our systems work to habit to an extent, so our digestive systems generate the amount of enzymes it's been used to, to cope with the usual diet, and it can take a few days for it to sort that out.

When are you actually seeing those spikes, in relation to when you are eating?

Some people do take some time to balance out their weight loss when following an LC or keto diet. I was one of those. It took several weeks to get my balance right.

I wouldn't like to comment too much on your C-Peptide test as I don't have much wisdom to offer you.

Yes, I was on the keto diet. One hour after meals.

 

[DCUKMod]

Yes, I was on the keto diet. One hour after meals.

It's worth you doing some reading, because if you arre eating carbs again, then that could explain the quick-order rises. Many non-diabetic folks have spikes, but snap back into line quickly. What are those readings a further hour later? I expect they would mainly be back close to your pre-meal test level.

 

[Alison54321]

There was a thread posted yesterday, based on a news story, about non-diabetics having blood glucose spikes after eating. Quite a few of them do, apparently.

https://www.diabetes.co.uk/forum/th...-people-without-diabetes.154588/#post-1846549

I suppose, if you're worried, that it's worth exploring the spike more, how long does it last, how much does it vary, dependent on how many carbs you eat? then do your own cost benefit analysis, and decide how much of a glucose spike you consider to be acceptable, relative to how many carbs you want to eat.

If, say, a meal of 40g carbs gives you just a small spike, and a meal you enjoy, then maybe just accept it. But then maybe, perhaps avoid more carbs, and higher spikes.

I think maybe you have to decide how much a spike is ok from your perspective.

 

[PrancingPony]

It's worth you doing some reading, because if you arre eating carbs again, then that could explain the quick-order rises. Many non-diabetic folks have spikes, but snap back into line quickly. What are those readings a further hour later? I expect they would mainly be back close to your pre-meal test level.

They are not back to pre-meal levels. They hover around 7-8 mmol/l sometimes higher at 2 hours, in other words my body does not reduce glucose in my blood to the second hour from the first very well. I do not understand what is considered a spike though. I have caught my brother to reach 10.2 mmol/l after tons of rice and tortillas. I read some studies and people don't go above 7.8 mmol/l usually. It is as if our pancreas kicks in too late, or are mostly asleep until glucose load is way above 7.8 mmol/l.

 

[DCUKMod]

They are not back to pre-meal levels. They hover around 7-8 mmol/l sometimes higher at 2 hours, in other words my body does not reduce glucose in my blood to the second hour from the first very well. I do not understand what is considered a spike though. I have caught my brother to reach 10.2 mmol/l after tons of rice and tortillas. I read some studies and people don't go above 7.8 mmol/l usually. It is as if our pancreas kicks in too late, or are mostly asleep until glucose load is way above 7.8 mmol/l.

Personally, I believe the understanding of normoglycaemia isn't incredibly well developed yet. Not too many studies have been done on normoglycaemia, and those that have have likely had the usual tight qualifying parameters meaning the study cohort is quite specific in it's make up and not necessarily representative of real life of real people, going about their day-to-day business. The Freestyle Libre is a bit of a game-changer in this respect in it's modest cost and therefore relative viability in studies.

My take for you, at the moment (and these are my personal viewpoint, not that of a medical professional) is that you get on with your life, but keep a weather eye on things. Your A1c is excellent, so your average blood sugar is way, way into the normal range, with the average suggesting any excursions from that to be relatively brief.

Should you elect, or be advised, to have another GTT, I would suggest that you follow the standard protocols for that; i.e. consuming at least 130gr carb per day for several days beforehand, so that the result isn't potentially skewed by that.

If your dialances with higher than you like blood glucose events were longer lasting it is highly your A1c would reflectis more than the current level suggests.

The only caveats I would add would be to just mention that A1cs can vary in individuals who are anaemic, have certain blood or renal conditions. In those instances fructosamine or glycated albumin tests are used, but those are certainly not the norms in day-to-day investigations.

 

[PrancingPony]

The endo did fructosamine test and said it was normal. I do not know the value he had. I think that my A1c might indicate low glycation because I usually see the BG level of 5.2 mmol/l while my A1c being 4.6% means 4.8. I have quite high RBC though, consistently, hence don't have anaemia and this kind of goes against the fact that lots of RBCs should mean A1c that might be over-glycated. I think my A1c is almost correct. And yes, this is what I do: eat plenty of fats, protein and mostly low-carb vegetables and life is okay so far...thanks for your detailed input.

 

[Lamont D]

The endo did fructosamine test and said it was normal. I do not know the value he had. I think that my A1c might indicate low glycation because I usually see the BG level of 5.2 mmol/l while my A1c being 4.6% means 4.8. I have quite high RBC though, consistently, hence don't have anaemia and this kind of goes against the fact that lots of RBCs should mean A1c that might be over-glycated. I think my A1c is almost correct. And yes, this is what I do: eat plenty of fats, protein and mostly low-carb vegetables and life is okay so far...thanks for your detailed input.

Hi there, and welcome to the forum.
Was both of your glucose tests, two hours long?
Have you ever tested past the two hours?
Do you keep a food diary?
Other than your first post, do you have any other symptoms or other conditions or on meds that could distort the readings?

I have a condition where those readings are similar to mine, fasting, and high spikes after eating. But I don't believe you have my condition, I can't diagnose you but I can help with how to go forward. I have a type of hypoglycaemia, but you have not mentioned symptoms of a hypoglycaemic episode.

We have our own forum, you may wish to read it.

Best wishes

 

[PrancingPony]

Hi there, and welcome to the forum.
Was both of your glucose tests, two hours long?
Have you ever tested past the two hours?
Do you keep a food diary?
Other than your first post, do you have any other symptoms or other conditions or on meds that could distort the readings?

I have a condition where those readings are similar to mine, fasting, and high spikes after eating. But I don't believe you have my condition, I can't diagnose you but I can help with how to go forward. I have a type of hypoglycaemia, but you have not mentioned symptoms of a hypoglycaemic episode.

We have our own forum, you may wish to read it.

Best wishes

Two hours. After second one, I crashed to 3.8 by hour 3.
Yes, I get down to pre-meal eventually.
I do not keep food diary because I eat same things every day.
I am on antidepressants, but I had those episodes before I got on them.

I do not have hypoglycaemic episodes in my opinion, and according to my meter.

 

[Lamont D]

Two hours. After second one, I crashed to 3.8 by hour 3.
Yes, I get down to pre-meal eventually.
I do not keep food diary because I eat same things every day.
I am on antidepressants, but I had those episodes before I got on them.

I do not have hypoglycaemic episodes in my opinion, and according to my meter.

Okay, I did say that you probably don't have Hypoglycaemia, but there are similar conditions as mine that mimic symptoms and have the results you have posted.
If you had crashed to 3.8 after 3 hours, do you know for definite that you could possibly go lower or your body naturally corrected your blood glucose levels?

As I said there are many types of Hypoglycaemia, and unless tested for them, you may not know if you are, because I didn't! I was misdiagnosed T2, nearly ten years ago, then I knew in 2012, I knew there was something else happening to me, with normal fasting blood glucose levels. That is what my meter was telling me.

You cannot be diabetic, unless you are in remission with normal fasting Hba1c levels.
With the high spikes you are recording, but you get back to normal after 3 hours.
That sounds to me, like your initial insulin response is weaker than it should be.
You are having the same food every day, that spike you. Can you give us an idea why and what you are having?

There is something going on which needs sorting, your meter says so.
Most GPs and endocrinologists are unaware of certain metabolic conditions, it wouldn't hurt to read up on hypoglycaemia even if you are not getting the episodes of Hypoglycaemia.

Why are you on anti depressants, if you don't mind asking?
I ask because, symptoms of fluctuating blood levels can give you certain mental health issues, mine were anxiety, forgetfulness, memory and a certain low level depression.

I was in the same situation as you, where my doctors couldn't work out what was wrong with me. I hope you get it sorted.

Best wishes

 

[PrancingPony]

Okay, I did say that you probably don't have Hypoglycaemia, but there are similar conditions as mine that mimic symptoms and have the results you have posted.
If you had crashed to 3.8 after 3 hours, do you know for definite that you could possibly go lower or your body naturally corrected your blood glucose levels?

As I said there are many types of Hypoglycaemia, and unless tested for them, you may not know if you are, because I didn't! I was misdiagnosed T2, nearly ten years ago, then I knew in 2012, I knew there was something else happening to me, with normal fasting blood glucose levels. That is what my meter was telling me.

You cannot be diabetic, unless you are in remission with normal fasting Hba1c levels.
With the high spikes you are recording, but you get back to normal after 3 hours.
That sounds to me, like your initial insulin response is weaker than it should be.
You are having the same food every day, that spike you. Can you give us an idea why and what you are having?

There is something going on which needs sorting, your meter says so.
Most GPs and endocrinologists are unaware of certain metabolic conditions, it wouldn't hurt to read up on hypoglycaemia even if you are not getting the episodes of Hypoglycaemia.

Why are you on anti depressants, if you don't mind asking?
I ask because, symptoms of fluctuating blood levels can give you certain mental health issues, mine were anxiety, forgetfulness, memory and a certain low level depression.

I was in the same situation as you, where my doctors couldn't work out what was wrong with me. I hope you get it sorted.

Best wishes

I think it was natural correction, I was not given insulin. I could maybe buy myself a FreeStyle Libre and just walk for a month with it and chart every day and see what happens. In my experience, I would see a flat curve between 4 and 6.5 mmol/l most of the time on keto. But you never know...

I was told that diabetes is not my problem and my failure on GTTs was because of my body being adapted to low carbs intake. When I was given a bunch of that, my body had to produce the insulin. According to some study I read, the pancreas produces insulin and stores it but in an amount that was enough to remove glucose from previous meal. Hence, if I stay on keto, my insulin levels will be chronically low and the pancreas will be in hibernation or something like that. But this is just my theory I produced after reading some science, there were doctors who said it does not matter. If you fast and then eat a cake, you will still be able to remove glucose from your blood efficiently.

My insulin response is weaker. I have a theory why. For years I have an issue of digesting fats. Larger amounts make my stool color yellow. I also have something wrong with my sympathetic nervous system, where parasympathetic response is slow to kick in. Parasympathetic response is responsible for digestion. I have issues with sleep for years, I did not have good night's sleep for years. I suspect my lack of sleep leaves my body in constant tension mode, hence reducing my ability to digest food well. I went to an unconventional doctor who measures signals of organ systems (sounds like cooky pseudoscience, but she helped a ton of people who were beyond help of regular medicine). I was put on antidepressants because my nervous system was at "5 out of 5 tension". Essentially, there is something wrong and no one can tell me why. I live with being in a foggy brain state all the time because of my sleep issues. And it is not sleep apnea - already got tested.

 

[Lamont D]

I think it was natural correction, I was not given insulin. I could maybe buy myself a FreeStyle Libre and just walk for a month with it and chart every day and see what happens. In my experience, I would see a flat curve between 4 and 6.5 mmol/l most of the time on keto. But you never know...

I was told that diabetes is not my problem and my failure on GTTs was because of my body being adapted to low carbs intake. When I was given a bunch of that, my body had to produce the insulin. According to some study I read, the pancreas produces insulin and stores it but in an amount that was enough to remove glucose from previous meal. Hence, if I stay on keto, my insulin levels will be chronically low and the pancreas will be in hibernation or something like that. But this is just my theory I produced after reading some science, there were doctors who said it does not matter. If you fast and then eat a cake, you will still be able to remove glucose from your blood efficiently.

My insulin response is weaker. I have a theory why. For years I have an issue of digesting fats. Larger amounts make my stool color yellow. I also have something wrong with my sympathetic nervous system, where parasympathetic response is slow to kick in. Parasympathetic response is responsible for digestion. I have issues with sleep for years, I did not have good night's sleep for years. I suspect my lack of sleep leaves my body in constant tension mode, hence reducing my ability to digest food well. I went to an unconventional doctor who measures signals of organ systems (sounds like cooky pseudoscience, but she helped a ton of people who were beyond help of regular medicine). I was put on antidepressants because my nervous system was at "5 out of 5 tension". Essentially, there is something wrong and no one can tell me why. I live with being in a foggy brain state all the time because of my sleep issues. And it is not sleep apnea - already got tested.

I sympathise and empathise with your mental issues, that was me back five years ago, a lot of those years, I cannot remember or my memory never formed, mine was because my brain was constantly struggling for glucose due to hyperinsulinaemia and fluctuating blood glucose levels up and down all day, insulin is necessary, but too much for too often is really bad for your brain and how it functions, the brain fog you mention is just one of those high insulin symptoms.
I can and do walk around all day, my blood glucose levels are in ketosis and that is the only way I know how to control my condition and have my health.
Do you feel better on a ketogenic lifestyle?
I also have read those science papers, that says you need to eat carbs to get an insulin response, before glucose tolerance test, all my extended fasting glucose tests were done without carbs, I still got a high spike from the glucose. I eat meat and you still get a response from meat but not enough on my first insulin response.
We do have a lot in common, despite probably not having the same condition, it is metabolic, your metabolism is not right, your digestion is not right. The common theme continues because I too have had two sleep tests, apnoea tests, one was inconclusive, the other definitely not. My sleep deprivation is chronicled in my blog pages. I have had weird dreams that wake me, they are worse when I was on the wrong diet, it has since been a lot better since starting keto. It is symptomatic with high insulin levels. Having Hypoglycaemia, and fluctuating bloods.
But you don't have that, but something is causing those similar symptoms!

Best wishes