I'm wondering if anyone has any insight into the following.... I don't know whether to be excited or scared. Apologies for long post, please scroll over if not interested, but I'm hoping someone will be able to respond. Maybe the very knowledgeable @Brunneria
I've had T2D for 19 years and adopted LCHF 8 months ago. My HbA1C went from from 62 in August to 40 in November. It will almost certainly be lower at my next test in May. I have been on 1000mg metformin daily throughout this WOE.
I've been using the Freestyle Libre for a month, and it estimates my HbA1C at 31. I have very few readings outside the physiological normal range of 3.9-7.8, my biggest numbers are usually mid-morning due to dawn phenomenon. Between 2am and 6am my BG averages 4.8 and the highest point of the day is usually between 8-10am with an average of 6.2 (112). (These are the averages of all the readings the Libre has taken over those time periods in the last 30 days).
So, essentially, my BG is normal - though I do see a higher peak if I eat something a bit more carby. But I decided to have a fasting insulin test done as a marker of how much insulin resistance remains. I have lost 4 stone, but am still about 5 stone overweight, so I was expecting to still have high insulin levels. I used the website medichecks.com which sends a kit to collect a sample and then provides a Dr's comment on the result.
I took the sample after 12 hours fasting, water only. I took Libre readings before and after filling the sample for the insulin, and also finger pricks. The mean of the finger pricks was 7.0. I calculated the boundary conditions as 6.0 and 7.9 - as in, taking into account meter accuracy those are the highest and lowest numbers my BG could have been when I took the sample for fasting insulin.
My fasting insulin, in mIU/l was 1.1 - normal range is 2.6 to 24.9
Plugging these numbers into the equations for HOMA-IR equations gives me HOMA-IR in the range 0.29-0.39 (normal healthy young adult typically 1, higher number indicates insulin resistance) and HOMA-beta (i.e. % beta cell function) of between 5.0 and 8.8%!!!!!!
The first bit I like, the second I do not, not at all. Can it really be true that I have less than 10% of normal beta cell function? Or is this simply a consequence of eating keto?
When I filled the form in, I told them that I'm eating very low carb to manage diabetes and my blood glucose readings are now largely normal. This is the doctor's comment on my result:
"Your insulin level is low. Given your largely normal blood glucose readings this is likely to be a normal finding. This is sometimes a sign that a type 2 diabetic needs to commence insulin therapy, however blood glucose would normally be high in this situation"
So... is it possible that, despite still being obese, I have restored my insulin sensitivity to normal? Not only normal - but better than normal, as the HOMA-IR score suggests? And if my Beta cell function is as low as these numbers suggest, why does my BG not skyrocket as soon as I look at a carb? Maybe metabolism is different in someone who is fully keto-adapted, and the numbers don't apply, i.e. "normal" fasting insulin in someone who eats keto is lower than in a carb-eater.
I'd be interested to hear any insight. I have read that if you are going to have a glucose tolerance test, a low-carber needs to eat higher carb for a few days before taking it as otherwise they will fail. I wonder if this is the same phenomenon??
Someone might suggest, are you sure you are T2 - perhaps you are LADA or something. I was aged 34 at diagnosis, which is young - but also severely obese. And I'd have thought that if I was LADA, I would have progressed to needing insulin before now.
I've had T2D for 19 years and adopted LCHF 8 months ago. My HbA1C went from from 62 in August to 40 in November. It will almost certainly be lower at my next test in May. I have been on 1000mg metformin daily throughout this WOE.
I've been using the Freestyle Libre for a month, and it estimates my HbA1C at 31. I have very few readings outside the physiological normal range of 3.9-7.8, my biggest numbers are usually mid-morning due to dawn phenomenon. Between 2am and 6am my BG averages 4.8 and the highest point of the day is usually between 8-10am with an average of 6.2 (112). (These are the averages of all the readings the Libre has taken over those time periods in the last 30 days).
So, essentially, my BG is normal - though I do see a higher peak if I eat something a bit more carby. But I decided to have a fasting insulin test done as a marker of how much insulin resistance remains. I have lost 4 stone, but am still about 5 stone overweight, so I was expecting to still have high insulin levels. I used the website medichecks.com which sends a kit to collect a sample and then provides a Dr's comment on the result.
I took the sample after 12 hours fasting, water only. I took Libre readings before and after filling the sample for the insulin, and also finger pricks. The mean of the finger pricks was 7.0. I calculated the boundary conditions as 6.0 and 7.9 - as in, taking into account meter accuracy those are the highest and lowest numbers my BG could have been when I took the sample for fasting insulin.
My fasting insulin, in mIU/l was 1.1 - normal range is 2.6 to 24.9
Plugging these numbers into the equations for HOMA-IR equations gives me HOMA-IR in the range 0.29-0.39 (normal healthy young adult typically 1, higher number indicates insulin resistance) and HOMA-beta (i.e. % beta cell function) of between 5.0 and 8.8%!!!!!!
The first bit I like, the second I do not, not at all. Can it really be true that I have less than 10% of normal beta cell function? Or is this simply a consequence of eating keto?
When I filled the form in, I told them that I'm eating very low carb to manage diabetes and my blood glucose readings are now largely normal. This is the doctor's comment on my result:
"Your insulin level is low. Given your largely normal blood glucose readings this is likely to be a normal finding. This is sometimes a sign that a type 2 diabetic needs to commence insulin therapy, however blood glucose would normally be high in this situation"
So... is it possible that, despite still being obese, I have restored my insulin sensitivity to normal? Not only normal - but better than normal, as the HOMA-IR score suggests? And if my Beta cell function is as low as these numbers suggest, why does my BG not skyrocket as soon as I look at a carb? Maybe metabolism is different in someone who is fully keto-adapted, and the numbers don't apply, i.e. "normal" fasting insulin in someone who eats keto is lower than in a carb-eater.
I'd be interested to hear any insight. I have read that if you are going to have a glucose tolerance test, a low-carber needs to eat higher carb for a few days before taking it as otherwise they will fail. I wonder if this is the same phenomenon??
Someone might suggest, are you sure you are T2 - perhaps you are LADA or something. I was aged 34 at diagnosis, which is young - but also severely obese. And I'd have thought that if I was LADA, I would have progressed to needing insulin before now.
