Everything gone up since strict keto :(

[lovinglife]

Had my first clinic today with DSN in my new GP surgery, I moved house in August and after being in the same practice for 57 years I had to change surgery.

I have been doing strict keto since January using the DD website for all my meals and menu planning and apart from 4 days in August when we moved and we were between houses I have stuck to it religiously, even then I didn't go too far from my plan.

Results today were very disappointing- Hba1c was up to 49 from 46, kidneys are leaking and blood pressure is up to 140/70 - I have never had blood pressure that high before, cholesterol is 7.8 but ratios still good. Weight stable but still too heavy

I am now on blood pressure tablets to protect my kidneys and reduce my blood pressure and have been given 3 months to try and reduce my blood sugar as she said I'm just on the cusp of going back to the gliclizide.

I'm so disheartened and at a bit of a loss to understand what has gone wrong (if anything) - can any one suggest anything else I could do - please not fasting as it triggers my eating disorder and the feelings around that and I certainly don't want to have to fight that battle again.

Thanks for reading as the post became quite a long one

 

[lucylocket61]

Keto is not always a positive experience for women.

https://www.wellandgood.com/good-food/keto-and-hormones-women/

https://www.saragottfriedmd.com/the-ketogenic-diet-for-women/

 

[HSSS]

she said I'm just on the cusp of going back to the gliclizide.

You are kidding me? At 49? Many at that level don’t even get offered metformin let alone gliclazide?

 

[HSSS]

When was the 46 reading? Before or since keto? What were figures like before keto started? Do you test yourself?

Any chance you could have an exhausted pancreas? If you were on gliclazide for a long time maybe it’s wrung out the organ and it simply cannot produce much insulin any longer. Did they do a c-peptide (Recently) to see how much it actually produces now?

As far as kidneys go I know little so won’t comment. The blood pressure is just on the cusp of being classed as high. Most practices only treat at 140 and above. Your new nurse sounds cautious and quick to medicate.

Stress, illness, lack of sleep, co-morbidities, other medications such as statins and steroids can all have a negative effect on hb1ac. Do any of these sound likely in the last few months?

Can you increase exercise and movement? Apparently even sitting for long periods can raise hb1ac.
Not fasting but do you or can you stick to just meals with no snacks in between? Can you delay breakfast a while and bring dinner forwards a bit to extend the food free period overnight?

some people find certain foods problematic regardless of carbs count. Eg grains or dairy. Could you explore having less of one or other of these and seeing what fingerpricks show?

 

[lovinglife]

Keto is not always a positive experience for women.

https://www.wellandgood.com/good-food/keto-and-hormones-women/

https://www.saragottfriedmd.com/the-ketogenic-diet-for-women/

Very interesting thank you

 

[HSSS]

Keto is not always a positive experience for women.

https://www.wellandgood.com/good-food/keto-and-hormones-women/

from the first article
“ Dr. Turner says that while in theory, people on the ketogenic diet burn fat for energy, it can actually dip into the body’s protein reserves because some people need more protein than what’s allowed for on the diet’s ratios. “You have to consume a minimum amount of protein to preserve your muscle mass,” she says—about 46 grams of protein a day for the average sedentary woman, although very active women need even more. Burning protein for energy instead of fat or carbs causes stress on the body, Dr. Turner says, spiking cortisol levels.”

this suggests lack of protein is the issue not the lack of carbs!

“Dr. Turner says another factor at play with keto is all of the fat. She says a diet high in fat spurs more estrogen production, which is also linked to weight gain (at least in mice).”.

I am not a mouse. How much extra fat is debatable and personal. It might just mean not low fat rather than blocks of lard added.


Although I agree keto it is not a perfect fit for everyone.

 

[lovinglife]

When was the 46 reading? Before or since keto? What were figures like before keto started? Do you test yourself?

The 46 was 5 months into keto and stopping gliclizide - I had 42 on 80g carb and gliclizide 40mg twice a day - have always tested never had anything over 8 for many years

Any chance you could have an exhausted pancreas? If you were on gliclazide for a long time maybe it’s wrung out the organ and it simply cannot produce much insulin any longer. Did they do a c-peptide (Recently) to see how much it actually produces now?

Not sure about the exhausted pancreas - could be maybe - I've always been on gliclizide but the trend has always been reduction from max dose to none

As far as kidneys go I know little so won’t comment. The blood pressure is just on the cusp of being classed as high. Most practices only treat at 140 and above. Your new nurse sounds cautious and quick to medicate.

I think it's the combo of the higher blood pressure and the leaky kidneys that has triggered the meds - the meds not only lower blood pressure but protect the kidneys

Stress, illness, lack of sleep, co-morbidities, other medications such as statins and steroids can all have a negative effect on hb1ac. Do any of these sound likely in the last few months?

High stress, lack of sleep are very long term things for me - at least 20 years so though present it's not a change

Can you increase exercise and movement? Apparently even sitting for long periods can raise hb1ac.
Not fasting but do you or can you stick to just meals with no snacks in between? Can you delay breakfast a while and bring dinner forwards a bit to extend the food free period overnight?

I eat at 5 am, 12pm and 5pm no snacks at all - can't really delay breakfast as if I don't get it then don't get chance and I get very hungry and tired and I need to be alert to care for my son

some people find certain foods problematic regardless of carbs count. Eg grains or dairy. Could you explore having less of one or other of these and seeing what fingerpricks show

Don't eat grains at all - will try cutting dairy but I don't really eat that much as not keen on cream but do like cheese
?

Thank you for your thoughts I do appreciate it it really does help to evaluate everything even if you think you are doing everything right

 

[Resurgam]

Can you give more information about what you are eating?
Not everything that is described as 'good for diabetics' is something I'd ever eat - low GI foods for instance - I just spike really high.
Gloclazide is - I would have thought a drug of last resort, to hammer out the last bit of insulin from a failing pancreas - not the sort of regime I'd expect in your circumstances.

 

[lovinglife]

Can you give more information about what you are eating?
Not everything that is described as 'good for diabetics' is something I'd ever eat - low GI foods for instance - I just spike really high.
Gloclazide is - I would have thought a drug of last resort, to hammer out the last bit of insulin from a failing pancreas - not the sort of regime I'd expect in your circumstances.

I only eat fresh food cooked from scratch - eggs meat fish cheese avocado a few nuts and leafy greens cauliflower and a few berries I use Diet Doctor recipes and food plans all keto usually around 15g carb per day never more than 20g - no sweeteners. I've never eaten foods described as good for diabetics

 

[Resurgam]

I only eat fresh food cooked from scratch - eggs meat fish cheese avocado a few nuts and leafy greens cauliflower and a few berries I use Diet Doctor recipes and food plans all keto usually around 15g carb per day never more than 20g - no sweeteners. I've never eaten foods described as good for diabetics

Oh - oh dear.
Have you had your insulin levels tested?
Your diet look really good, so there is something going on.....

 

[lovinglife]

Oh - oh dear.
Have you had your insulin levels tested?
Your diet look really good, so there is something going on.....

Thank you for your input - I've never had my insulin tested - do they do that on the NHS or would it be a private test? If things don't change on my next tests (3 months) I will request one

 

[Resurgam]

Thank you for your input - I've never had my insulin tested - do they do that on the NHS or would it be a private test? If things don't change on my next tests (3 months) I will request one

They must do such tests - at least I really hope so, rather than just guessing - but there again....

 

[HSSS]

They must do such tests - at least I really hope so, rather than just guessing - but there again....

Isn’t that what c peptide shows? It’s done on the nhs but getting a gp to do t might be another issue.

 

[Bluetit1802]

Hba1c was up to 49 from 46,

You moved house and change surgeries. Does your new surgery use a different lab with different methods of calculating HbA1c? A rise of 3 is insignificant in real terms, and different labs measure differently. My bloods are sent off to 2 different labs (from the same blood draw) and on each occasion the HbA1c result has been 4 points different from the 2 labs.

EDIT what do your finger pricks tell you?