Don't understand why this should happen

[halfpint]

Hi
About 7 yrs ago my BGs started getting a bit high after meals, so started testing, at that time I was not considered diabetic, or only just pre-diabetic. We have diabetes in the family though. My a1c were just entering the 6.00 mmol range, so at that point I started to reduce carbs and test. A1c have fluctuated around 6.00 to 6.3 ish for most of that time and LC has kept the spikes at bay unless I was silly, which, yes, occasionally succumbed to a pancake! However, my last a1c came in at 6.5, so actually now at diabetic level. At this point I would like to say that I am not overweight, never have been, never had a particularly sweet tooth (used to give my sweets to my brother as a kid !), my bmi is about 19, always been active, and LC at about 50gm per day. I have reduced my carb intake over the last couple of weeks down to between 20 and 35gm a ay. Last night I had a salad, half a small tin of salmon and walnut oil, and after 90 mins or so, felt a bit odd and was surprised to find my BGs had gone up to 10.6. These sorts of numbers never used to happen unless I ate something like 20-30gm of carb in one go, so any ideas as to what is going on.

 

[HSSS]

Ever been tested for GAD antibodies or c peptide?

I’m assuming you mean hb1ac as % as mmol would be lots higher numbers.

Anything else changed recently? Other medications? Stress, sleep, exercise?

and lastly did you double check that high readings? We all get a random odd one and it’s usually down to traces of food left on unwashed fingers or out of date test strips.

 

[halfpint]

Ever been tested for GAD antibodies or c peptide?

I’m assuming you mean hb1ac as % as mmol would be lots higher numbers.

Anything else changed recently? Other medications? Stress, sleep, exercise?

and lastly did you double check that high readings? We all get a random odd one and it’s usually down to traces of food left on unwashed fingers or out of date test strips.

Sorry, A1c is as is normally expressed in UK, just got in the habit of mmol ! I had both GAD and c peptide done a fair few years ago, GAD negative, c peptide very low. Checked numbers, actually don't have much in the way of contaminants in the house these days, but always a possibility. Nothing else has really changed, just a bit older. I have had a few liver 'dumps' in the past, but they usually happen around 10 or 11 in the morning if I've been working hard, but not in the evenings. That result just seems very strange, I've had a few highish ones in the evenings recently, had a 12.3 again with no real reason.

 

[ert]

A very low c-peptide supports you are not producing insulin, for whatever reason. This is why you are getting the patterns of higher blood sugars even when eating low levels of carbohydrate. This is a real reason.

 

[halfpint]

I must admit I have wondered about Mody, as there are several family members with diabetes, although on reading about the various gene defect senarios none of them actually seem to fit that well. Maybe its just getting old ! my brother was put on insulin at about my age, he is now classed as an extremely well controlled type 1, but he is still actually producing insulin (on a good day about 1/3rd of what he needs, on a bad day, none at all).

 

[ickihun]

Yep. If C-peptide is below 500 then insufficient insulin made. Pls refer this result to your health team.

 

[halfpint]

Could it be anything to do cutting the carbs down just that little bit more? I can't see how, but you never know. I do get slightly nauseous in the evenings, so is it possible that I'm kinda on the cusp of keto but not there yet, and there is just enough carbs in what I have eaten earlier in the day to fuel a dump in the evenings? Weird, I know, but ...

 

[halfpint]

Yep. If C-peptide is below 500 then insufficient insulin made. Pls refer this result to your health team.

500 what? I really wish all labs would use the same standard measurements, it would make everyone life easier - perhaps I should put that in a 'gumpy old gits' post !

 

[Dark Horse]

A1c is as is normally expressed in UK,

In the UK, HbA1c is now measured in mmol/mol. Previously it was expressed as a percent.

There is a converter on this page:- https://www.diabetes.co.uk/hba1c-units-converter.html

 

[KK123]

Hi @halfpint, with what you have described plus your family background and C Peptide result and so on, along with your low BMI (which I know is not an indication of much on its own) and your low carb diet, it is clear to me that you need to see your Dr again for more tests, including another antibody one or C Peptide. NONE of us can diagnose obviously but I personally would not leave it any longer as IF you do need insulin then no amount of low carbing or exercising is going to make a difference and you could become very ill or worse in the meantime. I was diagnosed 3 years before a type 1 diagnosis with 'pre diabetes' but I strongly believe it was actually slow onset type 1. Going keto is all well and good but as I say if you require insulin now then you NEED it now. The very best to you. x

 

[halfpint]

In the UK, HbA1c is now measured in mmol/mol. Previously it was expressed as a percent.

There is a converter on this page:- https://www.diabetes.co.uk/hba1c-units-converter.html

Thanks for that, a useful chart. Its funny really, because its says that they use IFCC in europe, mine was done about 6 weeks ago in france and it was %.

 

[halfpint]

Hi @halfpint, with what you have described plus your family background and C Peptide result and so on, along with your low BMI (which I know is not an indication of much on its own) and your low carb diet, it is clear to me that you need to see your Dr again for more tests, including another antibody one or C Peptide. NONE of us can diagnose obviously but I personally would not leave it any longer as IF you do need insulin then no amount of low carbing or exercising is going to make a difference and you could become very ill or worse in the meantime. I was diagnosed 3 years before a type 1 diagnosis with 'pre diabetes' but I strongly believe it was actually slow onset type 1. Going keto is all well and good but as I say if you require insulin now then you NEED it now. The very best to you. x

Thanks, I had wondered about that. I've been coping quite well for the last xxxx yrs, but things are obviously getting worse. I must confess that I have taken the precaution of ordering a ketone metre, just so I can keep track on that especially if my BGs go up more or stay up. The trouble is that while you are presenting for the most part sensible numbers, because of controlling carb intake, you will not be referred for further tests, they wont do anything until it goes pear shaped.

 

[HSSS]

Thanks, I had wondered about that. I've been coping quite well for the last xxxx yrs, but things are obviously getting worse. I must confess that I have taken the precaution of ordering a ketone metre, just so I can keep track on that especially if my BGs go up more or stay up. The trouble is that while you are presenting for the most part sensible numbers, because of controlling carb intake, you will not be referred for further tests, they wont do anything until it goes pear shaped.

Maybe not but sometimes some pushing will help. Explain that you’ve been controlling successfully with carbs but it no longer works and you are aware of a previous low c peptide and need it to be rechecked to see if it’s falling further. Explain the family history of type 1 too. Be insistent. Ask what happens if you’re right and honeymoon ends and you get dka because you weren’t receiving the right treatment. That you know early treatment in LADA with insulin may help prevent or slow beta cell deterioration Lay it on thick. Demand an explanation of why not if they won’t and ask for their refusal to be recorded in your notes. And watch them do it! Many will back down thus and order the tests or make the referral

 

[halfpint]

Maybe not but sometimes some pushing will help. Explain that you’ve been controlling successfully with carbs but it no longer works and you are aware of a previous low c peptide and need it to be rechecked to see if it’s falling further. Explain the family history of type 1 too. Be insistent. Ask what happens if you’re right and honeymoon ends and you get dka because you weren’t receiving the right treatment. That you know early treatment in LADA with insulin may help prevent or slow beta cell deterioration Lay it on thick. Demand an explanation of why not if they won’t and ask for their refusal to be recorded in your notes. And watch them do it! Many will back down thus and order the tests or make the referral

OK, get it, will do. Thanks to everyone for their help too.

 

[AndyMc]

Do you eat a lot of protein?

I am one of those people who seem to be hovering between type 1 and type 2 symptoms (for several years now), but so far I'm assuming/hoping it's 'severe' type 2.

Anyway, periodically I find my BG rising into 9s, 10s, 11s rather than the more normal 7s, 8s, even though I don't feel like I'm eating a lot of carbs. So I cut carbs even more, and it doesn't help that much, then I remember about protein, cut my meat intake, and hey presto, back down to 7s and 8s.

It's actually quite surprising how much protein is in even modest amounts of meat. So if you regularly eat meat, try cutting it well down and see if it makes a difference. For me the reduction in BGs after a reduction in protein only takes a couple of days, so it doesn't take long to see if it's having an effect.

 

[halfpint]

Do you eat a lot of protein?

I am one of those people who seem to be hovering between type 1 and type 2 symptoms (for several years now), but so far I'm assuming/hoping it's 'severe' type 2.

Anyway, periodically I find my BG rising into 9s, 10s, 11s rather than the more normal 7s, 8s, even though I don't feel like I'm eating a lot of carbs. So I cut carbs even more, and it doesn't help that much, then I remember about protein, cut my meat intake, and hey presto, back down to 7s and 8s.

It's actually quite surprising how much protein is in even modest amounts of meat. So if you regularly eat meat, try cutting it well down and see if it makes a difference. For me the reduction in BGs after a reduction in protein only takes a couple of days, so it doesn't take long to see if it's having an effect.

Hi, yes, I've read that excessive protein will get converted through a different pathway and will effectively become glucose. But, no, not a huge protein eater. Its always difficult to judge, you read one thing somewhere and something different elsewhere. According to most estimates I really struggle to eat even 3/4 of what the recommended protein levels should be for my weight, so on that score I wouldn't be classed as a big protein consumer.
At the moment I'm kinda thinking that perhaps it was a contaminated finger, you know the sort of thing, washed hands, then shillied about in the kitchen tidying plates, wipe surfaces etc., could easily have happened.
The last couple of salads I've had I've actually dropped e.g. 6.7 down to 6.2, so maybe it was just a silly panic!

 

[John93]

Halfpint, as has been suggested by others, new testing might be a good idea as it sounds like you might have type 1.5 diabetes and will eventually need insulin. The other test worth having is a 4 hr OGTT - Dr Wes Younberg in California, who has been very successfully reversing type 2 diabetes for decades and is probably the most authoritive doctor on the subject, says the OGTT will show up insulin resistance and adrenal fatigue.

Another avenue worth exploring is that LONG TERM, the low carb diets can worsen insulin resistance and after a while, there is very little sugar getting into your cells. The longer the carb avoidance goes on the worse that gets. Low carb diet advocates seem to avoid the OGTT because it shows that diabetes is still the condition and its just getting managed by low carbs but the root cause of type 2 diabetes i.e.insulin resistance is getting worse. an article I stumbled across here on this site explains a bit https://www.reversediabetes.com.au/why-keto-and low-carb-diets-fail-to-reverse-diabetes.htm Really worth reading up /listening to Dr Younberg - he looks at the whole person when dealing with diabetes- from what you say about your other conditions, a more whole of person approach might be needed as diabetes doesn't exist in a vacuum, its always part of a much bigger metabolic mess as Youngberg describes it. I know saying anything that challenges low carb or keto on this site, goes over like a lead balloon, but worth keeping a very open and inquiring mind. Good luck.

 

[HSSS]

Halfpint, as has been suggested by others, new testing might be a good idea as it sounds like you might have type 1.5 diabetes and will eventually need insulin. The other test worth having is a 4 hr OGTT - Dr Wes Younberg in California, who has been very successfully reversing type 2 diabetes for decades and is probably the most authoritive doctor on the subject, says the OGTT will show up insulin resistance and adrenal fatigue.

Another avenue worth exploring is that LONG TERM, the low carb diets can worsen insulin resistance and after a while, there is very little sugar getting into your cells. The longer the carb avoidance goes on the worse that gets. Low carb diet advocates seem to avoid the OGTT because it shows that diabetes is still the condition and its just getting managed by low carbs but the root cause of type 2 diabetes i.e.insulin resistance is getting worse. an article I stumbled across here on this site explains a bit https://www.reversediabetes.com.au/why-keto-and low-carb-diets-fail-to-reverse-diabetes.htm Really worth reading up /listening to Dr Younberg - he looks at the whole person when dealing with diabetes- from what you say about your other conditions, a more whole of person approach might be needed as diabetes doesn't exist in a vacuum, its always part of a much bigger metabolic mess as Youngberg describes it. I know saying anything that challenges low carb or keto on this site, goes over like a lead balloon, but worth keeping a very open and inquiring mind. Good luck.

This “for sale” plan that doesn’t appear to have anything supporting its theory has also been discussed on this thread https://www.diabetes.co.uk/forum/th...et-anyone-tried-it.171315/page-2#post-2204417. See post 22 for problems with it.
It makes an assumption of the cause of insulin resistance being fat in cells of which I see no evidence in the blurb you link to. It claims low carb users fail gtt but doesn’t specify if this is after reacclimatisation to carbs as otherwise physiological resistance occurs regardless of diabetes status.
It doesn’t evidence diabetes or insulin resistance being made worse by lchf in any other way
It says carbs are essential. They are not. Only fats and proteins are.
it doesn’t evidence how not eating carbs makes you sick in a multitude of other ways
The high carb low fat method of dealing with diabetes has been around for 40yrs and doesn’t seem to be helping “cure” the “progressive” disease this cure is aimed at.

this is why this forum is sceptical of “cures” like this, but you are right we should always investigate options.

 

[John93]

I wouldn't get too concerned about referenced evidence in articles, I'd suggest seeing what the 'big boys' do............... The problem with referencing evidence is that it is so subjective. My experience in academia is that researchers generally have a very fixed belief about an issue and what they do is design studies to reinforce that view by making sure the outcome is known before the study begins. Writers also just reference the literature that supports their already biased view. In any case, who has the time or expertise to say whether the referenced evidence is good quality or not. Anyone can cite an article or rubbish quality, safe in the knowledge, 99.9% of readers wont read it, understand it or evaluate it. A great example of designing a study to get the result you want is an egg board study to 'prove' eggs are healthy - https://nutritionfacts.org/video/how-the-egg-board-designs-misleading-studies/

These days, most researchers rely on industry funding to keep their research teams employed in order to continue their publishing. In academia its publish or perish. When a study doesn't get the results desired by the funder, it simply gets shelved and not published. The drug companies did this with anti-depressants for years until someone got hold of all the studies that didn't get published, via FOI requests, and then it showed anti-depressants were less effective than placebo except in very severe cases of depression. However, the 'brain chemical imbalance' myth got perpetuated in the meantime, the drug companies made billions and very few people know the truth. If you don't get results that the funder wants to hear, you wont get more funding.

The other thing to keep in mind is that for the last 40 years or so, most of the medical journals have been hijacked by big pharma in particular and if you don't toe the journal line and keep the real owners happy, you wont get published in that journal.This is why nothing but drug based treatments will ever be adopted as mainstream treatments for diabetes or anything else. There is much more money in having a diabetes patient for life, on medications, than having a food or lifestyle based treatment that manages the condition or worse still reverses or cures it. There is no money in lifestyle measures -you cant patent broccoli, apples or walking.

I could go forever about evidence and how it is so easily manipulated but the main point is look for independently funded research by authors with no conflict of interest. Even better - look at what the 'big boys' with the expertise to really evaluate evidence do and where they put their money.

In regards to low fat,high complex carb diets, they are the mainstay of heart disease reversal programs by Dr Dean Ornish in the USA. Medicare funds them after analysing the evidence for 16 years and now big US insurers like Kaiser Permanente suggest them as the first line of treatment for chronic lifestyle diseases, including heart disease. Cleveland Clinic now has a program based on it. Guess what the main complication of diabetes is? Heart disease. I think organisations like US Medicare, Cleveland Clinic and Kaiser might have done their own research on the research before they put their money down.

I started searching in this forum for the answer on how to reverse my own T2 diabetes and I have to say the answer is looking a lot clearer now. I initially thought low carb had the answers but through a process of open minded investigation, I'm pretty sure now its not the answer for me but I respect everyone else's right to differ on this. I'd just encourage really wide reading from a variety of sources and to be very wary of so called 'evidence'.

 

[halfpint]

Halfpint, as has been suggested by others, new testing might be a good idea as it sounds like you might have type 1.5 diabetes and will eventually need insulin. The other test worth having is a 4 hr OGTT - Dr Wes Younberg in California, who has been very successfully reversing type 2 diabetes for decades and is probably the most authoritive doctor on the subject, says the OGTT will show up insulin resistance and adrenal fatigue.

Another avenue worth exploring is that LONG TERM, the low carb diets can worsen insulin resistance and after a while, there is very little sugar getting into your cells. The longer the carb avoidance goes on the worse that gets. Low carb diet advocates seem to avoid the OGTT because it shows that diabetes is still the condition and its just getting managed by low carbs but the root cause of type 2 diabetes i.e.insulin resistance is getting worse. an article I stumbled across here on this site explains a bit https://www.reversediabetes.com.au/why-keto-and low-carb-diets-fail-to-reverse-diabetes.htm Really worth reading up /listening to Dr Younberg - he looks at the whole person when dealing with diabetes- from what you say about your other conditions, a more whole of person approach might be needed as diabetes doesn't exist in a vacuum, its always part of a much bigger metabolic mess as Youngberg describes it. I know saying anything that challenges low carb or keto on this site, goes over like a lead balloon, but worth keeping a very open and inquiring mind. Good luck.

Thanks for the article. Yes, I've been LC for many years, and now am borderline keto, but the funny thing is that I've had 4 OGTT over the years and passed all of them with flying colours, no carb refeeding either, and I mean literally not going above 6.5mmol/l the whole time ! yet give me a sandwich, and bam, I'm up there in the 14s or 15s for hours, a chile con carne can put me up around 15 mmol/l for 4 or 5 hours. This would indicate that either I have a sensitivity problem to all carbs (which seems unlikely), or that because I've been LC or VLC for years, that my stores of glycogen are actually pretty depleated and when given glucose the liver takes a large chunk up without having to produce much insulin (apparently athletes on keto and refeeding after heavy training do this, its only short lived) until glycogen stores are replaced, obviously I have no proof of this, but its a theory that makes sense. Also you can't have insulin resistance if you are not producing more than a spits worth of insulin. If your pancreas in cream crackered then no amount of medication or diet options are going to fix it, hence LC cannot reverse that situation. But if you are on LC or keto and in the diet for BG control and weight loss (which many are) and fat is their problem, then your diabetes can be reversed once the fat gets used up.
I've known people on LC that are grossly overweight, but the problem is that they might dump their carbs but still consume 3,000 + cals a day in fats and protein, and although people say that cals don't matter, they do when consumed on that sort of scale, then they wonder why they don't lose weight and feel sicky. I doubt that their insulin resistance improves in those situations either.
As with all things, no one thing suits all, we are all different and have other problems going on at the same time. Being hypothyroid I could be insulin resistant, its goes with the territory, but on c-peptide tests I'm right at the bottom of the range, this could be because I've been LC ! It would be interesting to see if I actually produce more insulin under a proper insulin challenge and what those levels are, just to see if I do produce enough, or over produce and am therefore insulin resistant !
Unfortunately doctors usually only do minimal tests for anything these days, with hypothyroidism the standard treatment, indeed the only treatment, is T4 (levo), they do not even consider that the problem may actually not be only a T4 insufficiency but could also be the way you actually handle the T4 and convert it to T3 or RT3, in which case no amount of T4 will ever make you well, it will in fact make your worse, if the problem is elsewhere in the system. All very complex.