Who's fasting today?

[Roggg]

Not fasting today. I have a high intensity running workout I'm hoping to fit in at lunch, and while I feel it's probably fine to do it fasted, I haven't really figured out the interaction between fasting and my exercise schedule yet. Actually the intervals workouts are the last holdout. I've done my long runs, easy runs and tempo runs fasted and frankly felt great during and after.

 

[John2003]

Just started low dose lantus 3 weeks ago. Didn't seem to have much effect even as I titrated the dose gradually from 6 to 30 units, still getting FBG's in the 17 to 14 range. What did work (for me, you're mileage may vary) was some fasts of longer than one day. I've been doing OMAD for several weeks. I managed a 44 hour fast in late April and two back to back 48 hour fasts this week with a single low carb meal in the middle. This has really pulled my BG down and after weeks of FBG in the 15 to 17 range I'm down into single figures, lowest was a 6.0, today was 8.8.

I still have a part syringe of Byetta and this has been documented as a combined therapy with Lantus. I find a shot of Byetta will pull the BG down (like it used to years ago). Today, 2.5 hours after the 8.8 I was down to 5.8 due to the Byetta. I also use Dapagliflozin if my BG is above 7 in the morning, to dispose of up to 40g glucose in my urine during the next 24 hours. Again, this is a documented combined therapy with Lantus.

48 hours into the last longer fast my ketones were 3.7mmol/l so I was definitely burning fat at that point. Previously I had 0.9 after 24 hours so mild ketosis. I was using 16 units Lantus for both these tests.

I'm very pleased with the results I'm getting now after being massively disappointed that the Lantus seemed to have very little effect when introduced. Higher doses of Lantus are reported to have diminishing effects on BG control (esp about 0.5units/kg) and I was trying to avoid large doses of Lantus that would suppress fat burning and ketosis. I'm hoping to fast 3 days at some point.

I'm hoping I'm burning the fat out of my liver as per Prof Taylor's paper on the reversal of T2D in patients who had bariatric surgery and underwent their 8 week 800kcal per day trial back in 2011.

 

[Roggg]

Hey John. Glad to see you're having some good results with fasting. I have 3 comments.

First I want to say that my experience with fasting has been similar to yours (minus the Lantus). I have been away from multi-day fasting for a while, but when I was doing it, I found I had great gains in my blood sugar, both fasting and average. And the gains seemed to last when I want back to 20/4, or at least partially so.

Second, I would caution against the idea that more (ketones) is better. A lot of the advocates these days say your specific level doesn't mean much as long as you are in the "nutritional ketosis" range, which starts around 0.5 mmol/l. There's a lot of dispute about what varying levels means, and some propose that you can have levels in the lower range simply because your body is using them more efficiently so they dont accumulate in your blood. I dont know where the truth lies, but this (along with cost of blood testing strips) is why I rarely test ketones anymore.

Third, just a comment, both studies on fasting and studies on low carb eating have shown that visceral fat loss outpaces total body fat loss, and liver fat loss outpaces visceral fat loss. It seems when you get the carbs out (either through low carb or fasting) your liver starts improving faster than pretty much anything else.