Just an update on keto/low carb high levels

lcarter

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504
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Type 2
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Tablets (oral)
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I use the freestyle LibreLink sensor, but I test with my meter too. I am confident in those.

I’m not showing any of the classic symptoms, I’m not even very thirsty. Since coming off the empagliflozin my urination has returned to normal.

I get the occasional headache and tiredness but I work too much so it could be that

This is the past twenty four hours and this morning.

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M

Member496333

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I have coffee and double cream for breakfast every day. Usually three cups.

Lunch is usually a salad— tuna Mayo or chicken Mayo with round lettuce and cucumber.

If I’ve made the low carb carrot cake I have a slice of that—3.6g of carbs in total.

If I snack it’s two squares of 85% Lindt dark chocolate, meat (Cold Cooked gammon/ chicken) peperami (not often) cubes of cheese or olives. Full fat yoghurt and seeds, walnuts and cashews.

(I’ve tried bovril and didn’t like it…)

Dinner is the same—homemade chilli without the kidney beans with cauliflower rice, homemade guacamole with chicken and salad or I have cheese and meat if I can’t be bothered to cook.

I have sugar free caramel in all my coffees but I’m stopping that now as I’ve ran out. Stevia sweetener Or Candarel.

That’s what i eat, could the sugar free caramel be the culprit or the sweetener?

Not sure about the sweeteners although they do apparently affect some people. 85% chocolate is 15% sugar so that won’t help. But it all sounds pretty ok really. I have probably missed it but do you have weight to lose? There doesn’t seem to be much fat in your diet which can be a problem if you’re already slim. Or even if you’re not slim then hyperinsulinemia could stop you burning fat and just make you hungry instead. Although if I recall you are producing ketones so it would appear that’s not the case.

It could still be that your body needs more time to deflate all its glucose stores. Fatty liver in particular, maybe. Especially as you’d been using exogenous insulin for a decade plus. You really do need a new insulin test to confirm or disconfirm your pancreatic function. On the face of it it sounds like you underproduce, but you may also just be an extreme example of insulin misuse in a type 2.
 
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lcarter

Well-Known Member
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504
Type of diabetes
Type 2
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Tablets (oral)
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My pancreas
Not sure about the sweeteners although they do apparently affect some people. 85% chocolate is 15% sugar so that won’t help. But it all sounds pretty ok really. I have probably missed it but do you have weight to lose? There doesn’t seem to be much fat in your diet which can be a problem if you’re already slim. Or even if you’re not slim then hyperinsulinemia could stop you burning fat and just make you hungry instead. Although if I recall you are producing ketones so it would appear that’s not the case.

It could still be that your body needs more time to deflate all its glucose stores. Fatty liver in particular, maybe. Especially as you’d been using exogenous insulin for a decade plus. You really do need a new insulin test to confirm or disconfirm your pancreatic function. On the face of it it sounds like you underproduce, but you may also just be an extreme example of insulin misuse in a type 2.

I’m 5’5 and I weigh 11 stone 13. I have lost two stone from being on empa. I’ll get the test sorted, in the meantime I’ll cut the chocolate out. Do I take insulin to bring this lot down is the question. As you can see from the photos above it doesn’t do much when I do
 
M

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I’m 5’5 and I weigh 11 stone 13. I have lost two stone from being on empa. I’ll get the test sorted, in the meantime I’ll cut the chocolate out. Do I take insulin to bring this lot down is the question. As you can see from the photos above it doesn’t do much when I do

Can’t advise on insulin use but those are consistently high numbers so it would seem wise if you have the option. But without knowing for sure the existing levels in your blood then it’s a tough call between short term gain and possibly making things worse overall in the long haul. Hope you are still testing for blood ketones and making sure they’re not going high along with simultaneously high glucose.

If it were me I would also remove all sweeteners and anything not a whole natural food, but your dietary choices are yours to make. It could be worth removing all that stuff just to see if you gain any benefit.

EDIT: the fact that injecting insulin doesn’t seem to help much is a red flag for major, major insulin resistance. It’s not my place to diagnose but this would be in keeping with insulin misuse thanks to incorrect original diagnosis. If your insulin resistance is as high I suspect it probably is then you may have to contemplate more extreme dietary measures of zero carb and extended fasting in order to get that liver cleared out, but that in itself will probably raise glucose for a while so there’s not going to be a quick fix.
 
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xfieldok

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4,182
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Type 2
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Tablets (oral)
Your diet looks pretty good. How long did you have your libre on before you activated it?
 

lcarter

Well-Known Member
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504
Type of diabetes
Type 2
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Tablets (oral)
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My pancreas
Can’t advise on insulin use but those are consistently high numbers so it would seem wise if you have the option. But without knowing for sure the existing levels in your blood then it’s a tough call between short term gain and possibly making things worse overall in the long haul. Hope you are still testing for blood ketones and making sure they’re not going high along with simultaneously high glucose.

If it were me I would also remove all sweeteners and anything not a whole natural food, but your dietary choices are yours to make. It could be worth removing all that stuff just to see if you gain any benefit.

EDIT: the fact that injecting insulin doesn’t seem to help much is a red flag for major, major insulin resistance. It’s not my place to diagnose but this would be in keeping with insulin misuse thanks to incorrect original diagnosis. If your insulin resistance is as high I suspect it probably is then you may have to contemplate more extreme dietary measures of zero carb and extended fasting in order to get that liver cleared out, but that in itself will probably raise glucose for a while so there’s not going to be a quick fix.

This is it: I think it’s severe insulin resistance. There isn’t anything I can do bar dietary things, am I right? I’m just worried how long I can have high sugar levels for. Gah. I’m probably going to have to put more insulin in which is CRAZY
 
M

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There isn’t anything I can do bar dietary things, am I right?

In your shoes that would be my strategy. I would, and did, go mega hardcore with practically zero carbohydrate and intermittent fasting. For me it was worse because I had no weight to lose so couldn’t gain any advantage in that respect. But it worked long term. Took probably three years total to get where I am now. Hopefully it can work for you too but only you can decide how hardcore you’re willing to go. I think you need to act and act fast before you end up resistant and deficient, but these are choices only you can make. You appear to be an extreme case, and extreme cases require extreme measures. Only my opinion, not medical advice :shifty:
 
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xfieldok

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4,182
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Type 2
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I can’t remember, roughly half an hour
It takes around 8 hours to settle in. I usually plug myself in 24 hours before activation. It can give inaccurate readings if done too soon. Take a finger prick to check.
 
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lcarter

Well-Known Member
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504
Type of diabetes
Type 2
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Tablets (oral)
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My pancreas
It takes around 8 hours to settle in. I usually plug myself in 24 hours before activation. It can give inaccurate readings if done too soon. Take a finger prick to check.

Just spoke to my go who was great. She said to hold my nerve and keep going for a bit longer, she said I’m not to panic about my levels unless they hit 20 or above considering I’m doing keto. My ketones are 1.4 this morning.

Levels still around the 18 mark so I took some insulin; gp agreed that I’m doing everything right and she said if keto doesn’t bring my levels down after a month on it (I’m 2 weeks in) then we can look at going back to empagliflozin 25mg and doing lower carb as opposed to keto.

Feel much better now.

Olives, cashews, cheese all measures and weighed out meaning I’ve had 12g of carbs so far today.
 

xfieldok

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4,182
Type of diabetes
Type 2
Treatment type
Tablets (oral)
Walnuts are lower carb than cashews but you are counting your carbs so you should be OK. How I miss honey roast cashews, not had any since dx.
 
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M

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Just spoke to my go who was great. She said to hold my nerve and keep going for a bit longer, she said I’m not to panic about my levels unless they hit 20 or above considering I’m doing keto. My ketones are 1.4 this morning.

Levels still around the 18 mark so I took some insulin; gp agreed that I’m doing everything right and she said if keto doesn’t bring my levels down after a month on it (I’m 2 weeks in) then we can look at going back to empagliflozin 25mg and doing lower carb as opposed to keto.

Feel much better now.

Olives, cashews, cheese all measures and weighed out meaning I’ve had 12g of carbs so far today.

That’s the spirit. Although personally I would dump the cashews and use pecans or macadamia. Or steak :shifty:
 
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M

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By the way @lcarter if you are super mega insulin resistant then you may also find that excessive protein starts to manifest as raised glucose. Particularly the following day. This happened to me and it took a very long time to settle down.
 
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lcarter

Well-Known Member
Messages
504
Type of diabetes
Type 2
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Tablets (oral)
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My pancreas
By the way @lcarter if you are super mega insulin resistant then you may also find that excessive protein starts to manifest as raised glucose. Particularly the following day. This happened to me and it took a very long time to settle down.

I’ve read about this! Out of interest, how did you combat your high glucose levels until they settled?
 

lcarter

Well-Known Member
Messages
504
Type of diabetes
Type 2
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Tablets (oral)
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My pancreas
Relentless tenacity, faith in the overall plan and the passage of time.

See my gp said to try for another few weeks, then if no change go back onto empa. Out of interest, how long did it take you to see your levels go down at all?

Here’s mine today.
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