|Blood Glucose Physiology

I will keep this short. Last December, I googled some symptoms and I thought it was diabetes. Went to a doc, who did A1c and fasting (normal). I also stopped eating carbs because of being afraid of type 1 diabetes and not being able to handle carbs. I did OGTT which I failed at 13.2 mmol/l at 2 hours. I was given endo appointment, where he redid those three tests. I got antibodies tested which were negative (4 of them). I failed OGTT again at 14.2 mmol/l at 2 hours. I was taken to the hospital for two days to observe. I was let go saying low carb diet caused insulin resistance hence failing OGTT and endo was sure I am not diabetic.

I was eating ketogenic diet for the last year but am now trying to add more carbs to the diet - have courage to see for myself what is happening. I started with beans. So far, I see the following: 6.5 mmol/l at 1 hour, around 6 mmol/l at 2 hours. But it eventually comes down. I am a bit afraid of increasing carbs because reaching BG 7mmol/l always makes me feel horrible. And I don't want to sit and sweat doing nothing at work. I have rresearched this and Internet told me of physiologic insulin resistance and that it should subside as carbs are increased and body switches to accepting glucose instead of fatty acids.

Is it safe to increase carbs and watch glucose spikes? When are they supposed to normalise if non-diabetic? The reason for this eating disorder is mostly fear and feeling unwell with BG above 6 mmol/l. I know ... but this is my body and I live in it so wanted to feel okay. Going towards 7 mmol/l gives me horrendous headache.

Is my endo correct or do I have a pathology?

I am slowly ramping up my carb intake and will find out soon if my glucose regulation will normalize, or not. I feel like the endo said to do exactly that: eat carbs again, measure for a few weeks and see what numbers tell. Then eat foods that won't send me sky high. Makes sense. Just needed courage to try this.

Have been feeling unwell, night was very weird: completely dry mouth, not peeing though. Glucose after 6 hours of last meal at 2am was 6.2 mmol/l and it stays there for the whole day today. Any food triggers horrible headache. I last time had glucose above 6 without any food when having a flu, it was 7 mmol/l fasting. Does stress cause prolonged elevated readings? I had insane week.

Jim Lahey said:

A low-carb diet may very well cause an intolerance to ingesting a solution of pure glucose (twice as much glucose as table sugar!), but in my view it’s a bit of a misnomer to state that it will cause insulin resistance. Certainly low carbohydrate diets have been shown to reduce insulin resistance in most diabetics, so that would seem somewhat of a logical fallacy.

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I think there is a crucial difference: if insulin resistance is pathological, then keto will reduce it because less insulin = reduced resistance. However, if a person on a carby diet does not have pathological resistance (close to 0), then keto induces physiological resistance which is a lot less severe than pathological in type 2. So, result of type 2 diabetic is reduction due to insulin output and need, while in a normal biochemistry, glucose is spared for parts of the body that need it the most.

sbnz said:

Hi Crumbling Wall,
My commiserations for a start - I myself hate the land of guesswork that diabetes can have us ambling around in. I have t1 and a tendency towards anxiety and pushing for 'perfection' - which I never attain and never likely will but taking a step back and seeing my unhelpful expectations driving my 'show' helps me to get perspective. I'm not saying - don't try for better or what you want - but give yourself a break too - this condition generally is effected by so many other factors in our lives that we have little control over. Perhaps take the view that your body may be fighting an infection at the moment or there is some background stressor for you that you are unaware of (not within your current focus) and do your best to treat your bgls for the present? And see how things go. It is known now that everyone's bgls are likely to rise in response to infection or trauma (whether diabetic or not) and so some emergency medicine and hospital thinking now is to keep an eye on patients bgls and treat with insulin if necessary (for the period they are in hospital) - as leaving them untreated of course can impede healing. I imagine that although I read about this in an article - it still has minimal practice in real life hospitals. All the best, be kind to yourself.

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Yes, I have tendency to perfection as well. I read up on what could be and want that for myself. This includes: being smarter than I am, earning more than I currently do, and also being healthier than now.

Being kind to myself is what I do not do. I tend to focus on black or white, and miss out on the in-between where most people can find fulfillment. Something to work on.