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Type 2 Blood sugar levels indicate prvediabetic but ketone levels indicate still in ketosis

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antonym

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I was diagnosed as pre-diabetic some years ago. In November last year I changed to a ketogenic diet, and within a short time my fasting blood sugar levels stabilized at an average of 6.7 mmol and my ketone levels averaged 1.60 mmol. In March 2021 my HbA1c reading was 35. In the past fortnight my blood sugar levels have shown a significant increase, averaging 7.48 mmol while, at the same time, my ketone levels have maintained the average of 1.35 mmol.

My readings - blood sugar (fasting, finger prick) and ketones - from 5th July are as follows:
July 5th 7.6 0.00
6th 7.9 1.40
7th 7.7 1.40
8th 7.4 2.50
9th 6.8 1.05
10th 6.7 0.75
11th 7.0 1.90
12th 9.6 0.00
13th 8.0 2.80
14th 10.8 1.85
15th 7.2 0.80
16th 6.8 2.95
17th 6.9 0.90
18th 7.2 1.60
19th 7.6 0.80
Average 7.48 1.35

My blood sugar readings indicate that I am prediabetic, but my ketone readings indicate that I am still in ketosis. Is this a common state of affairs?

My carbohydrate intake has been the same throughout - about 15-20g.
 

Hi,

From my understanding.
To be fair, morning readings could indecate the effects of liver dump into the system? Especially during the run around prepping to go to work on a "school day."
Or possibly a little more insulin resistant in the early part of the day?

What are your numbers like at other points in the day?
 
antonym said:
but my ketone readings indicate that I am still in ketosis. Is this a common state of affairs?
Click to expand...

Logically, if you're eating a keto or very low carb diet, you'll be in permanent nutritional ketosis, irrespective of your blood sugars.

The issues come if your bgs go up into the teens or much higher and you then start to wonder whether you're in nutritional ketosis or going into diabetic ketoacidosis (DKA). Rare but not totally impossible for T2s, much more likely for insulin deficient T1s.

Happy to be corrected if I'm wrong, I've never personally had a DKA though as a T1 I'm aware of it as a potential issue, particularly if I'm ill and my bgs go high.
 

Jaylee thank you.
I will take readings at different parts of the day and get back.
Many thanks.
Tony Sims
 
EllieM.

Many thanks for your response With my low carb diet I should be in permanent nutritional ketosis, and my ketone readings indicate this. I am not sure what bgs is/are. The nearest I got on Google was Bailer Gerold Syndrome, but that doesn't seem right somehow.

What I will do is take readings at various time of the day, and hope I do not run into any teens.
 
Blood Glucose level (BG, bgs, etc.) is generally not tied to being in ketosis.
The two should be independent.

As noted above if you are in ketosis because your body is in panic mode due to lack of insulin this is a totally different (and very dangerous) scenario.
 
I have taken blood sugar and ketone readings, as advised, from 19th to 27th July.
However I have been unable to post these results using copy-paste. Of the 9 results for fasting the average of the readings was 7.0, but 3 were above 7.0 mmol. Does that make me prediabetic, non diabetic, or something in between?
For 'meals plus 2 hours' I took 21 readings. Of these 3 were above 9.00 mmol, and the average was 8.4 mol.
For ketones I took 29 readings, and the average was 2.60 mmol.

I don't know whether there is anything to be worried about here. The average readings look OK, but some readings are high. I am hoping that my March Hba1c of 35 will see me through.
Many thanks to all.
Tony.
















DATE TIME FASTING
MEAL +
KETONES




2HOURS


JULY 19TH 700 6.80


2.05

1500

8.90
0.85

2100

8.90
8.20
JULY20TH 715 7.70


1.15

1000

8.70
1.40

1500

10.60
1.70
JULY 21ST 700 8.00


2.35

1100

8.10
2.11

1515

11.60
1.30

2010

9.30
1.40
JULY 22ND 700 6.90


0.85

1030

9.50
1.05

1500

8.00
6.55
JULY 23RD 700 6.10


2.55

1025

6.50
1.40

1520

7.40
2.10
JULY 24TH 700 8.70


2.55

1110

6.00
2.60

2130

9.20
2.00
JULY 25TH 700 5.80


6.15

1730

6.90
6.40

2130

9.00
2.50
JULY 26TH 715 7.10


0.95

1030

6.80
0.30

1515

7.60
0.40

2030

7.30
7.55
JULY 27TH 700 5.80


2.25

1000

6.70
0.95

1500

11.90
1.55









AVERAGE 7.00
8.40
2.60
 
Fingerpricks for meals are relevant in themselves for the starting point, the rise and the end point. A good pre meal reading, a rise of less than 2mmol and post meal below 8 are all good indicators. On a keto diet the <2mmol rise should be fairly easy to achieve so it’s just the start and end points that show how you’re going.

Averaging them over meals/days doesn’t help much, other than maybe as an indicator of what your hba1c might be like if you have enough data points.

I can’t make much sense of the numbers you’ve attached or what they relate to I’m afraid.

People on keto can sometimes be effected by adapative glucose sparing aka physiological insulin resistance. It’s not a problem but does give slightly raised fasting readings while on keto, but the overall improved blood glucose profile the rest of the day keeps hba1c at good levels. Eating more carbs removes this phenomenon. People usually carb up before OGTT or HOMA tests to avoid this as a confounding factor.
 
Dear HSSS
I have made a right horlicks of this. Thank you for taking the trouble to reply.

From July 19th to July 27th took fasting blood sugar, meal plus 2 hours, and ketone readings, and set them out on a spreadsheet. I tried to copy paste the results but that did not work. I was not aware that a strange arrangement of figures had appeared instead. I thought I had explained all of this in my reply post, but there is no trace.

To summarise:

Fasting readings- total 9. The average came to 7.0 mmol, and 3 readings were above 7.0 mmol
Meal plus 2 hours readings- total 20 : the average was 8.4 mmol, with 5 above 9.0 mmol.
Ketone readings – total 29: the average was 2.6 mmol.

I would love to know what you make of these readings. I am inclined to think that there is not much to worry about, but I may be wrong.
 
averages are pointless. What you need to focus on is each individual meal, unless you eat exactly the same meal every day.

test just before. Test 2 hours after first bite. If the difference is more than 2 points, that specific meal has too many carbs for your body to handle, so that specific meal needs adjusting.

repeat with each different meal. Your before meal figure is very important as a figure to compare your 2 hours after meal figure to. That is the purpose of the before meal figure.

Your body will deal with each meal combination differently, as the changes are due to the composition of the meal.
 
Lucy: thanks for your response. I am not sure I can face doing what you suggest. I will make a start though, and who knows, may continue.
Many thanks,
antonym
 
antonym said:
Lucy: thanks for your response. I am not sure I can face doing what you suggest. I will make a start though, and who knows, may continue.
Many thanks,
antonym
Click to expand...
Start with your main meal of the day, and see how you feel.
 
antonym said:
Lucy: thanks for your response. I am not sure I can face doing what you suggest. I will make a start though, and who knows, may continue.
Many thanks,
antonym
Click to expand...
Is your 15-20g of carbs per meal or per day?
Maybe if you could provide some examples of the meals you eat we may spot some problematic foods?

How many times a day do you usually eat and when?
 
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