Constant high blood glucose readings on LCHF

[Lynnzhealth]

I was diagnosed with T2 in March 2017 and was put on Metformin, which didn't agree with me. I gave it up and researched and found the LCHF lifestyle. I went on to lose 55 lbs, my A1C went to normal levels, everything was going well. This past December 2018, my fasting and post prandial readings started to go up. I was dealing with a family situation and my stress/anxiety levels have been through the roof ever since. At my last blood work my A1C was just below the cutoff. This past few days my readings have been higher, from 10.2 to 14.7, whether I eat or not. I am so worried which causes even more stress. I have no idea what to do anymore. The first thing the Dia Educator said was, 'Would you go back on Metformin', without even considering any other cause. I also have been reading on different sites that it could be Physiological Insulin Resistance, which happens when one has been on LCHF for a period of time. Has anyone else experienced this? How long does it take to regulate itself? Does anyone have any tips on lowering cortisol and other stress hormone levels? I would really appreciate any help anyone can give me.

 

[shelley262]

I was diagnosed with T2 in March 2017 and was put on Metformin, which didn't agree with me. I gave it up and researched and found the LCHF lifestyle. I went on to lose 55 lbs, my A1C went to normal levels, everything was going well. This past December 2018, my fasting and post prandial readings started to go up. I was dealing with a family situation and my stress/anxiety levels have been through the roof ever since. At my last blood work my A1C was just below the cutoff. This past few days my readings have been higher, from 10.2 to 14.7, whether I eat or not. I am so worried which causes even more stress. I have no idea what to do anymore. The first thing the Dia Educator said was, 'Would you go back on Metformin', without even considering any other cause. I also have been reading on different sites that it could be Physiological Insulin Resistance, which happens when one has been on LCHF for a period of time. Has anyone else experienced this? How long does it take to regulate itself? Does anyone have any tips on lowering cortisol and other stress hormone levels? I would really appreciate any help anyone can give me.

Stress and anxiety I believe were a major part both of developing my diabetes and currently puts my numbers up - temporarily- more than food now I follow a keto way of eating. What I found was that managing stress and my reaction to it is crucial for me keeping low numbers. I’ve worked out a stress management programme that works for me - as a carerof elderly mum and autistic adult son stress will happen can’t stop it! Just how I manage it. My strategies include daily mindfulness session ( or more in stressful situations) using headspace app, lots of walking out ideally taking photos of natural stuff - did some spring photos today - exercise, currently mix swimming and gym a few times a week with jacuzzi and steam session. Workout what you enjoy and can work into your life - could just be a few mins of mindfulness, walk-in a park, warm bath with candles, a short break for a few mins of deep breathing, a coffee or tea or chat with a friend, a listen to some music that relaxes you or you can sing along or jig around to, a comedy sketch, programme or film ............work out what takes you out of your worries if only for a few mins and give it a go. Small steps will work up and help take that cortisol and high bg reaction down a peg or two - good luck thinking of you.

 

[Lynnzhealth]

Thank you, Shelley262. We just got back from a walk. Chilly here in PEI, Canada and it's supposed to be spring. I think it's the stress, too, because I'm following Keto and I haven't gone back to the 'other' way of eating. My reaction to stress is not good. It's instant, then it takes hours for me to calm down. If my dog even grunts my whole body tenses up, it's terrible and then I am yelling at him. I have to try mindfulness/meditation, listening to music (which I don't do a lot of because I like it very quiet). That's why when the dog barks it immediately sets me off. Thank you for giving me all the tips. I give you lots of credit for managing to control your readings with just diet in spite of all your stress. HUGS! I think it's time for me to start taking small steps and get myself out of this downward spiral before something bad happens. Have an awesome day!

 

[DCUKMod]

Thank you, Shelley262. We just got back from a walk. Chilly here in PEI, Canada and it's supposed to be spring. I think it's the stress, too, because I'm following Keto and I haven't gone back to the 'other' way of eating. My reaction to stress is not good. It's instant, then it takes hours for me to calm down. If my dog even grunts my whole body tenses up, it's terrible and then I am yelling at him. I have to try mindfulness/meditation, listening to music (which I don't do a lot of because I like it very quiet). That's why when the dog barks it immediately sets me off. Thank you for giving me all the tips. I give you lots of credit for managing to control your readings with just diet in spite of all your stress. HUGS! I think it's time for me to start taking small steps and get myself out of this downward spiral before something bad happens. Have an awesome day!

Lynnzhealth, have you had a chat with your health care provider about your stress reactions? They seem quite extreme, which of course can happen, and can, as you suggest escalate as you anticipate the next stressful situation. However, it could be worthwhile having a chat and seeing what he/she thinks.

You talk about lowering your cortisol/strress hormones, and whilst I agree it could be helpful to you, it would be good to know if they are dirrectly implicated in your increased blood glucose levels.

Initial cortisol testing is either a 24 hour urine collection (boy, that's fun!), or saliva testing.

 

[Bluetit1802]

Physiological insulin resistance only normally happens on a very low carb diet when the body detects there is insufficient glucose in the blood for the brain to use. To counteract this, the cells are triggered to refuse to accept most of the glucose, thus saving it for the brain. It is known as "brain saving". The effect of this is that base line glucose levels increase (fasting, and pre-meals) but any rises after eating are not affected other than being higher because you are starting higher. The rise in base levels is not normally very much, just enough for us to notice. It is normally temporary and can be stopped by eating a few grams more of carbs for a few days. From what you say, I doubt this is what you have. I suspect it is the stress.

 

[Lynnzhealth]

Lynnzhealth, have you had a chat with your health care provider about your stress reactions? They seem quite extreme, which of course can happen, and can, as you suggest escalate as you anticipate the next stressful situation. However, it could be worthwhile having a chat and seeing what he/she thinks.

You talk about lowering your cortisol/strress hormones, and whilst I agree it could be helpful to you, it would be good to know if they are dirrectly implicated in your increased blood glucose levels.

Initial cortisol testing is either a 24 hour urine collection (boy, that's fun!), or saliva testing.

Yes, many times over the past few years. Once I told him that it gets really bad and I might kill someone. He said basically, "well, that's not my fault." Then I went to see a counselor last Oct and she picked up on my anxiety immediately. She told me to go back to my doctor, so I did. He raised my depression/anxiety meds and my anxiety got much worse, so I dropped the extra pill. I don't think family doctors know much about mental issues or know how to treat them. I didn't get much exercise over the winter because the weather was so bad, but we're now able to get for some long walks. I follow Keto, but nothing seems to be working. I'm starting to get very scared. And, the first thing my doctor and diabetic educator say is, "you need to go back on meds." They won't look at any other causes. It is terribly frustrating. Can one purchase cortisol tests at a pharmacy? I, too, would love to know what is causing these spikes. Thanks for your help.

 

[Adm_Mad]

Argh so you need carbs or your glucose will rise but it rises if you eat them too? I don’t get this disease at all. I’m not going to even call it diabetes, I’m going to call it the Trolling Disease. LOL.

I’ve only been monitoring my glucose for five days. Daily carbs between 15-18 except for one day with 0. Net Calories between 600 and 900 except for one day with 0 and one with 150. Every day my readings throughout the day have been between the mid 5’s and low 9’s. The only day I was able to keep to 5’s and 6’s I had fasted the day before.

I am praying when I see my doctor after Easter she won’t tell me I have to go on meds. But if the only way I can keep my glucose moderate is by not eating that might be hard.

 

[DCUKMod]

Yes, many times over the past few years. Once I told him that it gets really bad and I might kill someone. He said basically, "well, that's not my fault." Then I went to see a counselor last Oct and she picked up on my anxiety immediately. She told me to go back to my doctor, so I did. He raised my depression/anxiety meds and my anxiety got much worse, so I dropped the extra pill. I don't think family doctors know much about mental issues or know how to treat them. I didn't get much exercise over the winter because the weather was so bad, but we're now able to get for some long walks. I follow Keto, but nothing seems to be working. I'm starting to get very scared. And, the first thing my doctor and diabetic educator say is, "you need to go back on meds." They won't look at any other causes. It is terribly frustrating. Can one purchase cortisol tests at a pharmacy? I, too, would love to know what is causing these spikes. Thanks for your help.

Where are you based Lynnzhealth?

Cortisol really needs to be tested Ina controlled way, as it naturally follows a circadian rhythm- in a fit and healthy person, being higher in the morning, to give is get up and go, and in the simplest terms petering off towards evening for us to get some sleep. Obviously everyone can have additional "contributions" through the day, if we get to a highly stressful situations.

Serum cortisol should be done very early morning, but the 24 hour urine collection style of test is literally a collection of your total urinary output for 24 hours. That's all very dignified, you understand.

There is also an option to use a saliva test, at 4 points over the day at 08, 12, 16 and 20:00 hrs, but this isn't commonly used in U.K., despite it giving the most accurate personal profile.

To be honest, personally, I wouldn't bother with anything from the pharmacy, due to the foregoing, and even if a home test showed it to be very high, the chances of a doctor reacting to it would be limited, I'd guess, on the basis the test might not be accurate and not robust enough.

It's a trick you one.

In UK we have a couple of reputable labs doing private tests on demand. If you would like any further information on them, please let me know.

 

[mariavontrapp]

I'm sorry to hear you are having a difficult time. Stress puts up my blood glucose too; also if I have a virus that raises bg. Personally I wouldn't bother getting cortisol tested as it would only tell you what you already know - that you are stressed. Stress is the cause of so many health conditions but also one of the hardest things to address. It can seem easier to control our eating or look for a magic pill, but the stress has to be addressed. As a starting point I would suggest getting into a really good sleep routine, as poor sleep can also affect glucose levels.

 

[DCUKMod]

I'm sorry to hear you are having a difficult time. Stress puts up my blood glucose too; also if I have a virus that raises bg. Personally I wouldn't bother getting cortisol tested as it would only tell you what you already know - that you are stressed. Stress is the cause of so many health conditions but also one of the hardest things to address. It can seem easier to control our eating or look for a magic pill, but the stress has to be addressed. As a starting point I would suggest getting into a really good sleep routine, as poor sleep can also affect glucose levels.

Marion, whilst I agree that @Lynnzhealth already knows she is stressed, she has expressed some quite extreme reactions. In my view, things are often worth checking out, just to tick a box to know it isn't an issue, as much as that it is.

There are also a number of medical conditions which can cause high levels of cortisol to be circulating, as a baseline, then when stress is introduced can become even higher.

The test is a straightforward endochrinology test, although in UK anyway, the straightforward serum cortisol tests is often not done early morning, so that can influence view of the results.

Lynzzhealth, I'm certainly not trying to back you into a corner to have your cortisol tested, or suggest I know you have a cortisol issue, because I'm doing neither, I'm just sharing some learnings I have picked up along the way in the puzzle that is my hormonal issue.

 

[Traceymac23]

Argh so you need carbs or your glucose will rise but it rises if you eat them too? I don’t get this disease at all. I’m not going to even call it diabetes, I’m going to call it the Trolling Disease. LOL.

I’ve only been monitoring my glucose for five days. Daily carbs between 15-18 except for one day with 0. Net Calories between 600 and 900 except for one day with 0 and one with 150. Every day my readings throughout the day have been between the mid 5’s and low 9’s. The only day I was able to keep to 5’s and 6’s I had fasted the day before.

I am praying when I see my doctor after Easter she won’t tell me I have to go on meds. But if the only way I can keep my glucose moderate is by not eating that might be hard.

Are you on metformin yet?

That's likely to be the first prescribed medication

 

[Adm_Mad]

@Traceymac23 No meds yet, I won’t know what my GP wants to do until I see her after Easter. I am praying she won’t prescribe medication straight away. I’ve lost a bit over 2 kg/4 pounds this first week and hope I’ll lose more before our appointment. I know what I’m doing now isn’t sustainable long term (between 600-700 net calories a day as well as low carb) so if she lets me try to manage without meds or insulin I’ll raise the calories slightly and lose weight slower but hopefully still steady.

After exercising today (2 x 40 min on the stationary bike with a 10 minute break between, approx 470 calories burned) it had dropped to 3.9 which was a relief. And even in the 8’s it hasn’t risen more than 2 when I test two hours after eating.

I’m doing what I said I wouldn’t when I was diagnosed on Monday, over testing and obsessing. I know that’s probably normal for people right after diagnosis though.

 

[Traceymac23]

@Traceymac23 No meds yet, I won’t know what my GP wants to do until I see her after Easter. I am praying she won’t prescribe medication straight away. I’ve lost a bit over 2 kg/4 pounds this first week and hope I’ll lose more before our appointment. I know what I’m doing now isn’t sustainable long term (between 600-700 net calories a day as well as low carb) so if she lets me try to manage without meds or insulin I’ll raise the calories slightly and lose weight slower but hopefully still steady.

After exercising today (2 x 40 min on the stationary bike with a 10 minute break between, approx 470 calories burned) it had dropped to 3.9 which was a relief. And even in the 8’s it hasn’t risen more than 2 when I test two hours after eating.

I’m doing what I said I wouldn’t when I was diagnosed on Monday, over testing and obsessing. I know that’s probably normal for people right after diagnosis though.

it's perfectly normal after diagnosis.....the key thing is that when you do stop 'over testing' and 'obsessing' you don't go too far and lose interest in it altogether.......hopefully you'll find a regime that suits your metabolism and lifestyle.......I'm sure with the right support you'll do fine..........just hoping you get a decent GP who LISTENS....although that works both ways, they do know some stuff.

 

[Chook]

Just to say... your GP and DN are there to support you in YOU in controlling your diabetes. If you think you need more time to get it under control with diet and/or exercise and don't want meds (yet) then don't be afraid to express your opinion. They might be surprised because most people are happy to take the pills and carry on eating as they have always done but you are choosing to take control. Well done you!!!

 

[Lynnzhealth]

Physiological insulin resistance only normally happens on a very low carb diet when the body detects there is insufficient glucose in the blood for the brain to use. To counteract this, the cells are triggered to refuse to accept most of the glucose, thus saving it for the brain. It is known as "brain saving". The effect of this is that base line glucose levels increase (fasting, and pre-meals) but any rises after eating are not affected other than being higher because you are starting higher. The rise in base levels is not normally very much, just enough for us to notice. It is normally temporary and can be stopped by eating a few grams more of carbs for a few days. From what you say, I doubt this is what you have. I suspect it is the stress.

I'm suspecting it is the stress/anxiety, too.

Where are you based Lynnzhealth?

Cortisol really needs to be tested Ina controlled way, as it naturally follows a circadian rhythm- in a fit and healthy person, being higher in the morning, to give is get up and go, and in the simplest terms petering off towards evening for us to get some sleep. Obviously everyone can have additional "contributions" through the day, if we get to a highly stressful situations.

Serum cortisol should be done very early morning, but the 24 hour urine collection style of test is literally a collection of your total urinary output for 24 hours. That's all very dignified, you understand.

There is also an option to use a saliva test, at 4 points over the day at 08, 12, 16 and 20:00 hrs, but this isn't commonly used in U.K., despite it giving the most accurate personal profile.

To be honest, personally, I wouldn't bother with anything from the pharmacy, due to the foregoing, and even if a home test showed it to be very high, the chances of a doctor reacting to it would be limited, I'd guess, on the basis the test might not be accurate and not robust enough.

It's a trick you one.

In UK we have a couple of reputable labs doing private tests on demand. If you would like any further information on them, please let me know.

Good morning. I am in Prince Edward Island, Canada. This morning my fasting blood sugar was 17.2. It's going up more each day. I even started taking Metformin again because I had a few here at home. I don't know of any labs over here and my doctor only wants to prescribe medications. I am really getting worried about this. Thanks for your information and help.

 

[Lynnzhealth]

Just to say... your GP and DN are there to support you in YOU in controlling your diabetes. If you think you need more time to get it under control with diet and/or exercise and don't want meds (yet) then don't be afraid to express your opinion. They might be surprised because most people are happy to take the pills and carry on eating as they have always done but you are choosing to take control. Well done you!!!

Thank you. My DN said she supports me although she does not like the "Keto" lifestyle. She immediately wants me to take meds, as does my GP. I don't feel much support there. I have told them that I do NOT want to go on meds. It's just this past 4 months, dealing with lots of stress/anxiety and lack of exercise, due to nasty weather, that my blood has been rising. It's very scary. Maybe with the nicer weather every day or so, I'll be able to go out and get more exercise and see if that helps. I'd rather control it with diet/exercise than meds. I volunteer at our hospital and I see those people who take meds and eat everything coming in to have limbs removed, being stuck in wheelchairs, having heart problems and being on dialysis. And, there is at least one a week, or more, dying due to diabetes complications. I don't know how their GPs and DN's can sleep at night. Thank you for your support.

 

[Lynnzhealth]

@Traceymac23 No meds yet, I won’t know what my GP wants to do until I see her after Easter. I am praying she won’t prescribe medication straight away. I’ve lost a bit over 2 kg/4 pounds this first week and hope I’ll lose more before our appointment. I know what I’m doing now isn’t sustainable long term (between 600-700 net calories a day as well as low carb) so if she lets me try to manage without meds or insulin I’ll raise the calories slightly and lose weight slower but hopefully still steady.

After exercising today (2 x 40 min on the stationary bike with a 10 minute break between, approx 470 calories burned) it had dropped to 3.9 which was a relief. And even in the 8’s it hasn’t risen more than 2 when I test two hours after eating.

I’m doing what I said I wouldn’t when I was diagnosed on Monday, over testing and obsessing. I know that’s probably normal for people right after diagnosis though.

Diabetes is a roller coaster ride in my opinion. I obsess, too, and that probably adds to my stress. Good luck with your appointments.

 

[Lynnzhealth]

I'm sorry to hear you are having a difficult time. Stress puts up my blood glucose too; also if I have a virus that raises bg. Personally I wouldn't bother getting cortisol tested as it would only tell you what you already know - that you are stressed. Stress is the cause of so many health conditions but also one of the hardest things to address. It can seem easier to control our eating or look for a magic pill, but the stress has to be addressed. As a starting point I would suggest getting into a really good sleep routine, as poor sleep can also affect glucose levels.

Thank you. I do NOT sleep well at all and haven't for a long time. There are so many things that can affect diabetes that it's mind-boggling. No wonder I'm confused. I was doing so well up until these past 4 months. Thanks.

 

[Resurgam]

I usually have insomnia - up until dawn many times - but I saw some folic acid tablets at the supermarket and decided to give them a go (what use is a BSc degree if there is no experiment going on?) and see what happens.
Well - after just over a week, definite differences mentally, but for the past three nights I have slept really well, felt tired in the late evening, woken before noon. I saw a slightly different person in the mirror this morning - someone smiling.

 

[Lynnzhealth]

I usually have insomnia - up until dawn many times - but I saw some folic acid tablets at the supermarket and decided to give them a go (what use is a BSc degree if there is no experiment going on?) and see what happens.
Well - after just over a week, definite differences mentally, but for the past three nights I have slept really well, felt tired in the late evening, woken before noon. I saw a slightly different person in the mirror this morning - someone smiling.

Thank you. I believe I will give them a try and see if they help me. Smiling would be nice instead of being cranky all the time from lack of sleep.