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Do things get worse before they get better?

S

Stronggirlsclub

Well-Known Member
Messages
85
Type of diabetes
Type 2
Treatment type
Tablets (oral)
Hello everyone,

Last Monday I was told that I had a very high HBA1c reading and immediately went LCHF. I had some great improvements in my SMBG readings initially, but over the last few days I have consistently had higher base line readings (although post prandial readings are the same as before I’ve eaten)

I’ve stuck to 20-40g carb per day and my macros are inline with recomendations.

Is it normal for this to happen? It seems like my liver is kicking out a lot of extra glucose because I’m not feeding my body carbs. Will this settle down as my body adapts to this new way of life?

Thank you

SGC
 
My understanding is that the less carbs you eat of a day will subsequently reduce the amount of glucose which is sent to the liver stores.....so in theory yes.....it should settle down......I don't know how long it takes though.....as I personally don't follow low carb....therefore I still actually see a significant dawn rise.......[defeated with the pump of course..]
 

Thank you for taking the time to reply.

I’m really hoping that things settle down soon. I’m still very motivated to improve my diabetes though diet and exercise; I just wish I knew if it is working/ will work.

SGC
 
This sounds to me very much like physiological insulin resistance. (PIR). This is entirely different from the normal diabetes related insulin resistance. It is also known as glucose sparing. When someone is on a very low carb diet and accordingly the glucose in the blood stream is nice and low, the body decides it needs to save this glucose for the brain and some red blood cells that need it, so the rest of the cells are "instructed" to reject this glucose. This causes base line BGs to increase a bit but rarely affects post meal levels. It has happened to me. It is likely to be temporary so you can ride it out for a few weeks. Or you can increase your carbs slightly for a few days to give your body a little more glucose that it seems to think it wants. Not a lot else you can do. There are plenty of websites about it if you have a Google.
 
If you have a liver full of stored fats and sugars - usually with a bay window effect, then I think that the symptoms are actually a good indicator or changes for the better.
My waist softened - it was not compressible before - and then shrank down quite quickly.
As long as you feel OK and things are changing for the better in other ways I don't think that you need to worry.
The next step I saw was post meal readings drifting down, even though I ate the same things. Less insulin resistance I think.
 
I am not sure how low carb you have gone - very, I think, from your other posts?
But I don't think you would expect PIR (physiological insulin resistance) to kick in for a while yet. It usually takes months, not a couple of weeks, and will only happen once your body is adapted to ketogenic eating, which usually takes over 6 weeks, sometimes longer.

However, what I am guessing may be happening, is that your body is used to higher blood glucose levels, and your liver is used to using its stored glucose (stored as glycogen) in the liver and the big muscles, to bump up your blood glucose to those levels. The body tends to like feeling 'normal' and if you have been running on high blood glucose for months if not years, then high feels 'normal'.

So your liver may well be raiding its stores to keep your blood glucose high.

The good thing is that this is temporary.
Firstly, glycogen stores in the liver are not endless, and when they run down, the bumping up effect will reduce.
Secondly, your body will, over time, adjust to the new lower 'normal' and won't need to keep asking to raid those glycogen stores.

I expect that there will come a time in the near future when your blood glucose drifts down, and you feel a bit wobbly for a while - just until you adjust. When that happens, it may be worth you having your glucometer handy, and testing to see what your blood glucose is. Sometimes the new lower numbers feel very strange, when in fact they are still not low enough to class as hypos (a hypo would be a reading below 4mmol/l)

Obviously, this is all guesswork, based on the things you have told us.
The best thing to do is keep checking your blood glucose, and allow your body the time to adjust.
Remember, your glucose dysregulation didn't happen overnight, so expecting it to resolve may take some time too.
 

This is so so helpful. Thank you so much for taking the time to write such an informative reply.

It does make total sense. I hope this is the case and that things gradually start to drift to more normal levels.

I suspect your right about my body struggling with the new lower glucose levels. I’ve felt light headed a few times recently, but when I checked, my Bg was mid 6’s.

I’ve noticed over the last few days that my levels rise overnight and then seem to stay high until lunch time when they tend to come down a little. What is good though is that my post prandial readings are always the same or lower than my pre-prandial readings; all hints to liver glucose I expect.

Thank you again. The scientist in me is desperate to know exactly what’s going on!
 
Hi @Stronggirlsclub it happens to us all! LCHF does take time to reduce the bg numbers and especially the fasting and morning numbers. You just need to keep going. It took several months of this way of eating before all my bloods came in line to where I wanted them to be and even now they can be erratic occasionally. Stress, poor sleep and exercise for example can cause the bgs to go up even when you haven’t had even a sniff of a carbohydrate but you will start to notice an overall trend downwardsover time if you keep going. We are all different starting at different levels of insulin resistance and even our tolerance of different carbs. For me stress has a big effect and I find if I use mindfulness and exercise that can help lower my bgs alongside this way of eating. I can understand your frustration but it will take time as @Brunneria says it probably didn’t develop overnight so won’t go away overnight either. Remind yourself too just how far you’ve come in a short time - you've had some low numbers and they will slowly and steadily get lower.
 
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