Type 2 Does my body think 115 mg/dL (6.4 mmol/L) to 135 mg/dL (7.5 mmol/L) is normal?

[Winnie53]

I started the LCHF diet in mid-February, and it's made a huge difference in my blood glucose levels. I went from a A1C of 9.9 to 5.5 - (I live in the US not UK).

On good days, my fasting blood glucose (FBG) and 2-hour post-meal blood glucose (BG) ranges from 115 - 135 mg/dL (6.4 - 7.5 mmol/L). I know this is asking a lot, but want to be in the 75 - 95 mg/dL (4.2 - 5.3 mmol/L) range. As my husband often says, "I can dream"...

Something interesting happened yesterday.

FBG/Pre-breakfast BG was 124 mg/dL (6.9 mmol/L). Breakfast BG was 143 mg/dL (7.9 mmol/L); pre-lunch BG was 126 mg/dL (7 mmol/L); Post-lunch BG/Pre-snack was 130 mg/dL (7.2 mmol/L). Not a great day, but this is what happens if my BG spikes after dinner the previous night, which was what happened.

I met my friends for our weekly coffee at 4 p.m. and I forgot to bring a snack - (1 oz of walnuts, almonds, or pecans). Was 20 minutes early so bought some sunflower seeds in the shell. Couldn't get the kernels out of the shell despite my friend's best attempt at coaching, so gave up.

At the coffee shop, I noticed they had a 4 oz greek yogurt with granola topping, so bought one with my tea. Not ideal but my best option given their other offerings of "refined grains and sugar" or...more of same.

The yogurt was plain, by that I mean no fruit, but it tasted sweet and after eating it, I still felt hungry, so it probably was low fat too. Not good.

Post-snack BG was 225 mg/dL (12.5 mmol/L). I haven't had a reading that high since I started eating low carb in February. I was in shock. All I could think of is "How long is it going to take to get my BG back into the normal range?".

But to my surprise, pre-dinner (2 hours after the high reading) my BG was 179 mg/dL (10 mmol/L). Then 2 3/4 hours later, post-dinner BG was 125 mg/dL (6.9 mmol/L), a 100 mg/dL (5.6 mmol/L) drop in a little less than 6 hours.

After this, I ate a whole avocado. My post-snack/pre-sleep BG was 143 mg/dL (7.9 mmol/L). FBG this morning was 135 mg/dL (7.5 mmol/L) so still not back to normal.

I find this interesting, because after I started eating low carb, it took me 21 days to get my BG down to 125 mg/dL (6.9 mmol/L) for the first time.

I believe, thanks to the LCHF diet, I'm less insulin resistant now. That's good.

My questions:

If I'm less insulin resistant now, and I'm producing adequate insulin, why are my blood glucose levels still stuck in the 115 - 135 mg/dL (6.4 - 7.5 mmol/L) range for the last 3 months? It's as if my body thinks my normal FBG is 115 mg/dL (6.4 mmol/L). How do I change that to 85 mg/dL (4.7 mmol/L)? Any and all thoughts on this most appreciated.

To summarize, here's my blood glucose levels again from yesterday...

124 mg/dL......(6.9 mmol/L)......FBG/Pre-breakfast......9:29 a.m.
143 mg/dL......(7.9 mmol/L)......2 hours post breakfast......12:03 p.m.
126 mg/dL......(7 mmol/L)......Pre-lunch......1:30 p.m.
130 mg/dL......(7.2 mmol/L)......2 hours post lunch/pre-snack......4:01 p.m.
225 mg/dL......(12.5 mmol/L)......2 hours post-snack......5:53 p.m.
179 mg/dL......(10 mmol/L)......Pre-dinner......7:59 p.m.
125 mg/dL......(6.9 mmol/L)......2 3/4 hours post dinner......10:45 p.m.
143 mg/dL......(7.9 mmol/L)......post snack of whole avocado......12:12 a.m.
135 mg/dL......(7.5 mmol/L)......FBG/Pre-breakfast......9:14 a.m.

 

[Lamont D]

I believe that I answered a similar questions before.
It could be that you have plateaued at that current level.
You have done brilliant in achieving what you have done.
Long may it continue

 

[Winnie53]

Yes, I've definitely plateaued Nosher8355.

What got me thinking more about this, after reflecting on what happened, is a post I read recently.

The poster was a type 2 diabetic. During a meeting with his/her healthcare provider it was observed that his/her blood glucose (BG) levels were higher than they'd been previously. In response, it was explained that sometimes the body's set point for BG gets stuck at a higher than normal level and that switching to a different medication sometimes returns the BG to its previous, lower levels.

I find this idea interesting.

 

[Lamont D]

Yes, I've definitely plateaued Nosher8355.

What got me thinking more about this, after reflecting on what happened, is a post I read recently.

The poster was a type 2 diabetic. During a meeting with his/her healthcare provider it was observed that his/her blood glucose (BG) levels were higher than they'd been previously. In response, it was explained that sometimes the body's set point for BG gets stuck at a higher than normal level and that switching to a different medication sometimes returns the BG to its previous, lower levels.

I find this idea interesting.

Sometimes your pancreas needs a kick in the **** to get it moving again!

 

[Winnie53]

Sometimes your pancreas needs a kick in the **** to get it moving again!

Yes.

But then maybe no. I'm speculating, but I think I'm producing enough insulin and I think I've come along way in reducing my insulin resistance too. So what else is at play here?

Another question that I'm trying to sort out is "Why are people who do the whole foods, plant based, low or no fat diet that includes whole grains, starchy vegetables, and legumes as successful as those who do the low carb, high fat diet?" From what I've read, their blood glucose drops too after a few weeks.

 

[Brunneria]

I think our bodies get habituated to a certain BG range.
And it it drifts back into that range, when BGs stray above or below.
In order to get habituated to a new, lower range, is harder work than just staying where you are. I think habituation takes several weeks at the new level before you fully adjust.

I find it impossible to get below 5.1mmol/l
Literally, impossible.

If I hit a 4 my body goes into full melodramatic hypo. Now, a 'hypo' at that level isn't actually a hypo. So they say. Hypos are apparently only real if you dip below 3.6. Tell that to my body. I get the full works. Numb cheekbones, lost words, apathy, blankness, zoned out brain deadness, followed by shaking, sweating, wobbly knees, homicidal rage, tendency to violence... I could go on. And remember, my BG will only have dropped 0.5 mmol/l from its 'normal' range.

So, the question is:
is this a 'false hypo' because my BG usually hangs out in the 5-7 range?
Or is it a 'real hypo' for my body, which just happens to be higher for me than others?

Whichever is the case, my body is clearly habituated to that 5-7 range.

 

[Lamont D]

I think our bodies get habituated to a certain BG range.
And it it drifts back into that range, when BGs stray above or below.
In order to get habituated to a new, lower range, is harder work than just staying where you are. I think habituation takes several weeks at the new level before you fully adjust.

I find it impossible to get below
If I hit a 4 my body goes into full melodramatic hypo. Now, a 'hypo' at that level isn't actually a hypo. So they say. Hypos are apparently only real if you dip below 3.6. Tell that to my body. I get the full works. Numb cheekbones, lost words, apathy, blankness, zoned out brain deadness, followed by shaking, sweating, wobbly knees, homicidal rage, tendency to violence... I could go on. And remember, my BG will only have dropped 0.5 mmol/l from its 'normal' range.

So, the question is:
is this a 'false hypo' because my BG usually hangs out in the 5-7 range?
Or is it a 'real hypo' for my body, which just happens to be higher for me than others?

Whichever is the case, my body is clearly habituated to that 5-7 range.

I think you have found your 'comfort son's and you are happy there!

 

[Indy51]

There are so many things at play that I end up totally confused whenever I try to get a handle on it. There's downregulation of digestive enzymes that require rehabituation to carbohydrates to work optimally - the reason we need to "carb up" before having an OGTT and the reason for the extra high spikes when we eat carbs after a period of low carbing.

Then there's normal physiologic insulin resistance caused by the low carb diet - there are a series of posts on the subject by Peter Hyperlipid that explain it:

http://high-fat-nutrition.blogspot.co.uk/2007/10/physiological-insulin-resistance.html

http://high-fat-nutrition.blogspot.co.uk/2008/05/physiological-insulin-resistance-2-dawn.html

http://high-fat-nutrition.blogspot.co.uk/2008/08/physiological-insulin-resistance.html

http://high-fat-nutrition.blogspot.co.uk/2008/09/physiological-insulin-resistance.html

http://high-fat-nutrition.blogspot.co.uk/2008/09/physiological-insulin-resistance-wild.html

http://high-fat-nutrition.blogspot.co.uk/2008/09/terminator.html

http://high-fat-nutrition.blogspot.co.uk/2009/09/physiological-insulin-resistance-and.html

http://high-fat-nutrition.blogspot.co.uk/2009/09/chewing-fat.html

http://high-fat-nutrition.blogspot.co.uk/2009/09/physiological-insulin-restisance-guess.html

http://high-fat-nutrition.blogspot.co.uk/2010/02/physiological-insulin-resistance.html

 

[Lesleywo]

Yes.

But then maybe no. I'm speculating, but I think I'm producing enough insulin and I think I've come along way in reducing my insulin resistance too. So what else is at play here?

Another question that I'm trying to sort out is "Why are people who do the whole foods, plant based, low or no fat diet that includes whole grains, starchy vegetables, and legumes as successful as those who do the low carb, high fat diet?" From what I've read, their blood glucose drops too after a few weeks.

I read somewhere recently about this and it's to do with weight loss. Seems it's not so much what we eat but more how much weight we lose.

I recently had my fasting insulin tested again and it's dropped way down ... I've not lost much more weight since last test in January but I've been doing a lot more weight training which I believe makes it easier for the muscles to take up glucose.

Lots of things at play it seems.

 

[Winnie53]

Nosher, I feel like the child who's always asking the exasperated parent, "Yes, but wh-h-y-y?"

Brunneria, your range of 5 - 7 mmol/L (90.1 - 126.1 mg/dL), though a lot better, is similar to mine, 115 - 135 mg/dL (6.4 - 7.5 mmol/L). It helps knowing that at least one person shares my experience.

I do empathize with your hypoglycemic episodes. I suffered with hypoglycemia for a number of years in the early 80's, and don't want to ever go through that again. I also had a bad temper. Kept food available at all times. If forced to choose, my preference would be pre-diabetes over hypoglycemia in a heartbeat!

I think you're dead on in your statement, "our bodies get habituated to a certain BG range. And it drifts back into that range, when BGs stray above or below. In order to get habituated to a new, lower range, is harder work than just staying where you are. I think habituation takes several weeks at the new level before you fully adjust."

I also think there's something to what you say about getting the BG down and keeping it there for several weeks. I hadn't thought about that until I read your post.

That's essentially what @Ian DP did. His BG was so high, they had to medicate him to get it back down. Afterward, he was able to stop the medication, and has continued to maintain his healthy BG levels with the LCHF diet and exercise. (Ian, if I got any of that wrong, please correct me.)

Have you seen the movie Wild starring Reese Witherspoon? http://www.rottentomatoes.com/m/wild_2014/#

"With the dissolution of her marriage and the death of her mother, Cheryl Strayed has lost all hope. After years of reckless, destructive behavior, she makes a rash decision. With absolutely no experience, driven only by sheer determination, Cheryl hikes more than a thousand miles of the Pacific Crest Trail, alone. WILD powerfully captures the terrors and pleasures of one young woman forging ahead against all odds on a journey that maddens, strengthens, and ultimately heals her."

Not that desperate. I prefer modern day conveniences, and am terrified of bears, cougars/mountain lions, venomous snakes and spiders.

But it's inspired me to try walking a little bit further every other day, on thoughtfully chosen routes in and around the city. I do multiple, shorter walks on alternate days to give my heart and legs a day of rest. If it's cold or raining, I walk 2 - 3 miles at the local mall.

Other items in my bag of tricks are taking Berberine and fasting, but can only make so many changes at a time. I've recently begun taking Meriva, an anti-inflammatory supplement to calm my inflamed arteries, and I'm researching probiotics which I want to take next. Perlmutter writes this in his Brain Maker book, page 107:

"Research is underway examining how certain probiotics might be able to reverse type 2 diabetes and the neurological challenges that can follow. At Harvard's 2014 symposium on the microbiome, I was floored by the work of Dr. M. Nieuwdorp from University of Amsterdam, who has done some incredible research related to obesity and type 2 diabetes.(22) He has successfully improved the blood sugar mayhem found in type 2 diabetes in more than 250 people using fecal transplantation. He's also use this procedure to improve insulin sensitivity."

Brunneria, I can't say for sure, but I think I'd be satisfied with BG levels as good as yours.

Looking back, knowing what you know now, when did your problems with BG begin? How long have you had healthy BG's? Do you have or are you developing any diabetes related complications?

I think I've had problems with BG for at least 35 years beginning with hypoglycemia. My only complication is what I believe to be atherosclerosis, but I haven't confirmed that with testing beyond two high hsCRP scores, one four years ago, the other last month.

 

[Winnie53]

Indy51 and Lesleywo, thanks for joining the conversation. Have to walk now before it gets too late. Will be back in a few hours.

 

[Brunneria]

Looking back, knowing what you know now, when did your problems with BG begin? How long have you had healthy BG's? Do you have or are you developing any diabetes related complications?

I think I've had problems with BG for at least 35 years beginning with hypoglycemia. My only complication is what I believe to be atherosclerosis, but I haven't confirmed that with testing beyond two high hsCRP scores, one four years ago, the other last month.

Hi

I think all you thoughts - walking, enzymes, persistence, etc. - make sense. And so does the 'don't change too much at one time'.

My BG issues started young. Looking back, I think I had reactive hypoglycaemia at 3 or 4 years old (white, shaky, floppy and needing food regularly). No one know what it was though. Doc disinterested. I just got a reputation for being lazy, grumpy and preferring to sit reading. Then I had major hormone stuff that kicked in late teens (PCOS and prolactinoma of pituitary gland). All of which led to obesity, and further BG issues.

No idea when I became prediabetic, but it was identified when the PCOS and prolactinoma were - about 15(?) yrs ago, in my early 30s.

My saving grace is that I learned that sweets, sugar and cake made me feel dreadful very early. So I read a bit and drifted into low carb (trial and error) in my teens. Every dietary change and weight loss attempt would push me further into LC to avoid the hypo misery.

But my error, right up until I found this forum, was to low carb consistently with occasional carb binges. Typical carb craving, carb creep, high sugar spikes. These could last a snack, a day, a month. Always triggered by a hypo. Heaven knows how much damage those did! During a bad one, I would eat my own body weight in crisps (chips), gateaux and still-frozen cheesecake. To a low carber, that must have been a terribly damaging spike. Now I have my meter, a single sandwich and scone sends me to 15mmol/l...

So, in answer to your question, 45 yrs of wacky glucose and 3? 4? yrs of full blown T2 (I'm now 48) has left me with appently no diabetic style complications - yet. I get occasional stabby pain in the soles of my feet - no idea if that is the first intimation of neuropathy. Retinas good. Digestion seems OK for a middle aged woman with mild grain intolerances...

I'm happy with the 5-7 range, except for my $~¥#}^¥€ing Dawn phenomenon, which has failed to come down despite 18 months VLC. So I spend 4-6 hrs a day with BG above my target.

 

[Winnie53]

Indy51, thank you for the introduction to that blog. I enjoy reading blogs like this, so subscribed. Not fully understanding what he's discussing, so going to give brain a break and try again later.

Lesleywo, cardiologist Mark Houston also thinks we need to be doing both aerobic exercise and resistance training. I haven't gotten to that chapter of his book yet, but hoping I can do the resistance training at home. It's a good strategy. I've lost and kept off 32 pounds over the years, yet I still weigh 50 pounds more than I did as a young adult. I'd like to lose a minimum of another 25 pounds. The good news is that my waist measurement is now 36 1/2", just inches away from where I need to be eliminate that marker of insulin resistance - (35" for women; 40" for men). The weight loss stopped months ago, but my body continues to change. It's gotten to the point where I have to buy a new set of pants. If I could get more lab tests done, measuring my insulin level would top the list. Glad yours is coming down. That's so encouraging...

Brunneria, I know we adjust and adapt, but can't be very much fun living with multiple health issues. I hope you stay under 7 mmol. It's a good number for us. Has it been primarily the LFHC diet that's helped you the most? Or have other things helped too?

 

[Lesleywo]

Indy51, thank you for the introduction to that blog. I enjoy reading blogs like this, so subscribed. Not fully understanding what he's discussing, so going to give brain a break and try again later.

Lesleywo, cardiologist Mark Houston also thinks we need to be doing both aerobic exercise and resistance training. I haven't gotten to that chapter of his book yet, but hoping I can do the resistance training at home. It's a good strategy. I've lost and kept off 32 pounds over the years, yet I still weigh 50 pounds more than I did as a young adult. I'd like to lose a minimum of another 25 pounds. The good news is that my waist measurement is now 36 1/2", just inches away from where I need to be eliminate that marker of insulin resistance - (35" for women; 40" for men). The weight loss stopped months ago, but my body continues to change. It's gotten to the point where I have to buy a new set of pants. If I could get more lab tests done, measuring my insulin level would top the list. Glad yours is coming down. That's so encouraging...

Brunneria, I know we adjust and adapt, but can't be very much fun living with multiple health issues. I hope you stay under 7 mmol. It's a good number for us. Has it been primarily the LFHC diet that's helped you the most? Or have other things helped too?

Yes we need to do some sort of cardio to exercise the heart muscle and resistance training to cover the rest! I am a huge proponent of weight training. It builds bone density, increases lean muscle mass which in turn increases metabolism, gives your body a more youthful, toned appearance and it seems is good for insulin resistance. Exercises also increases HDL so no reason really not to do it! Of course, you have to find something you like otherwise you won't stick to it

 

[Brunneria]

Brunneria, I know we adjust and adapt, but can't be very much fun living with multiple health issues. I hope you stay under 7 mmol. It's a good number for us. Has it been primarily the LFHC diet that's helped you the most? Or have other things helped too?

Diet has always been the biggest factor - to everything.
Despite all that time low carbing, going deeper and being in ketosis 24/7 was like getting my life back.

So many of us on here have so much more in the way of debilitating multiple health issues, I'm so profoundly grateful that VLC sorts me out so well!

 

[Winnie53]

Lesleywo, if you know anyone who's having bone density problems, have a look at the COMB study and consider sharing it with them... http://www.hindawi.com/journals/jeph/2012/354151/ I have to say, I'm so glad I've had these last four months to rethink everything I'm doing healthwise. My goal is to maintain my new routines when I begin working again. It's encouraging to hear from people like you who are doing well

 

[Winnie53]

Brunneria, I'm grateful too.

 

[vintageutopia]

@Winnie53 and @Brunneria , add me to your unusual club. I have the same exact issue with the Dawn Phenomenon which impacts my post-prandial readings for the rest of the day. Usually, it rights itself by lunch, but definitely by late afternoon/pre-dinner.

I have made it to 94 fasting ONCE in several months, yet I didn't do anything different than what I do every day. I have logged my food and watched my BS patterns, but I can't figure out what the correlation may be, although I think it may be sleep...or lack of. I do have a 22 month old who calls for me if anything wakes her up during the night. <sigh>

Last night, I ate peanuts for a snack and was well-within both my daily carb allotment AND my meal allotment (I never allow myself to go > 10 carbs max at a meal/snack, although 5-7 is my typical). My FBS this morning was the highest it has been in such a long time at 136. I think I need to write off peanuts.

Anyhow, if my FBS is high in the morning, it takes it all day to drop it and then the wicked cycle begins the next day.

 

[Brunneria]

* nods understandingly *

I find my dawn phenomenon and 'wake up surge' is more affected by stress than anything else. A disturbed night really messes me up. So does work stress, arguments, job interview stuff, going on hol stress, etc. etc.

I have also noticed that the more carbs I eat the day before, the lower my DP.
But I don't think it's a good thing. It just means that I've over stimulated my beta cells, they are on a hair trigger (yes, that IS an exaggeration!) and I will have to watch for excessive highs and lows for a day or so.

I would rather have a higher DP and predictable BG for the next 2 days, than the jangly mess I get after carbs...

Have you seen this DP thread? various ppl have come up with some fab DB ideas in it.

 

[vintageutopia]

* nods understandingly *

I find my dawn phenomenon and 'wake up surge' is more affected by stress than anything else. A disturbed night really messes me up. So does work stress, arguments, job interview stuff, going on hol stress, etc. etc.

You mean...life?

The DP makes me want to throw things. I have tried some of the experiments listed on the DP thread, but so far, I haven't stumbled on one that consistently works for me. I am going to keep trying, though!