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Discussion in 'Vegetarian Diet Forum' started by Cocosilk, Aug 4, 2019.
A tweet from Prof Noakes is surprisingly well timed
Ha ha, yes, good! A bit like how the Steve Jobs' diet story that showed up yesterday in the news when my friend told me she had tried Tim Ferris' Slow Carb diet but then found herself craving sweet so she would eat 4 apples with her coffees.
Think it was the raw fruitarianism that did for him in the end.. all that fructose going to the liver..
I think the first I heard about the temporary insulin resistance you will experience while eating very low carb was when I was preparing to do a follow up glucose tolerance test. They tell you to make sure you have eaten at least 150g of carbs per day for the 3 days leading up to the test otherwise your results won't be reliable.
I think I messed my GTT up because I only ate a few extra carbs (pancakes) for 2 days prior instead of 3.
This article also talks about the kind of insulin resistance you get while low carb eating. https://www.dietdoctor.com/low-carb/fasting-blood-glucose-higher
I assume though that this should go back to whatever your normal is after 3 days of reintroducing carbs again based on how to prepare for a GTT.
For me the problem is I'm not sure if I'm still a bit more insulin resistant than I should be because I actually have a glucose intolerance and not just because of keto/low carb eating.
I guess I'm talking about what people refer to as "cheat days" while on keto.
People who go on keto for reasons other than blood sugar issues (perhaps they think it's a trendy diet to follow) like to have cheat days so they can socialise and eat normally for a day per week. And the ones who are checking their blood glucose levels are noticing diabetic spikes that they wouldn't otherwise be having and those spikes are probably damaging, so are they better off not being on keto and actually eating carbs more moderately so their more liberal carb days won't necessarily cause the big spikes? Of course, long term, metabolically speaking, everyone is probably better off eating lower carb, right?
I'm not having cheat days as much as trying to reintroduce a few carbs while I'm breastfeeding but I've noticed that if I eat a few too many carbs at once, I've had terrible spikes (10 mmol is terrible for me), and I haven't worked out yet if that is because of keto or because I'm actually glucose intolerant now.
I possibly screwed up my latest GTT by only eating probably half the recommended 150g of carbs per day for 2 days instead of 3 days prior to the test and my 1h spike was 12.1 mmol. Although a few people on this forum have done a GTT straight off keto and still kept the 1h spike just under or slightly above 11 mmol - and you have already been diabetic and reformed. I was gestationally diabetic and am trying to work out if my carb tolerance will return to a more normal level or whether I'm going to remain glucose intolerant and have to stick to very low carb indefinitely (which I probably should anyway). Just struggling on keto while breastfeeding because of dehydration.
@Cocosilk perhaps you would get more participation in a thread in the low carb forum? Plant based diets are not automatically high carb - or moderate, low or anything else. Your question seems to be just about carbs and not about plants. Good luck getting an answer to your dilemma.
Thanks for that. I think the key phrase from that article is:
‘The scientific name is “physiologic insulin resistance” and it’s a good thing — unlike “pathologic insulin resistance.” ‘ (There is a longer explanation of what that means, but in essence a keto diet is improving the type,of insulin resistance that underpins Type 2, not worsening it.
I don’t understand the assumptions made by Jason Fung regarding physiological insulin resistance and adaptive glucose sparing. Jason Fung frequently says that the the body isn’t stupid. Why would the fasting blood sugar run higher if the body is running on fat like in keto? (One would think the body would keep tight control on the glucose and not have more in the blood than needed. Less should be needed when one is burning fat.)
I think you may be confusing the last meal effect with physiological insulin resistance
Last Meal Effect aka known as the https://en.m.wikipedia.org/wiki/Staub-Traugott_Phenomenon is where the body downgrades insulin production (or increases it) According to the amount of insulin required to deal with recent meals. This is what causes spikes after an unexpectedly carby meal. It can take a few days for the body to wake up to the fact that more carbs are coming in regularly now, and until that happens, the person experiences bg spikes after carbs. The intake of carbs/spikes means that they are extremely unlikely to be in ketosis.
Physiological Insulin Resistance is the glucose sparing bit, where people who have been in nutritional ketosis for months, tend to find that their fasting blood glucose rises a bit, and their overall blood glucose levels stay very stable. It only happens in the consistent absence of carbs, and if carbs are reintroduced to the diet, the Last Meal Effect will kick in, insulin production will increase, and the individual will lose their PIR, probably resulting in somewhat lower fasting bgs and more fluctuation in bgs through the day, due to the carbs.
Yes, I agree with @Brunneria
I had a bout of physiological insulin resistance a few years ago now. What happened to me was my base line levels increased, fasting, before meals and bedtime, but the rises post meal stayed the same as before. If I had a meal that would see me rise by 1.5mmol/l before the PIR , the same meal would also see a similar rise, but the levels would be higher because I started higher.
It lasted a few weeks, then disappeared, never to return.
You are both probably right. And the insulin resistance I was having is either the phenomenon that Brunneria linked or a general carb intolerance maybe.
But I have been in and out of ketosis often because I can measure it with my dipsticks but I think it's the ketosis you go into overnight from not eating, but also sometimes I'm in ketosis by the end of a very low carb day, and I put that down to breastfeeding.
Whether or not that is contributing to the perceived carb intolerance I seem to have, I'm not sure.
Either way though, those spikes seem worse than expected and I can't imagine it's a good thing. Maybe I am just glucose intolerant and it's nothing to do with low carbing.
Perhaps not damaging carb spikes, but that doesn't mean that you don't get spikes.
Using the Freestyle Libre I have noticed that my keto friendly "bullet resistant coffee" which is coffee, butter and double cream will cause quite a significant spike in the morning.
I suspect I may be having an extended dawn phenomenon where my liver is dumping glucose but I'm not seeing a corresponding insulin response (glucagon suppressing it?).
If I have something like a beer later in the day I can get a rapid spike and then an insulin response which takes me lower than when I started (I suppose almost like mini reactive hypoglycemia) which makes me think that something is messing with my insulin response in the mornings.
I'm finding this thread very useful, and am about to follow up on the "last meal response".
Can we please get back to discussing the title of this thread now?
I think the answer is no.
[To the OP's question.]
Do we have to? I love the different tangents. I often find I learn something new when someone comes in with a comment like LittleGreyCat's.
This tweet from Ted Naiman also points out the difference between the two types of insulin resistance....