Type 2 Eat to the meter, or play the long game?

[Ponchu]

I came here hoping for very low moderate interference.

I’m discouraged to read that comments are being deleted.

Personal attacks, foul language —I get it.

But it quickly moves to the reference point popular today of

“I’m offended.”

I hope the board allows for spirited discussion.

 

[Mbaker]

That's exactly how I feel about carbs. We went to a lovely hotel for 3 days over Christmas and I stayed keto throughout our stay. The hotel provided a wonderful selection of cheese which I ate instead of the sugary deserts. I actually averaged about 15g of carbs a day but did eat huge amounts of fish meat and cheese.

The upside for the likes of us are minimal to no cravings for carbs, which perhaps leads to a step easier (mental) management; I have learned more acceptance and patience for those who really miss the previous stuff, for which I am a little proud as a growing exercise, as my personality is an on off switch when management of diabetes is nuanced.

 

[Krystyna23040]

The upside for the likes of us are minimal to no cravings for carbs, which perhaps leads to a step easier (mental) management; I have learned more acceptance and patience for those who really miss the previous stuff, for which I am a little proud as a growing exercise, as my personality is an on off switch when management of diabetes is nuanced.

I agree that for me that the best part of keto is the absolute absence of any cravings for carbs. It does make it much easier to manage the diabetes and I am hopeful that I will eventually move from 'in remission' to 'diabetes reversed '. This for me is 'the long game'.

I do appreciate that it may be a very very long game as it was highly likely that I had undiagnosed diabetes for over 20 years. In 1990 we had a super nurse at work. I had some strange symptoms so she did a urine test for glucose. It was very high so she sent me straight to my GP. He was angry and said she didn't know what she was talking about and refused to do any tests and told me to go away and forget about it. He said that it was an overflow of glucose from my kidneys So nothing to worry about.

So no treatment until I was admitted to hospital in 2012 with an HbA1c of 125 and put straight on insulin. Started low carb in 2016 and then went keto. Off the insulin and no meds but blood sugars not absolutely normal yet.

Sorry it's taken me so long to get to the point. What I am trying to say is that for someone like me keto is vital if I want to stay off insulin. But if diabetes had been picked up in 1990 I would have not been so damaged and there may not have been a need to go keto to reverse the diabetes.

So the 'long game'' might have involved eating more carbs than I can now. So low carb would have sorted it. Who knows - maybe by then only keto would have sorted it. Either way the meter is a superb tool to help unravel what is going on.
Edited to say - hope this rambling post makes sense.

 

[Mbaker]

Great post. Thanks for sharing

Coincidentally I was listening to Dr. Shawn Baker on Pete Evans’ Recipes for Life podcast just a couple of days ago. Very interesting fellow

Edited to add a link for those of the Apple persuasion;
https://itunes.apple.com/gb/podcast...-pete-evans/id1306697084?mt=2&i=1000426911702

Watching Shawn slaughter over 180 kgs for 20 reps deadlift, increased my reps by 50%! (at less weight of course, he's got super human strength). Interesting that his A1c is around pre-diabetic, but his insulin is on the floor, as is his HOMA IR - there seems to be a paradox with some elite performers and circulating glucose (even so low carbers).

 

[bluecurlylegend]

So could I use my meter as a fuel gauge ? If my blood glucose is above, say, 6 mmol/l, I just don't eat at all until it's below 6mmol/l ?
I seem to have got myself in a bit of a pickle. I've been as near to Keto as I can for the last year and a half and have had some very encouraging results.... an impressive weight loss, skin complaints disappearing, colitis calming down.... BUT the best I can do with my blood glucose readings is maybe stabilise them. Not lower them .
So in a fit of madness I decided if I can't improve my readings, how easy is it for me to make them worse ?
Very easy, actually. I jumped right off the horse and sat and ate half a box of chocolates, the equivalent of 120grams of sugar. I tested at 6.2 before I ate a couple of home made burgers for dinner and 7.8 two and a half hours later. Two hours after wolfing the chocolates I was at 9.2 and an hour later had risen to 11.1.

Suitably chastened I slunk off to bed but guilt stopped me sleeping well and I was up at 5.20 am and tested at 8.2. So it's been nothing but black coffee and black tea and water since. At 10.00am I tested at 8.5 and over the course of the day watched my numbers come down to 6.3, more or less 24 hours after my blow-out.
This morning at 9.00am I tested at 6.8 and at 12.30pm I was reading 7.0.

So that's nearly 42 hours with water, some salt, black coffee and tea. Should I just fast until my readings are more respectable ?

I use an app on my phone which give me a three month average of After Sleep at 6.3, Before Dinner at 6.3, After Dinner at 6.5, Fasting at 5.9 and an overall average of 6.3 …. all reading from a Code Free meter.
My last HBA1c, nearly a year ago, was 5.6% 37mmol/l

Any comments ?

 

[Member496333]

The important thing to remember is that glucose in the blood is only the symptom, not the cause. The cause is too much glucose in the body. If you eat to the meter or use it as a “fuel gauge” you are only measuring the excess that is spilling into the blood.

Many people have this idea that sugar only exists in the blood, as glucose, and in the muscles and liver, as glycogen. The truth is that almost every cell in the body can use glucose and become engorged with it. The blood carries glucose around the body, but when the cells cannot accept any more, and when the liver has run out of places to stash it as glycogen and fat, it begins accumulating in the blood. This is all you are measuring with a glucometer - the overflow. If you truly want to beat insulin resistance then one must focus ruthlessly on carbohydrate restriction irrespective of what is appearing in the blood.

If you’ve been on a keto diet for a year and you’re still struggling with blood glucose then you may be sensitive to protein. Fasting will definitely help. The aim should be to drain the sugar from the body, not negotiate with a glucometer and unwittingly top it up.

All the above is my view only and is not meant as prescriptive advice.

 

[britishpub]

The aim should be to drain the sugar from the body

I agree, and that has always been my way (attempted way). I like to think I'm a sponge and have to squeeze all the glucose out

PS I have never read anything by Jason Fung, nor watched any Youtube videos on any subject related to diabetes, although I have seen @bulkbiker photo where he is standing next to the geezer.

 

[Listlad]

Yes it probably would have been easier to ask “low carb or keto?”

Got it. And that was my original question. How low should one go?

An interesting thread nonetheless and one that I have only just got around to reading.

 

[Member496333]

Got it. And that was my original question. How low should one go?

An interesting thread nonetheless and one that I have only just got around to reading.

In my opinion, as low as you need to go in order to start seeing a reduction in dawn phenomenon. DP is probably the single greatest practical metric of understanding your metabolic health. If your liver and pancreas are healthy then you shouldn’t even notice it. This is why DP is usually the very last thing to be “fixed”, if ever.

 

[bluecurlylegend]

The important thing to remember is that glucose in the blood is only the symptom, not the cause. The cause is too much glucose in the body. If you eat to the meter or use it as a “fuel gauge” you are only measuring the excess that is spilling into the blood.

Many people have this idea that sugar only exists in the blood, as glucose, and in the muscles and liver, as glycogen. The truth is that almost every cell in the body can use glucose and become engorged with it. The blood carries glucose around the body, but when the cells cannot accept any more, and when the liver has run out of places to stash it as glycogen and fat, it begins accumulating in the blood. This is all you are measuring with a glucometer - the overflow. If you truly want to beat insulin resistance then one must focus ruthlessly on carbohydrate restriction irrespective of what is appearing in the blood.

If you’ve been on a keto diet for a year and you’re still struggling with blood glucose then you may be sensitive to protein. Fasting will definitely help. The aim should be to drain the sugar from the body, not negotiate with a glucometer and unwittingly top it up.

All the above is my view only and is not meant as prescriptive advice.

Well, that makes sense. I should burn off the overflow by fasting and/or exercise. Wait till my blood is not carrying any excess glucose and then eat. I agree, Jim, I really must start paying closer attention to the amount of protein I eat. I didn't think I was eating too much but I don't think it will do me any harm if I reduce it a bit.

OK, thanks folks, that's me back on track now.... I hope !

 

[Member496333]

Well, that makes sense. I should burn off the overflow by fasting and/or exercise. Wait till my blood is not carrying any excess glucose and then eat. I agree, Jim, I really must start paying closer attention to the amount of protein I eat. I didn't think I was eating too much but I don't think it will do me any harm if I reduce it a bit.

OK, thanks folks, that's me back on track now.... I hope !

Just remember that the glucose in the blood is not the damaging part of diabetes. It’s the glucose elsewhere where it cannot be measured. This is why exogenous insulin and oral hypoglycaemics are not associated with improved outcomes - because they just cram the sugar into the tissues and leave behind clean blood.

Whilst the blood glucose is obviously a very useful measure, it should never be viewed as a green light. Putting more sugar in could top it up in one meal. Whereas emptying the body gives you a far greater buffer. Hope I’m making sense.

 

[Listlad]

In my opinion, as low as you need to go in order to start seeing a reduction in dawn phenomenon. DP is probably the single greatest practical metric of understanding your metabolic health. If your liver and pancreas are healthy then you shouldn’t even notice it. This is why DP is usually the very last thing to be “fixed”, if ever.

I need to understand this DP @Jim Lahey

I am normally asleep at that point. Presumably it occurs in the morning regardless of shift pattern?

I would imagine a Libre gizmo would help with that too...

 

[Member496333]

I need to understand this DP @Jim Lahey

I am normally asleep at that point. Presumably it occurs in the morning regardless of shift pattern?

I would imagine a Libre gizmo would help with that too...

Assuming a regular sleep pattern, it will usually begin a couple of hours before you wake. Glucagon, cortisol and posssibly adrenaline and others, signal the liver to secrete glucose. This is normal for all humans. What’s not normal is an insulin resistant fatty liver that continues to pour out the glucose even when the pancreas begins ramping-up compensatory insulin. It’s meant to give us energy for waking, but when your liver is bricked the whole process runs away with itself and causes a major malfunction. Usually it’s impossible to completely get rid of DP until the hepatic and pancreatic fat have cleared.

 

[bluecurlylegend]

Assuming a regular sleep pattern, it will usually begin a couple of hours before you wake. Glucagon, cortisol and posssibly adrenaline and others, signal the liver to secrete glucose. This is normal for all humans. What’s not normal is an insulin resistant fatty liver that continues to pour out the glucose even when the pancreas begins ramping-up compensatory insulin. It’s meant to give us energy for waking, but when your liver is bricked the whole process runs away with itself and causes a major malfunction. Usually it’s impossible to completely get rid of DP until the hepatic and pancreatic fat have cleared.

Usually around 6am I am often woken with peculiar sensation in my legs and feel. It's hard to describe but it's like your blood is all of a sudden pumped full of gas and you can feel it bubbling out in your muscles etc. It sometimes borders on the painful side. My DP is all over the **** place, although my three month average is, maybe, not too bad ?

 

[bluecurlylegend]

Just remember that the glucose in the blood is not the damaging part of diabetes. It’s the glucose elsewhere where it cannot be measured. This is why exogenous insulin and oral hypoglycaemics are not associated with improved outcomes - because they just cram the sugar into the tissues and leave behind clean blood.

Whilst the blood glucose is obviously a very useful measure, it should never be viewed as a green light. Putting more sugar in could top it up in one meal. Whereas emptying the body gives you a far greater buffer. Hope I’m making sense.

I'm taking it you mean keep fasting or whatever until your Blood Glucose is satisfactorily low ? Like 5.5mmol/l for example ? And then eat till you're full but be very strict about carbohydrates. I'm still assuming no one will die due to lack of ingested carbohydrates.....

 

[Member496333]

I'm taking it you mean keep fasting or whatever until your Blood Glucose is satisfactorily low ? Like 5.5mmol/l for example ? And then eat till you're full but be very strict about carbohydrates. I'm still assuming no one will die due to lack of ingested carbohydrates.....

In a sense I suppose yes. In most people ~5mmol/L could be considered a baseline where insulin circulation is low and isn’t still sloshing about trying to mop up glucose. This certainly puts you in the best position to eat. But again the focus shouldn’t be too much on blood glucose. If you eat the right foods, and only when you’re hungry, everything will eventually settle down - “the long game” - as opposed to being a slave to a meter that only tells you by how much your body is currently overflowing with sugar.

Again I stress this is only my view based on research and experimenting with my own body. It’s not my place to tell anyone what to eat and when.

 

[Brunneria]

In my opinion, as low as you need to go in order to start seeing a reduction in dawn phenomenon. DP is probably the single greatest practical metric of understanding your metabolic health. If your liver and pancreas are healthy then you shouldn’t even notice it. This is why DP is usually the very last thing to be “fixed”, if ever.

I agree that probably applies to a majority, but there are (as bloomin’ always) exceptions.
Sadly I am a case in point.
5 years of keto, 1 year of carnivore at keto ratios, and my Dawn Phenomenon is as alive and kicking as ever.
But then I have wangier hormones than most, and bg and carbs play a surprisingly small part, whilst stress hormones appear to be the major influence.

 

[Member496333]

I agree that probably applies to a majority, but there are (as bloomin’ always) exceptions.
Sadly I am a case in point.
5 years of keto, 1 year of carnivore at keto ratios, and my Dawn Phenomenon is as alive and kicking as ever.
But then I have wangier hormones than most, and bg and carbs play a surprisingly small part, whilst stress hormones appear to be the major influence.

Yeah for sure but then that implies persistent insulin resistance. It can take a very very very long time for this to be reversed, and of course may not even be possible in individuals with other compounding factors. Perhaps indeed you fall into this bracket

 

[Brunneria]

Yeah for sure but then that implies persistent insulin resistance. It can take a very very very long time for this to be reversed, and of course may not even be possible in individuals with other compounding factors. Perhaps indeed you fall into this bracket

Oh yes, absolutely I do.
Hormones all the way... since before puberty.

 

[Mr_Pot]

Many people have this idea that sugar only exists in the blood, as glucose, and in the muscles and liver, as glycogen. The truth is that almost every cell in the body can use glucose and become engorged with it. The blood carries glucose around the body, but when the cells cannot accept any more, and when the liver has run out of places to stash it as glycogen and fat, it begins accumulating in the blood.

I am one of those people, at least I am until I have been convinced otherwise by scientific explanations, not vague notions of overflow. Cells in the body cannot absorb glucose as such, as it is water soluble and osmotic pressure would cause the cell to absorb water and rupture. Cells therefore store glucose in the form of glycogen which is not water soluble. Glycogen stores are finite and store approximately 400grams of glucose in the skeletal muscles and 100g in the liver of a 70Kg person. When the glycogen stores are full glucose is stored as fat. I have not seen any suggestion that the body can accumulate glucose elsewhere.