Glucose not a problem, but carbs are !

I've had pre-D levels for at least the past 4 yrs, but inspite of low-carbing have only managed a small reduction in a1c, but at least now it is just below pre-D levels. However, I think that there may be something else going on with me, as I can tolerate glucose but not carbs ! ! ! 75g of glucose will take me to just 6.3mmol/l maximum, with no reactive hypo either, but even 23g or carbs (in food) can easily take me from anywhere between 9 and 13 mmol/l. Don't know if anyone else has experienced this? But the plain fact is, if I keep on eating carbs as normal I will be in double figures at every meal and will easily produce an elevated a1c to diabetic levels. So, its LCHF for the foreseeable future, and anyway, its a very healthy way of eating too.

Apart from a problem with wheat, I don't seem to have any other food sensitivity.

Thanks Indy, don't suppose you know if you can just sort of suddenly lose your ability to make amylase do you? The other thing of course is that in an OGTT the glucose is, I think, used immediately by the liver, i.e. straight into your bloodstream, without having to be digested.

Hi Bebo321, it is a bit strange isn't it ! !
I'm in the process of doing intensive BG recordings on different foods, thats basically how I discovered the problem with bananas ! 4.1 pre-banana, and 4.1 and +1 hr, so I thought, gee, thats great, I can get away with that, but I did feel a bit wobbly and shaky, so next time tested from about +20 mins, then every 5 mins. That showed a rise to 9.7 at +35 mins, then a drop back down to 4.1 at around +50 mins, not a comfortable experience. Its the long slow rises that can be less detectable. A couple of small slices of toast, for example, will take me from low 4s to around 11.5 at +2hrs and can take up to 3 or 3.5 hours to come back down again. So it all looks like the usual start of being unable to cope with starches. But I've done a couple of home OGTT tests, and had lab tests too, and they have all been pretty similar. My first test about 18 months ago, with 75g of glucose did take me to around 8mmol/l, but after going LC the results have improved. The last one of 75g glucose took me to just 6.3 mmol/l, had a 50g glucose too and that took me to 5.3mmol/l - I would call those two, absolutely rock solid normal. I did finger prick tests every 15 mins throughout the test just to make sure there were no hidden spikes and there were none. Trouble is, fasting is now generally in the low 4s, a1c have gone from 6.2, 6.3, 6.0 to 5.8 over the last 3 yrs, and the OGTT is normal. So it looks as though there is nothing wrong. But in the meantime I get big spikes if I stray, so things are definitely not right.

Hi cobrakatie, in a word - NO ! ! !

But, had an interesting response from a medical researcher friend, who specialises in endocrinology, his thought was that if I was his patient he would want me admitted into a teaching hospital for extensive tests, because it doesn't make sense, he would wand to do insulin clamp tests and fixed meal tests etc. There is a possibility that the signalling mechanism, in the stomach, intestines, liver or brain isn't sending off the signal to release insulin on sensing that there is a meal present - slightly different pathways to those that just sense glucose. Another possibility is that because I low carb, and am on rather low calories too - just not hungry, often well below 1000 cals a day - so its possible that my glucogen stores are more or less permanently empty, so when I get glucose, the liver doesn't need to do anything with it - just absorb - to replenish, and the bit left over just get dealt with as its so small! ! !

However, because I was getting cramps and excessive thirst I started looking into mineral deficiencies. The obvious ones are sodium and potassium - in my case both fine. But magnesium is also important in muscle relaxation amongst many other things. Its also important in the synthesis of carbohydrates and metabolism, its what called a cofactor, so is vitally important. Its also important in insulin production and insulin resistance. so I thought I would give it a go.

I've been on 300mg a day since the beginning of June, within a week the cramps stopped. Mid-July I upped the dose to 500mg a day, plus I now eat lots of avocados and nuts. It has not made any difference to my fasting and pre-meal levels, they remain in the low 4s as before. But my 1hr and 2hr response is about 2mmol/l lower than before. So something that would have taken me to 10mmol/l and would have put me above the 7.8 safety barrier for around 2 hrs, will now only take me to around 8mmol/l max and the time spent above 7.8 is down to around 15 mins.

Now, this has worked very well for me, but I assume I must have been pretty magnesium deficient for this to have happened. The few reports out there do not show that magnesium has much of a general effect on diabetics, BUT, if they happen to be mag. deficient, it could well help quite a bit. So, I think its a kind of try it and see if it works for you. Magnesium is fairly safe to take, but if in doubt talk to your doctor, you might even manage to convince him to run some tests - mine was not particularly obliging - basically just not interested in anything other than the a1c ! ! !

Hi nosher, I don't get any hypos. Didn't with the OGTT, nor with food that spikes rapidly and decends quickly, it just gets back to base and no further. Have you ever had a c-peptide done? just wondered if you were producing too much insulin in your case that caused the reactive low. I had a c-peptide done about 18 months ago and it was low-normal, its what started me wondering about LADA in the first place, but recently I got a GAD test and it was well and truly negative.

Guess you're right about that. TBH I really don't mind lchf, occasionally I will have something a bit carby, but maybe only once or twice a month and I guess I can live with a bit of a blip on the odd occasion. The main problem I have now, or at least at the moment, is, I'm just not hungry and I'm sure that only around 700 cals a day isn't really a good thing ! ! maybe that will change with the onset of the cold weather.

Dibbles1 said:

I found that last week, If I take a magnesium calcium citrate supplement with my dinner I don't spike so high. Thought it might just be fluke, so stopped the supplement to see. I spiked higher without the supplement. Glad you started this thread, as It explains what's happening now.

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In that case dibbles I would definitely give it a go, take it on a regular basis over several months and see what the overall picture is then. Apparently magnesium deficiency is quite common, but quite hard to test for as most of it is stored in our soft tissue and bones, only a few percent is in the blood, when the blood magnesium goes low, you simply remove some from the other tissues to make it up.