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How has this happened?

R

Rocinante

Well-Known Member
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I've been pre-diabetic for 4 years now. In April, soon after Covd hit I weighed in at 92kg, BMI 28. Had my HBA1C which came out at 38.9MMOL.

Since then I've been on a low card diet, been exercising regularly (70km cycles + running every week) and lost 13kgs, weighing in at 79kg now.

I've just had my HBA1C and it has got worse... it is now 42MMOL.

How is this possible? I've done everything right and lost so much weight, exercise regularly, yet my numbers are worse?
 
Well done on the weight loss, diet and exercise. 39 to 42 mmol isn't a significant increase. I'd read it as the same ballpark figure.
 
Thanks for the reply.

I'm really shocked, I'd hoped to see a decrease not an increase. This all makes me question if I'm doing the right thing...
 

Hi @Rocinante,

First of all, welcome to the forum.

Very well done on the weight loss and improved lifestyle. This is a brilliant achievement.

Do you measure your blood sugars regularly? This might give you an insight into what is happening.

For example, exercise can significantly raise your blood sugars for a short time (maybe one hour). Maybe your food (even though low-carb) might still not be optimal for your levels.

At this point, it might actually be worthwhile to invest in an Abbott Freestyle Libre to get a better picture of what is going on throughout the day (and night).

Also, would you be willing to share what a typical day of eating looks like for you?

Again, welcome to the forum.
 
Thanks for the reply.

I eat a veg and protein heavy diet, with a perhaps ridiculous amount of eggs. Lots of steak, Cabbage and mince Stirfry. Also fair amount of salads, feta, tomatoes, peppers, avocados with olive oil.

Drink wise, lots of coffee with either soya milk or semi skimmed.

Only have very occasional sweet stuff, and it's normally 85% chocolate.

Few fruits.

Very few carbs in my diet, only tend to have a treat of bread and nuttella before my cycle. On the cycle, I fuel with sports drinks / energy gels.

For my runs, which are short (but building up at the moment) I do not fuel.

I just shocked that despite all these changes my numbers have got worse, rather than better.
 
Rocinante said:
Very few carbs in my diet, only tend to have a treat of bread and nuttella before my cycle. On the cycle, I fuel with sports drinks / energy gels.
Click to expand...

there could be your problem, when you get fat adapted you will no longer need the above as your body will use your fat as fuel which will keep you going longer than a spurt of carbs.
 
Metabolic syndrome is different for everyone. No two people are the same and IR has many different causes. You need to test before and 2 hours after your meals and change your diet accordingly.
https://www.diabetes.co.uk/insulin-resistance.html
I've cycled competitively and used to do my morning 2 to 4-hour rides, fasting, on salt and water to make sure I was training my body to burn body fat.
 
zeeeee said:
there could be your problem, when you get fat adapted you will no longer need the above as your body will use your fat as fuel which will keep you going longer than a spurt of carbs.
Click to expand...

Would this explain why my Hba1c has deteriorated?
 
The only way of knowing would be to test yourself, but it's looking like the only culprit. I don't know a lot about those energy gels but I guess they are more or less sugar.

Each time you take one one or have an energy drink your blood sugar will be spiking
 
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I did wonder a bit when you stated a low carb diet and then added that you have bread, Nutella and other high carb stuff. As it is occasional you might be even more unable to deal with the spike in glucose than you would be normally, having been headed towards being fat adapted you then switch back to using glucose when cycling.
 

Understand... Would 1 infraction per week be enough to cause such a spike?

Is the suggestion then that I try and cycle without any carb fuelling at all and see how it goes?
 
Rocinante said:
Understand... Would 1 infraction per week be enough to cause such a spike?

Is the suggestion then that I try and cycle without any carb fuelling at all and see how it goes?
Click to expand...

Try cheeses or some nuts, pork crackle, eggs (Yeah, I said eggs even if you eat a lot of them) and steer clear of the junk like sports drinks, gells, bread and Nutella which are high carb choices.

I'm a coffee fanatic also, so perhaps give full cream a try instead of soy or skim milk.

And see what you get testing wise.
 
Reactions: ert
Yes you should try without the carb fuelling you might be pleasantly surprised.

I walk daily quite early around 5 or 6am (getting later now the dark mornings are slowly upon us) and I always have a coffee and mct oil before I set off and that seems to give me an energy boost and I haven't eaten for 12-14 hours, somedays I feel like I could go on and on after 6-7 mile brisk walk.
 
Rocinante said:
Understand... Would 1 infraction per week be enough to cause such a spike?

Is the suggestion then that I try and cycle without any carb fuelling at all and see how it goes?
Click to expand...
I suspect so - if can take a couple of days to establish ketosis, particularly if you are 'topping up' supplies of glucose in the liver which is then having to push it out bit by bit in an uphill struggle if - like many type twos - you over produce insulin at the drop of a hat - or slice of bread.
Like the fellow pushing the rock up a slope, each time the rock rolls down to the bottom you have to trail after it and start all over again.
My usual breakfasts are protein and fat with maybe 10 gm of carbs , and coffee with cream (and a pinch of cinnamon and a tiny one of salt) and I can then go out all day. You might find that you do better if you have some chicken thighs or cold sausages to eat when you take a break, and put rehydration salts in your water for ease of absorption. You might find that you can't sprint as fast, but endurance is extended - I was once surprised to find that I had been trundling along for five hours at a steady pace admiring the scenery, only pausing to take a drink of water three or four times without even getting off the bike.
 
Rocinante said:
Understand... Would 1 infraction per week be enough to cause such a spike?

Is the suggestion then that I try and cycle without any carb fuelling at all and see how it goes?
Click to expand...
The reaction may be a bit extreme because you're not used to it anymore the rest of the week. Nutella and bread... Yikes. (And I wish i could say it didn't make my mouth water, a couple of weeks into strict carnivore... But it does. Nutella used to be a daily staple when i was a kid. ) The energy drinks, are they carb-loaded as well? Because they'll hit your system hard and fast if they are, as that's what liquid carbs do.

I understand there's professional athletes out there who follow a keto way of eating. Not my area of expertise though so I can't toss out names. No need to do a carb-load if you're fat-adapted. Might want to look into electrolyte supplementation though. Just in case.
 
The energy drinks are sport specific and on a 70km cycle I'll have 2 gels and drinks - about 500 calories made up of 100-150 grams of carbohydrate.
 
Rocinante said:
Understand... Would 1 infraction per week be enough to cause such a spike?

Is the suggestion then that I try and cycle without any carb fuelling at all and see how it goes?
Click to expand...
I have been through this myself, having been cycling much more over the last few months. When I started, I did run out of energy (not puff, but muscle energy) pretty easily. I was quite worried that my low-carb life wouldn’t support vigorous exercise, even though I knew that there a substantial number of keto performance athletes.

Someone here suggested I read this

https://www.amazon.co.uk/gp/product/0983490716/ref=ppx_yo_dt_b_search_asin_title?ie=UTF8&psc=1

which greatly reassured me. I think my body had not quite achieved the sunlit uplands of fat-burning nirvana and I was still adapting. I’m seem to be there now, as long as I stay hydrated and warm up properly before making a strong physical effort. I usually do my (very noddy) mountain biking in the early morning, before I eat, and I am neither hungry not fuel-depleted whereas my much fitter, much more experienced friend is looking for a snack as we finish.

The main thrust of the book is, that an athlete who preloads carbs can only store around 2000 calories of glucose, after which they bonk, or must refuel. The fat-adapted athlete does not need to preload or refuel because even the leanest person has access to around 20000 calories of fat-based fuel. I may have the exact figures wrong, but that’s the general idea as I remember it.
 
Rocinante said:
The energy drinks are sport specific and on a 70km cycle I'll have 2 gels and drinks - about 500 calories made up of 100-150 grams of carbohydrate.
Click to expand...
That's a massive amount of carbs.... Might want to rethink that and go for a drink with electrolytes only, (Might be called snake juice?) and just have plenty of protein to keep your muscles happy.

It'll be a little bit of an adjustment and you might feel off or weak for a bit, but your blood sugars should lower. It wholly depends on where your priorities lie though, and that's entirely up to you. Good luck!
 

Ok, I will go for this. I really need to get my blood sugars down.

For those of you guys who do fasted endurance activities, how long did it take you to adjust? Presumably you started with shorter rides and then built up?
 
Rocinante said:
Ok, I will go for this. I really need to get my blood sugars down.

For those of you guys who do fasted endurance activities, how long did it take you to adjust? Presumably you started with shorter rides and then built up?
Click to expand...
I just want to say that 150g of carbs in one day a week, on its own, would raise my levels for three or four days afterwards. Which would be enough to raise my hba1c test.
 
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