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How quickly do you let the liver shed glucose?

Discussion in 'Type 2 Diabetes' started by Sal87, May 21, 2019.

  1. Sal87

    Sal87 Type 2 · Member

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    As I've moved to strict keto with time restricted eating (generally 18/6) my blood glucose numbers have spiked as that fatty liver dumps its glucose. Well and good. But how to regulate this process is the question.
    Some people say let the liver dump its load, the sooner the better, but in Jason Fung's clinic the approach is to allow some higher BG numbers but within limits, as regulated by continued use of medication.
    What have those limits been for people in transition like me? How high can BG go before you feel anxious about it? How soon did you start cutting back or cutting out insulin?
     
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  2. jpscloud

    jpscloud Type 2 · Well-Known Member

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    Very interesting question - I'll be watching for replies.
     
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  3. Jim Lahey

    Jim Lahey I reversed my Type 2 · Well-Known Member

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    I think the only practical measure we can take is to gradually reduce our medications. I know that when I completely stopped Metformin cold turkey it didn’t work as planned. I had to go back on it and then reduce from 3x500mg in x1 steps over a period of about five months.
     
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  4. Jim Lahey

    Jim Lahey I reversed my Type 2 · Well-Known Member

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    Also - eating. I think it’s important to keep eating properly, otherwise the liver is just going to keep shedding its load unabated.
     
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  5. bulkbiker

    bulkbiker Type 2 · Master

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    Are you still taking all your medication or have you been advised to cut back?
     
  6. Chook

    Chook Type 2 · Well-Known Member

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    Same here.
     
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  7. jpscloud

    jpscloud Type 2 · Well-Known Member

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    Just for information, I stopped Januvia a few weeks ago and my diet (complete with unfortunate lapses) has been roughly the same as before stopping it, but I'm seeing lower blood sugars - in the 4s instead of 5s and 6s when eating low carb.

    I'm not sure what action Januvia has on the liver if any but I was surprised by this drop in blood sugars.
     
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  8. mariavontrapp

    mariavontrapp Type 2 · Well-Known Member

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    I've just begin to learn about the significance of the liver, non-alcoholic liver disease and how the liver dumps glucose into our blood stream. I'd love to see more discussion about these things but am not very articulate in framing my questions!
     
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  9. Resurgam

    Resurgam Type 2 (in remission!) · Expert

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    Could it be the time restriction which is the main reason for the dumping?
    After a lifetime of calorie controlled diets, my liver panics if I don't eat regularly, so I eat morning and evening.
    I was back to normal levels of glucose very quickly, and got a normal Hba1c at 6 months from diagnosis.
     
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  10. Sal87

    Sal87 Type 2 · Member

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    I've cut injected insulin considerably back and am using it on an as needed basis -- but it's the specifics of the as-needed basis I'm trying to figure out. I need really well informed medical counsel for this process and am trying hard to get the necessary referrals but the high demand will put me in a queue for a couple of months.
     
  11. Sal87

    Sal87 Type 2 · Member

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    Yes, I think you're right that the time restriction/intermittent fasting is what's driving the glucose spikes. The challenge is that there's a considerable body of opinion that wants us to let that fatty liver divest itself of all that glucose, although at what rate is my question. You've obviously done well with your approach.
     
  12. Resurgam

    Resurgam Type 2 (in remission!) · Expert

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    I probably trust my body to do the right thing when not restricted by medication.
    My waist is a lot smaller than at diagnosis, as I was wearing XXL then and now can fit into an M. I have had my clothes fall off a couple of times - luckily when at home, so I'd really advise testing to see how your BG changes over time for a couple of days when trying out different timings. My waist was rock hard so that I could not bend over, at diagnosis.
    As soon as I tried two days of two meals a day morning and evening I could see my levels were far more even, so stuck to that.
     
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  13. Sal87

    Sal87 Type 2 · Member

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    At least until I can get a keto and fasting-savvy medical consultation I probably should accept that or any other approach that will even out my BG numbers -- and clearly it has been very successful for you. But I'm loathe to lose the power of intermittent fasting or time restricted eating which is so acclaimed for greatly intensifying the results.
     
  14. ringi

    ringi Type 2 · Well-Known Member

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    If I recall correctly from one of his books, he dose not consider 10 for a few days to be a problem.
     
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  15. Sal87

    Sal87 Type 2 · Member

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    Ringi, you have made dramatic progress, congratulations.
     
  16. Sal87

    Sal87 Type 2 · Member

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    Jim, I'm sure that's sensible. I admit to having been in a hurry to drop insulin because insulin just keeps the vicious circle turning. I've had an okay from the doctor on that even though my average BG based on continuous monitoring is 7.4, which is not what I want, of course. The issue is if I can reasonably ride with it while the weight drops (down 18 pounds in six weeks). You're certainly right about the importance of continuing to eat well.
     
  17. Sal87

    Sal87 Type 2 · Member

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    bulkbiker I had an early middle of night bout of hypoglycemia after going strict keto and that emboldened me to drop the insulin, for which I got doctor approval after the fact. Now I"m trying to drop the morning Glicazide, a med that promotes insulin response. It feels like walking a tightrope right now, I've had BG numbers that worried me for a while. The worst of those have abated and I'm losing weight but the BG isn't yet where it should be. I'd restore the Glicazide if I need to but I'm not injecting insulin again, ever.
     
  18. bulkbiker

    bulkbiker Type 2 · Master

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    What kind of BG levels are you seeing without insulin?
     
  19. ringi

    ringi Type 2 · Well-Known Member

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  20. Sal87

    Sal87 Type 2 · Member

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    bulkbiker my current average based on continuous monitoring is 7.4. This includes a protracted dawn effect which can rise to over 9 while fasting until into the afternoon and a number approaching 9 for three or four hours post-prandial. Those aren't attractive numbers but it seems to me significant that they're already considerably better than they were in the initial weeks, i.e. that things are going in the right direction. Dr. Fung's clinic give some leeway for elevated BG for patients with diabetes while they're transitioning through fasting and keto -- I understand the limit is 10 before they tamp things down with med. The one thing I'm not doing right yet is alcohol consumption. Hard spirits only but, a few times a week, too much of them.
     
  21. ringi

    ringi Type 2 · Well-Known Member

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    @Sal87 if you are not on metformin it could be worth considering as it helps some people lose weight a little faster.
     
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