Prediabetes How to gain weight and build muscle with prediabetes

Hello all. This is my first post here and please correct me if the way I post is not in line with the forum guideline. Please kindly note that english is not my first language. The measurement I'd be using will be in mg/dl (I'm not so familiar with the unit used in UK, but maybe later I will edit this post with mmol equivalent.

I have been checking my blood glucose for quite a long time, fanatically I may say. I know for a fact that I am insulin resistant and borderline prediabetic (or I am already?). My diet is mostly carbs, moderate to rather large size. (Note: I know LCHF diet will be the most suitable for me, but as of right now that diet is not possible for me -- let's skip that suggestion for taking that diet for now).

Here's the facts about me:
- I am Asian. 49yo. Very skinny. 175cm tall, 65kg in weight. My BMI is 21.
- No matter how hard I try, it's difficult for me to build muscle. I suspect it's because of my insulin resistance.
- My fasting blood glucose is always around 85-90mg/dl. (normal)
- If I eat three times a day, my BG will spike to 160-170 (in 1 hour), 150 (in 2 hours) and mostly return to normal (which is on the low 100s or high 90s) after 4 hours. This happens after each meal. I consider this somewhat acceptable considering the amount of carbs I consume (every meal always contains at least two bowls of white rice).
- Recently I'm doing One Meal A Day (OMAD). I eat only once after 20-23 hours of fasting everyday. I'm not upping my calori intake with OMAD. So basically I skipped two meals and not compensating for the missing calories. Of course I'm losing weight considerably.
- I feel great with OMAD and I don't plan to change anytime soon.

Now here's my problem:
- I love OMAD but I don't like losing weight. When I started OMAD two months ago I was 73kg. Now I'm 65kg.
- With one high-carb meal-a-day, my blood glucose spikes to 180-200+ mg/dl (in 1 hour), 170mg/dl (in 2 hours), 150 (in 3 hours), 130 (in 4 hours) and 100 (in 6 hours). So basically my BG returns to normal after six hours.
I'm very concerned with the high BG during the first 4 hours after meal although after that my BG will be steady on 90-100mg/dl until the next meal.
- Exercising before meal will spike my sugar even higher. I thought my insulin will become more sensitive during OMAD. This frustrates me.
- I cannot build muscle no matter how (rather) hard I try. If I eat a lot (like three times day), fat will only 'build' around belly

Can anybody give me some suggestions how to deal with my problems. How to gain weight, build muscle, prevent high sugar spikes while still in OMAD?

JohnH2019 said:

Please have a look at the books that helped me in this thread.

Check out Mark Sisson who is seriously built even in his 60s by following primal food and exercise. Muscle is the hardest to gain and will only happen when you start lifting heavy weights and lots of weight bearing exercise. No matter how much you eat, that will not make you gain muscle unless you do the activity to build muscle. Otherwise excess energy intake will make your body try to store it, in other words, fat. And do not underestimate the health impact of visceral fat, which may not be as visible when skinny.

Please check your fasting HbA1C levels and triglycerides levels as an indication of your carb intake.

Too much insulin in your blood will hinder fat loss, as it is a hormone that helps with storing excess glucose.

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Thanks for your reply and suggestion. Yes I exercise with weights (not necessarily heavylifting tho). My problem with exercise is, it spikes my blood sugar very high, especially since someone told me to exercise in fasted state just before meal (which makes sense for me). And I couldn't think any better time to exercise with weights except before meal since I'm doing OMAD.

NicoleC1971 said:

Your high bgs will impair muscle building. OMAD works well metabolically but eating a load of rice means you are likely to be missing out on nutrients as well as spiking you! If you replace the rice with enough protein and fat, your body should be able to use the food to sustain you and make you new muscle rather than dipping into your own fat supplies. Can you add some fat snacks into the regime e.g. butter coffee (bullet prooof) or 'fat bombs' during the day so that you are not stimulating insulin but are getting enough energy and nutrients?
You may never be able to bulk up too much for genetic reasons but you can be 'wiry strong' by dong the classic push, squat, pull, hinge and plank type exercises. These could be body weight or at home with a kettle bell and a pull up bar.
Anyway I think the key thing is to stabilise the blood sugars by upgrading your diet and then to ensure you eating enough to achieve muscle gain (not fat).

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Thanks @NicholeC1971! I think I will pay more attention to adding more protein and fat to my diet.

Mbaker said:

This is a difficult one, as it is a real concern that you are asking for things which could be harmful. The spikes you are getting are hard to ignore. I would not be able to offer up the methods I use as I am genuinely concerned, as my method tends to increase IGF-1, which is unsafe potentially in someone with blood sugar dysregulation. If you change your mind on protocol, I am by no means a body builder, but I have been a high level martial artist and have a wife who is an expert on such matters so on LCHF / Keto

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These guys are worth researching, but I highly recommend you do what is required to get your spikes much lower:

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Mbaker, thanks for your references, I will look into them.
Btw, regarding the blood sugar spikes, my GP actually suggested I take metformin, which he said is relatively safe. Metformin does lower the spike a bit, but I can't stand the side effect of it which is from upset stomach to diarrhea . I'm curious about yor method tho'

ert said:

I find cardio exercise and lighter weights spike my blood sugars, especially while fasting. I find exercising two to four hours after eating optional for dropping my blood sugars rather than elevating them. I start with cardio and finish with heavy weights. For example, today 20 minutes on the stepper my blood sugars went down 1 mmol/l then, bench press and leg press 3 x 8 heavyweights to exhaustion 3 with minute rest I decreased 2.5 mmol/l of blood sugar. (If I try this before my meal or too soon afterwards, it doesn't have the same effect.)

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Thanks for your suggestion. I will definitely try to exercise a couple hours or more AFTER meal instead of BEFORE. It may work for me.

ert said:

I change the weight type daily so that I cover a full body programme. It's the anaerobic nature of the heavyweights which decreases blood sugars. There are research studies I can post if you're interested.

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Yes please. I'm very interested

ert said:

I've just realised my favourite study is a type 1 study: Resistance Versus Aerobic Exercise, but as I'm not injecting insulin, and neither are you it's still relevant to trial. Of particular interest is figure 1. I've tried running intervals for 50 minutes and found that although there is an initial decrease in blood sugar, I end up with a recovery spike afterwards, whereas weights (and shorter cardio) decrease my blood sugars over time. (Also, shown in figure 1.) This study suggested the 3 x 8 weights to exhaustion. Every other weights program I've tried seems to spike my blood sugars.
http://care.diabetesjournals.org/content/36/3/537

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The study seems interesting although for me, reading it in a glance, is not absolutely conclusive yet, particularly considering that the test participants were T1 diabetics who took insulin injections. The amount of basal and bolus injections for them, I believe, varied. Also, even if by any chance they took the same amount of insulin, they will have different levels of insulin resistance. I definitely need to read again a few more times to really understand the science behind the conclusion

Back to your earlier suggestion to exercise post-meal, I will definitelly try that and check my blood glucose hourly to see if it works better for me. Hopefully it will.

ert said:

Try intermittent fasting as it increases human growth hormone which helps you build muscle, as well as burning fat. See Dr J Fung for details. Also, try 3 sets of 8 of heavyweights to failure (as heavy as you can lift) with 3 minutes between sets. These sets are anaerobic, which drops your blood sugars rather than elevates them.

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Thank you for your reply. As I wrote above, I have been doing OMAD (which as you know, a stricter version of IF). I have no problem doing OMAD, but my concern is, my blood sugar spikes very high after meal. (High blood sugar spikes do not happen if take three meals a day). The spike is worsened when I do exercise before meal.

ert said:

Fasting causes insulin levels to drop off

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Yup, that's why I like OMAD or long fasting. It drops off the body's insulin level which I know for a fact is healthy for my body. I have no other concerns except for the spikes. Other than that, I feel much healthier with OMAD now that I've been doing it for months. As for the BG spikes, I thought to myself "Rather than having three BG spikes a day, one spike is a lot better (even though this one is bit higher and prolonged - but not longer than 6 hours)". I will eventually sort this out, with the help of good people in this forum!

ert said:

Well if you sort this out, let me know. I have had the same issue. I had cut back to one meal a day from three for the exact same reason, to stop the 6 hours or longer spikes after every meal. I'm back up to two meals a day with the help of weights, but now have an issue of overnight spikes (on the cgm.)

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I certainly will.