I have blood sugar questions!!

[Auto E]

Hello! I am brand new here. I am a college professor; I teach Anatomy & Physiology and I have always had a particular interest in type II diabetes. Maybe I sensed something coming.

My Grandmother had type II diabetes; I was declared "borderline" gestational diabetes with my second son, and he weighed almost 9 pounds.... so yeah, I think something was going on that I was kind of trying to ignore, in hindsight.

1 year ago I officially started restricting carbohydrates very carefully to between 50 and 75 g/day on weekdays and 75 -100 g on weekends. My A1C at the start of this was 5.6% (37.7mmol/mol). I lost over 20 pounds and my BMI dropped from 26.9 to 22.5. Great stuff, right? But last week my A1C was 5.9% (41 mmol/mol). Sigh. Cry. Pout.

So, in the planning of my next experiments to see if I can figure out what's going on with my blood sugar, I have a few questions for y'all. Please answer one or all of them based on your personal experiences and your passions! I am really looking for your personal experiences, not what the literature says (which I have read ad nauseum).

How, if at all, have the following factors affected your personal A1C (or your blood sugar readings, if you take them) over time?
1. skipping breakfast or other types of intermittent fasting (I currently do this and I'm seeing my blood glucose worsen)
2. having a small amount of carbs before bed (I do not do this - never have - but I have read it actually helps some people keep their FBG lower)
3. having a small amound of protein and/or fat before bed (I do not do this - never have - but I have read it actually helps some people keep their FBG lower)
4. exercising in the fasted state (I currently do this at a fairly gentle level, but I still see a rise in BG and I'm beginning to wonder if this is also counterproductive for my particular body)
5. high-fat yogurt (this is not noticeably affecting my blood glucose, but I am wondering if it is overall making me more insulin resistant.... have read of some people this can happen to)
6. alcohol (I am wondering if anyone has found that dry wine is an important key for them to keep their A1C down. I quit drinking and my A1C worsened. Could this just be temporary?)

So I'll wrap up with my personal hypothesis - almost 4 months ago I quit drinking wine. I had been having 2-4 glasses pretty much every night. And man were my fasting glucose values awesome - sometimes in the mid-70's (4.2mmol). I was rocking it! But I'm wondering if the alcohol was MASKING my hepatic insulin resistance and now my liver has full freedom to pump out glucose like a fiend. I've been seeing FBG of between 100 and 112 regularly since I started testing again (since I got that higher A1C and I've gone back to analysis mode). But even if my hypothesis is right, I'm in a bit of a pickle. I was drinking too much and I'm otherwise feeling much better without drinking. I don't trust myself to have a glass of wine every night to keep my fasting blood glucose down.

Here is my typical diet (on a weekday - weekends involve more eggs and also more carbs)
B: coffee w/ half&half, coffee w/collagen protein + MCT oil (I estimate 6 g carb for all coffee)
L: full-fat yogurt w/berries (est. 30 g carbs - blood glucose goes up to about 120 after this meal)
D: protein (beef, fish, poultry, or eggs) + giant kale or similar type salad and usually a buttery side of broccoli, asparagus, or something like that. Lots of fat and protein, lots of butter and/or oil - blood glucose doesn't change much after dinner
decaf coffee w/half & half

I walk/jog every day for about an hour. I do pull-ups. I try to sleep 7-8 hours nightly (but often my sleep is not excellent, but certainly better than before I quit drinking!).

Thanks for reading this whole post if you did. I'm a bit stressed and disappointed right now (easy there cortisol!). I have mild chronic kidney disease and I really want to stay on top of my blood sugars. I just ordered 100 more strips and I'm ready for more experiments based on your suggestions.

 

[JoKalsbeek]

Good morning!

Let's see... Due to intermittent fasting, my fasting blood glucose is up in the morning, usually no more than up to 108 or something though. This is in part due to the liver dump (before I started keto and IF my FBG was lower, on LCHF only), part because my muscles are in fat-burning mode. My liver still dumps glucose, but my muscles refuse the use of it. So while the liver dump is smaller than it was, say, 2 years ago, my muscles not using it is causing my fasting BG to go up... Which is fine. I don't like it, have to admit, but at least I know why it's up, and it's a good thing. Which I have to keep reminding myself. The rest of the day I'm decidedly lower. I had to cut out all snacking so can't say much of anything about having carbs, protein or fats before bed.... If I eat more than my 2 meals a day my insulin response keeps going and the weight comes back on (in part due to PCOS, my turning 40 and hormonal issues.). So can't comment on that, sorry. If I exercise in a fasted state my liver dumps yet more glucose my muscles refuse... So I go up. Not by a lot though, sorry i don't have specific numbers... Can't say much on the high fat yoghurt except it tastes wonderful and it triggers my migraines, so haven't had that in a while. And I don't drink. Keeping your liver busy with alcohol could have been the cause of the smaller liver dumps, but since most prediabetics and T2's have non-alcoholic fatty liver disease, you don't want to tax your liver more than it absolutely has to be taxed. Also, with the dump it's often getting rid of stored rubbish, which is good... So while the not drinking may impact what your FBS looks like, it doesn't have to be bad that it's up a little. Me, I just look at my pre-and postprandials. I don't go up more than 2.0 mmol/l, and I've been in the normal range for almost 3 years now. I usually see fours and vies during the day.

From what I'm seeing here you're not exactly eating a very varied diet, unless those salads are all over the place... I'm missing eggs, cheeses, that sort of thing. There's more in life than yoghurt and salad. Keep an eye on your vitamins & minerals. And if the FBG is really bothering you, you could opt for metformin. And it's possibly side effects. but if you aren't prone to those, or go straight for the slow release kind, that could help reduce the liver dump by 75%. (And keep an eye on your B12, because on Met you don't absorb it well and can become deficient).

Good luck!
Jo

 

[Guzzler]

I think you're gonna need more strips.

Booze delays carb absorption which testing more would have shown you. Because alcohol is a toxin the liver will deal with that first. You may also have been having liver dumps inbetween times.

Get yourself a food diary and start systematically testing foods against your meter (get a cgm if possible).
Skipping meals does no harm whatsoever, in fact it allows insulin levels to return to baseline for longer (great for autophagy) and curbs hyperinsulinaemia which imo is as bad as hyperglycaemia.

 

[bulkbiker]

1 year ago I officially started restricting carbohydrates very carefully

How restrictive have you been?

1. skipping breakfast or other types of intermittent fasting

I have done this almost since the day of diagnosis. I find it easy and believe that the benefits combined of ultra low carb and fasting are the way to go.

having a small bolus of carbs before bed

Why?

3. having a small bolus of protein and/or fat before bed

Again why? I eat my dinner around 7 pm stop at 8 and thats it apart from a coffee. Snacks aren;t a good idea

4. exercising in the fasted state

I haven't really increased exercise much apart from a brief foolhardy period when I went to the gym and gave myself a hernia!

5. high-fat yogurt

In moderation.... oh no I said the M word..

6. alcohol

I don't.. but I haven't since before T2 anyway

Hope that helps
My stats in my sig below.

 

[Brunneria]

How, if at all, have the following factors affected your personal A1C (or your blood sugar readings, if you take them) over time?
1. skipping breakfast or other types of intermittent fasting
2. having a small bolus of carbs before bed
3. having a small bolus of protein and/or fat before bed
4. exercising in the fasted state
5. high-fat yogurt
6. alcohol

Hi and welcome

1. Depends what you eat (or don’t) at breakfast. I have lower blood glucose during the late morning if i have a protein fat brekkie (or snack), strictly no carbs.
2. V bad idea in my case. Likely to cause me a hypo in the small hours. Your mileage will probably vary.
3. Completely unnecessary if you eat enough for your evening meal.
4. Depends on the exercise.
5. Yogurt gives me higher bgs than the carb content would suggest, so I strictly limit portion sizes and add cream to extend and reduce the rise.
6. I don’t drink. Can’t see the point of stressing my liver unnecessarily.

And just one more thing you may find useful - I completely understand why you used the word ‘bolus’ to describe your snacks, but around here, ‘bolus’ is more usually used to describe actual medication, and in particular bolus insulin injections. So using it in the context you did might lead to a bit of confusion or queries.

Are you in America? The reason I ask is that you’ve mentioned half and half. That isn’t usually available around me (the UK) so we just use cream, usually double cream. I think it is known as heavy whipping cream in the States.
Half and half is probably higher carb than cream, but there won’t be all that much in it.

Hope that helps.

 

[Resurgam]

I can't really throw a lot of light on things, as I am approaching this from a different direction.
Both my babies were over 9lb but I was never tested for diabetes - other than a urine dip but even when fully diabetic and a Hba1c of 91, I never saw a positive urine test.
I did find out, by testing, that if I eat two meals a day, one early and one in the evening, my levels are kept at their best. I don't have snacks. I drink at most two mugs of coffee with cream a day - sometimes I don't have any. I drink water.
I do eat full fat Greek yoghurt, but not every week - I sometimes grab a couple of large tubs if there is any - often the shelves are empty.
Exercising increases my BG levels if it is energetic and on an empty stomach - obviously my liver considers I need energy to find food.

 

[Auto E]

Good morning!

Let's see... Due to intermittent fasting, my fasting blood glucose is up in the morning, usually no more than up to 108 or something though. This is in part due to the liver dump (before I started keto and IF my FBG was lower, on LCHF only), part because my muscles are in fat-burning mode. My liver still dumps glucose, but my muscles refuse the use of it. So while the liver dump is smaller than it was, say, 2 years ago, my muscles not using it is causing my fasting BG to go up... Which is fine. I don't like it, have to admit, but at least I know why it's up, and it's a good thing. Which I have to keep reminding myself. The rest of the day I'm decidedly lower. I had to cut out all snacking so can't say much of anything about having carbs, protein or fats before bed.... If I eat more than my 2 meals a day my insulin response keeps going and the weight comes back on (in part due to PCOS, my turning 40 and hormonal issues.). So can't comment on that, sorry. If I exercise in a fasted state my liver dumps yet more glucose my muscles refuse... So I go up. Not by a lot though, sorry i don't have specific numbers... Can't say much on the high fat yoghurt except it tastes wonderful and it triggers my migraines, so haven't had that in a while. And I don't drink. Keeping your liver busy with alcohol could have been the cause of the smaller liver dumps, but since most prediabetics and T2's have non-alcoholic fatty liver disease, you don't want to tax your liver more than it absolutely has to be taxed. Also, with the dump it's often getting rid of stored rubbish, which is good... So while the not drinking may impact what your FBS looks like, it doesn't have to be bad that it's up a little. Me, I just look at my pre-and postprandials. I don't go up more than 2.0 mmol/l, and I've been in the normal range for almost 3 years now. I usually see fours and vies during the day.

From what I'm seeing here you're not exactly eating a very varied diet, unless those salads are all over the place... I'm missing eggs, cheeses, that sort of thing. There's more in life than yoghurt and salad. Keep an eye on your vitamins & minerals. And if the FBG is really bothering you, you could opt for metformin. And it's possibly side effects. but if you aren't prone to those, or go straight for the slow release kind, that could help reduce the liver dump by 75%. (And keep an eye on your B12, because on Met you don't absorb it well and can become deficient).

Good luck!
Jo

Thank you Jo! I really appreciate your response. I love your detailed description of how your FBG has changed over time. And my diet is reasonably varied (not as much as some, I'll admit, but similar meals helps me track my blood glucose more easily and also make sure I don't gain weight - it's easier to tweak if I go up a few pounds). I love cheese and I've never met a salad without it. I often have bacon & eggs on the weekends, when I am more varied with what I eat. I get pretty much exactly 1g protein/kg body weight (I know this exactly because I have to have regular kidney function tests).
Thanks for the thought about metformin. I'd prefer not to have to take it, but I won't hesitate if my A1C keeps going up like this.
Thanks again for taking the time to reply.

 

[Auto E]

I think you're gonna need more strips.

Booze delays carb absorption which testing more would have shown you. Because alcohol is a toxin the liver will deal with that first. You may also have been having liver dumps inbetween times.

Get yourself a food diary and start systematically testing foods against your meter (get a cgm if possible).
Skipping meals does no harm whatsoever, in fact it allows insulin levels to return to baseline for longer (great for autophagy) and curbs hyperinsulinaemia which imo is as bad as hyperglycaemia.

I have been keeping a food diary for 6 years and I test my blood sugar like a crazy person. Alcohol has never done anything but lower my blood sugar, which I took for granted when I drank, but now I'm wondering if alcohol was actually a beneficial thing for my particular scenario. Which would be unique, possibly.
Skipping breakfast raises my fasting blood sugar and it keeps rising in the morning until I eat. If there were posters that saw this same phenomenon and still had a lower A1C result, I would feel more confident to stay the course. Since doing this, my A1C has worsened, hence the reason for my question. I was curious if others have experienced this and STILL seen their A1C's improve (unlike mine).

 

[ianf0ster]

Hi.
My answers are:
1. Very good. I use it once or twice a week along with a general LCHF lifestyle. But it may increase the BG level when testing after normal breakfast time.

2. Why do that? Unless you are on a glicazide or insulin, and so be at risk of an overnight hypo, it can only make things worse. - Sorry I have strayed here, since I am not stupid enough to actually try this out!

3. I have not tried added fat or protein before bed either. Fat won't hurt but protein might.

4. Also very good since it encourages your liver to dump even more from its stores. But may increase the BG in a test just afterwards. Generally the more vigorous the exercise the more BG the liver will need to dump. Still that is only going to be good for the longer term - Ha1bc etc.

5. High Fat natural yoghurt is (or double cream) is the only way I can eat conventional fruit (in my case only berries) without spiking my BG.

6. Alcohol is tricky because it slows down carb processing and also affects confidence/recklessness and makes you hungry. Most beers and obviously sweet wine and mixers for spirits are carb loaded. Having said all that, I still consume a bottle of red wine over Friday night to Sunday night.

 

[Guzzler]

I have been keeping a food diary for 6 years and I test my blood sugar like a crazy person. Alcohol has never done anything but lower my blood sugar, which I took for granted when I drank, but now I'm wondering if alcohol was actually a beneficial thing for my particular scenario. Which would be unique, possibly.
Skipping breakfast raises my fasting blood sugar and it keeps rising in the morning until I eat. If there were posters that saw this same phenomenon and still had a lower A1C result, I would feel more confident to stay the course. Since doing this, my A1C has worsened, hence the reason for my question. I was curious if others have experienced this and STILL seen their A1C's improve (unlike mine).

I am teetotal so I've never tested with booze.

 

[Auto E]

How restrictive have you been?

I have done this almost since the day of diagnosis. I find it easy and believe that the benefits combined of ultra low carb and fasting are the way to go.

Why?

Again why? I eat my dinner around 7 pm stop at 8 and thats it apart from a coffee. Snacks aren;t a good idea

I haven't really increased exercise much apart from a brief foolhardy period when I went to the gym and gave myself a hernia!

In moderation.... oh no I said the M word..

I don't.. but I haven't since before T2 anyway

Hope that helps
My stats in my sig below.

I am not super restrictive; I should have been more clear about that. What I really mean is that I am consistent, and measured, and I am certain of what I am eating. Weekdays I am between 50 and 75 grams carb; weekends closer to 100 each day. However, that is a drastic reduction from my diet when I got the 5.6%. Since going low(er)-carb, my A1C has worsened to 5.9%.
The reason I am wondering about bedtime snacks is because I do not have any snacks ever, and my A1C has worsened! I have read a few things about bedtime snacks curbing the dawn phenomenon and wondered if anyone on this forum has been trying that to good success. I don't snack and I'm usually done eating at 6pm. Fasting in the morning is definitely causing a giant liver dump in my case (that I believe alcohol muted before) and my A1C has risen. If I were confident my high morning numbers aren't worsening my overall glucose control, I would be less worried about staying this course.
Thanks again for taking the time to reply.

 

[Auto E]

Hi.
My answers are:
1. Very good. I use it once or twice a week along with a general LCHF lifestyle. But it may increase the BG level when testing after normal breakfast time.

2. Why do that? Unless you are on a glicazide or insulin, and so be at risk of an overnight hypo, it can only make things worse. - Sorry I have strayed here, since I am not stupid enough to actually try this out!

3. I have not tried added fat or protein before bed either. Fat won't hurt but protein might.

4. Also very good since it encourages your liver to dump even more from its stores. But may increase the BG in a test just afterwards. Generally the more vigorous the exercise the more BG the liver will need to dump. Still that is only going to be good for the longer term - Ha1bc etc.

5. High Fat natural yoghurt is (or double cream) is the only way I can eat conventional fruit (in my case only berries) without spiking my BG.

6. Alcohol is tricky because it slows down carb processing and also affects confidence/recklessness and makes you hungry. Most beers and obviously sweet wine and mixers for spirits are carb loaded. Having said all that, I still consume a bottle of red wine over Friday night to Sunday night.

LOL, you guys really hate my question about bedtime snacks. Don't worry, I don't have them. I was wondering about TRYING them out to curb the Dawn Phenomenon a bit. Yes, believe it or not, I have read that for some people it helps. But I don't care if my FBG is a little high as long as my overall A1C drops. Sadly, mine hasn't. It's gone up. All I ever drank was the driest red wine I could find. It only ever lowered my blood sugar, both acutely and the next morning.

 

[Auto E]

Hi and welcome

1. Depends what you eat (or don’t) at breakfast. I have lower blood glucose during the late morning if i have a protein fat brekkie (or snack), strictly no carbs.
2. V bad idea in my case. Likely to cause me a hypo in the small hours. Your mileage will probably vary.
3. Completely unnecessary if you eat enough for your evening meal.
4. Depends on the exercise.
5. Yogurt gives me higher bgs than the carb content would suggest, so I strictly limit portion sizes and add cream to extend and reduce the rise.
6. I don’t drink. Can’t see the point of stressing my liver unnecessarily.

And just one more thing you may find useful - I completely understand why you used the word ‘bolus’ to describe your snacks, but around here, ‘bolus’ is more usually used to describe actual medication, and in particular bolus insulin injections. So using it in the context you did might lead to a bit of confusion or queries.

Are you in America? The reason I ask is that you’ve mentioned half and half. That isn’t usually available around me (the UK) so we just use cream, usually double cream. I think it is known as heavy whipping cream in the States.
Half and half is probably higher carb than cream, but there won’t be all that much in it.

Hope that helps.

Thanks for the welcome! I appreciate your replies! Sounds like having a little something in the morning (low-carb) is actually useful for you? I am thinking I might try having eggs in the morning to see if that calms my liver down.

Good point about the word "bolus". Thanks for pointing that out. Totally makes sense. And yep, I'm in the U.S. I can get double-cream if I like, but the half & half is just 1 g/carb/2TBSP so it goes a little farther for me. Thanks again!

 

[Auto E]

I can't really throw a lot of light on things, as I am approaching this from a different direction.
Both my babies were over 9lb but I was never tested for diabetes - other than a urine dip but even when fully diabetic and a Hba1c of 91, I never saw a positive urine test.
I did find out, by testing, that if I eat two meals a day, one early and one in the evening, my levels are kept at their best. I don't have snacks. I drink at most two mugs of coffee with cream a day - sometimes I don't have any. I drink water.
I do eat full fat Greek yoghurt, but not every week - I sometimes grab a couple of large tubs if there is any - often the shelves are empty.
Exercising increases my BG levels if it is energetic and on an empty stomach - obviously my liver considers I need energy to find food.

This is great and very helpful! So you do break your fast fairly early in the day? And that works better for you than waiting until lunch to eat? I think this is a very good experiment for me to try.
And just for curiosity, you said you are approaching things from a different direction? Tell me more - unless I missed something, you seem to be very similar to me. I eat two main meals a day and only have coffee otherwise. The difference is I eat the first meal at lunchtime.
Last, based on your experience, do you avoid exercising on an empty stomach then (energetically, that is)? Or overall do you not think that BG rise is not hurting your overall A1C?

 

[Resurgam]

I was fully diabetic, and I am sure that I had been unable to deal with carbs for a long time, but all my claims that carbs were not what I should be eating were met with anger and derision - I was given diet sheets to follow which were all cereals, potatoes, wholemeal bread, so I tried and tried to comply as my weight crept up and up - I stopped weighing myself at 264lb.
I usually eat soon after I get up, but from time to time I do not feel hungry - such as today, and I have just eaten at 4 pm. I will probably not eat again today. I found, when I tested, that to eat only protein and fat, or not to eat at all even if hungry, normally resulted in elevated BG. Those were fairly early days, when I was still taking Metformin, and it had such nasty side effects that I would go out first thing and eat when I got back, then spend the rest of the day unable to go out of the house.
These days I do not exercise as a specific activity - I go out with the morris men and for other activities, and usually eat beforehand as I don't know when I will be back, so eat in order to be sure I will not need to be trying to find something to eat out of the house.

 

[JoKalsbeek]

I have been keeping a food diary for 6 years and I test my blood sugar like a crazy person. Alcohol has never done anything but lower my blood sugar, which I took for granted when I drank, but now I'm wondering if alcohol was actually a beneficial thing for my particular scenario. Which would be unique, possibly.
Skipping breakfast raises my fasting blood sugar and it keeps rising in the morning until I eat. If there were posters that saw this same phenomenon and still had a lower A1C result, I would feel more confident to stay the course. Since doing this, my A1C has worsened, hence the reason for my question. I was curious if others have experienced this and STILL seen their A1C's improve (unlike mine).

Oh, yes. My HbA1c hovers between 33 and 35. Before IF it was 38. Not a huge difference, but yeah.