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Insulin Resistance and Fatty Liver

Needing help! said:
I'm so desperate to get reversing the insulin resistance as soon and quickly as possible - it's hard knowing your fighting against your internal hormones that you can't see/properly measure at all... I'm a scientist so love a good bit of hard data and facts haha!!
The fasting insulin test I find some people use as a measure of insulin sensitivity is a waste of time because they all report how keto decreases IR but that's only because they're taking away the carbs so of course insulin secretion will be lower... doesn't actually show how your body is responding to the insulin that IS there!
After much research I found somewhere that would privately do a GTT with insulin which I think is more accurate as it tests how much is needed after the carb stimulus but you have to pay nearly £600, and frankly - I just cannot do that!

Unfortunately, my doctor is point blank refusing any medication - they claim as my HbA1c isn't raised they will not prescribe any... despite my protestations that its only not raised because I eat once a day and less than 20g of carbs!!! I refuse to put my body through 3 months of constant highs by eating 3x a day just to prove to them I do need medication!

I don't know for sure, but I think the hepatic insulin resistance may have been the primary cause of all this to be honest... my fasting BG was the first to raise rather than my post meal values, and I've read that to be due to poor body response to the early morning liver dump.
Buy yes, I agree - keto/super low cal are going to be the only way to start reducing liver fat (and the BG issues as well)... I'm just hoping it is reversible and I can see actual improvements!

And thank you also for your suggestion about meal replacements shakes - but to be honest, it just goes against absolutely every inch of my being - I understand it helps some people, but I just wouldn't be able to compute how drinking grey gloop a couple of times a day is any better for my body than some spears of asparagus and a dollop of spinach!

I guess I just need to come to terms with the fact this is going to be a very long old slog, but the only way out is having to push through it...
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The scientific way to do an insulin resistance test is the IGTT which uses euglycemic clamps and a glucose kick up the jacksy via an intravenous portal. It is expensive. The poor man's equivalent is the OGTT which they use to verify gestational diabetes but you have to be pregnant to get the doctor to prescribe it.

The beauty of MR shakes (er -???) is that they are carefully blended and are fortified with the vitamins and minerals you need to meet your RDA. The Newcastle diet plan does add some proper veggies to bolster the fibre. But they are definitely not going to get any stars from the Michelin guys and gals. They are also low fat by design.
 
These guys do full on insulin testing. They had a stand at the recent PHC (Public Health Collaboration) conference. Haven’t used them myself or investigated costs, but might be worth a look.

https://www.meterbolic.org/
 
Goonergal said:
These guys do full on insulin testing. They had a stand at the recent PHC (Public Health Collaboration) conference. Haven’t used them myself or investigated costs, but might be worth a look.

https://www.meterbolic.org/
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They seem to have a mobile insulin testing kit that looks similar to the Covid PCR Home test kit. It is not cheap. Seems to be only available on subscription. Their painless laser lancet device is not cheap either. Not sure how accurate the test strip result will be, With PCR it was a Go/Nogo binary test not numeric.
 
Goonergal said:
These guys do full on insulin testing. They had a stand at the recent PHC (Public Health Collaboration) conference. Haven’t used them myself or investigated costs, but might be worth a look.

https://www.meterbolic.org/
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thanks for this - I hadn’t heard of them before.
But from looking at the website they seem to just do a GTT and only use finger prick blood glucose during that time, and from the video it says any measures of insulin or anything else are done at a ‘separate time’ from the GTT anyway so would again be akin to a fasting value I suppose. And again - it was just finger prick.
Probably not worth the cost at all!
But thank you so much for your help/resources - I can’t believe how helpful everyone is on this forum! People give so much time, help and advice to each other - it’s really motivating me and keeping me hopeful!
 
bulkbiker said:
Any numbers? Sky high could be anything.. and if you are really 26 then I'd be looking for some more tests c-peptide/ fasting insulin to see what's really happening.
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Highest I’ve had is 22.
And about a week ago I got an 18.8.
Most days the highest is around 10-12.

And yes - I am 26! I had a fasting insulin done about a year ago and it was slightly raised (can’t remember the exact value of the insulin but the HOMA-IR was 2.1
But my symptoms (and weight!) have gotten much worse since so it probably would be worth testing again… can’t imagine it will be a nice finding though haha!
 
Goonergal said:
Really? Do you have any evidence for that? Plenty on here reversing type 2/losing weight with minimal exercise.
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I can only speak from experience and it is true that it is different for everyone. I mean well.
I should really say that I am no expert and my advice should not be taken as basis for medical diagnosis. only a qualified professional can do that. I can also confirm that I have never come across anyone not exercising managing their BG levels only through diet. all the best
 
BorisP said:
I can only speak from experience and it is true that it is different for everyone. I mean well.
I should really say that I am no expert and my advice should not be taken as basis for medical diagnosis. only a qualified professional can do that. I can also confirm that I have never come across anyone not exercising managing their BG levels only through diet. all the best
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well, there's me for one. I have ME and cant exercise. I have controlled my type 2 diabetes through diet only for 10+ years now. I find generalisations, based on ones own individual experience, are seldom helpful.
 
BorisP said:
I can only speak from experience and it is true that it is different for everyone. I mean well.
I should really say that I am no expert and my advice should not be taken as basis for medical diagnosis. only a qualified professional can do that. I can also confirm that I have never come across anyone not exercising managing their BG levels only through diet. all the best
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Well my exercise for the day is getting my clothes on in the morning. I am doing pretty well considering. I do take a small dose of one med, but having had T2D for over 30 years now, I am not expecting full remission just like that. My BMI is a steady 21 and I can still navigate the stairs unaided. My primary control lever is indeed diet. and my recent HbA1c was 46. My bgl tonight at the 2hr PP was 6.1 mmol/l after a 3 egg cheese and ham omlette with bell pepper and lettuce salad with salad cream.
 
BorisP said:
I can only speak from experience and it is true that it is different for everyone. I mean well.
I should really say that I am no expert and my advice should not be taken as basis for medical diagnosis. only a qualified professional can do that. I can also confirm that I have never come across anyone not exercising managing their BG levels only through diet. all the best
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You’ll find quite a few here, I lost over 100lb low carbing and no exercise apart from housework and day to day living, I still don’t exercise and manage my diabetes with keto and a small dose of metformin 14 years in
 
Same here with the weight loss. I have lost 5 stone and only go for a walk with wife and dogs now and again. Have athritis and muscular problems so difficult to do things. Tryed resistance band exercises for a few weeks but was in alot of pain all the time :sorry:
 
I've used low carb to stop my rising fasting BG since 2008. It was around 6.8 to 7.0 back then. These days I manage 4.5 to 5.0. In those years I've played around with checking ketones in my wee and can say that ketones will appear for me in two ways; either normal (protein+fats) calorie intake (around 2500kcal) but NIL carb...... OR very low carb (600-800kcal) eating anything.
 
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I achieved normal BG and went down 4 clothes sizes on no exercise apart from normal living, shopping, housework and 1 to 2 hours walking daily.
When my bloods were normal and I was young, I took part in extreme sports, was very fit, and still had to starve to keep my weight down, because I didn't know about keto/low carb in those days.
 
Needing help! said:
It normally goes from around 5.5-6ish to 8 at 2 hours after eating - and it’s more the big rise considering how few carbs is it that concerns me… surely such little should not be causing a sustained rise of that level?! And it takes a good 4ish hours to fall back to baseline whenever I eat.

I mainly want to know what more I can do to actually get into Ketosis and lose weight rather than just control BG as I understand a rise to 8 isn’t a huge concern.

But the dramatic rises do happen all by themselves (thanks fatty liver….!) and I saw a BM of 12 at 4am this morning, so it’s not even just the food that’s a problem at the moment!

so infuriating as I feel I have zero control or even influence whatsoever over my body at the moment…
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the reason that your BG level rises through the night is because that is when your body does most of its food digestion and the resultant glucose is released into the blood stream and Liver . That is perfectly normal for everyone not just T2 Diabetics. If you want to reduce the effects of this overnight BG level rise and the accompanying sweats, restless legs, itchy shins and all other symptoms of T2 then you could try eating your main meal at mid day and something light in the early evening .
The other key thing to remember is that every time you eat something that contains carbohydrate or sugar , you get an Insulin spike so its important to cut down on the snacking throughout the day if you want to help your Liver and Pancreas.

. I speed walk for approx 8-10 minutes up one of my local hills every day and then enjoy a relaxed stroll back down again .My BG level drops 2-3 mmol/L within 1x hour of that exercise and it only takes less than 20 minutes . It has a significant effect on my BG levels for the rest of the day.
 
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johnnyxs said:
the reason that your BG level rises through the night is because that is when your body does most of its food digestion >>>>>
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Do you have any evidence for this statement? I believe that the digestion actually slows down during sleep, It is this time that glucose levels drop and autophagy (cell repair) takes place. The only ongoing digestion activity will be fibre absorbtion in the lower intestine due to fermentation and that is a slow process.
https://www.sleepadvisor.org/sleep-and-digestion/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2990190/
 
Hi , I am a T1D and have spent the last 6 years trying to manipulate diet and exercise to achieve good BG levels . You are having high BG levels but your A1C is normal which means at some point you are experiencing lows or even hypos . Without a CGM or multiple regular fingerpricks you have no idea what your blood is doing in response to exercise , food volume or type . Initially you need a baseline without shakes , IF or any other adapted eating program . Establish a typical calorific needs diet based on your BMI and spread this throughout the day . Invest in a CGM for a short period , Freestyle Libre would be fine which will provide 14 days of 24 hour data per sensor . Keep a food diary , I use Myfitnesspal . After 2 weeks you can use your libre report and food diary to cross compare your data . At present there are too many variables to make a call . You may be pre-diabetic , you may be T2 you may have LADA ultimately developing to T1 ( my own diagnosis ) identified by positive tests for T1D anti-bodies , etc . I know how you feel with your GP it took me 18 months of pressure to finally get the anti-body tests despite having a normal A1C at the beginning and then months of extreme overeating to push up that A1C . One more thing , exercise is vital in conjunction with a balanced diet and a lot more successful as a lifestyle change than IF etc but whatever you choose it really has to be data driven tailored for you , all the best
 
Oldvatr said:
Do you have any evidence for this statement? I believe that the digestion actually slows down during sleep, It is this time that glucose levels drop and autophagy (cell repair) takes place. The only ongoing digestion activity will be fibre absorbtion in the lower intestine due to fermentation and that is a slow process.
https://www.sleepadvisor.org/sleep-and-digestion/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2990190/
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well seeing as you raised this query let me ask you a question. Have you got any medical or scientific evidence to refute my statement ? i would like to know your reasoning on this. If you eat a main meal in the evening then sit and watch TV for a few hours before going to bed....when do you think digestion occurs ?? Next day ?

While I await your reply I'll do a little research myself

looks like you are correct in that digestive processes do slow down during sleep but digestion certainly doesn't stop altogether like you seem to be suggesting. All the while digestion is taking place the body is breaking down food and blood glucose levels will rise as a result.

Autophagy is very unlikely to occur when there is plenty of other immediately available sources of glucose constantly stored within the Liver the blood and muscles

Digestion is a very complex process and not one to be explained in a few sentences by plagiarising random pieces of text from the Web
 
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johnnyxs said:
well seeing as you raised this query let me ask you a question. Have you got any medical or scientific evidence to refute my statement ? i would like to know your reasoning on this. If you eat a main meal in the evening then sit and watch TV for a few hours before going to bed....when do you think digestion occurs ?? Next day ?

While I await your reply I'll do a little research myself

looks like you are correct in that digestive processes do slow down during sleep but digestion certainly doesn't stop altogether like you seem to be suggesting. All the while digestion is taking place the body is breaking down food and blood glucose levels will rise as a result.

Autophagy is very unlikely to occur when there is plenty of other immediately available sources of glucose constantly stored within the Liver the blood and muscles

Digestion is a very complex process and not one to be explained in a few sentences by plagiarising random pieces of text from the Web
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Simple observation of an OGTT plot or a CGM plot after a meal is sufficient to lnow that in most people the glucose levels wil spike at 10 minutes after first bite (Stage #1 insulin response to salivary amylase activity) followed by the main peak at the 2 hr PP mark (stage 2 insulin response to gut generated amylase enzyme). Normal people will establish stasis ( i.e;. return to baseline) by the 4 hr PP time. Diabetics and those with metabolic disorder do not usually manage to meet this as most of us on this forum know from experience. But this is due to the metabolic disorder, not the digestive process.

I was indeed incorrect to use the term autophagy to describe the body repair mechanism process, which does not have a specific name per se. Autophagy can be induced by fasting, but is also triggered by excess glucose levels raising the AMPK marker, but the general repair process occurs during N3 sleep time. (deep sleep) and is melatonin triggered.
 
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Exercise shouldn’t be discounted as a way to help reduce IR. I needed both diet and exercise to get out of the mess I was in. Some people can’t and need to push more on diet, that’s fine. But if you can exercise, it’s another tool in the toolbox.

low carb and walking 2500 steps after every meal can do wonders
 
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