Ketone Meter as Insulin Indicator?

Hi @JohnH2019 , a very interesting thought ! But too many variables involved i would opine. We have differences in our metabolisms one from the other, plus Dr McPinney in his videos etc states that people vary as to when they show blood ketones in the 24 hour .intervals. But it would be an interesting experiment to do nonetheless !

JohnH2019 said:

it would mean that insulin level is zero?

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I think that would have quite serious health consequences.

In a sense, yes. I like to be close to 1:1 glucose/ketones when I test my blood ketone concentration weekly. Ketones are almost always 3+ and sometimes 4 or even 5. This data correlates well with my frankly ridiculous HOMA-IR of 0.3

EDIT: key point - my fasting insulin value was a rock bottom 1.7mIU/L, correlating well with high ketones.

JohnH2019 said:

Thanks. I just changed it to read 'healthily low' instead. I read that a fasted level of <3 µIU/ml is what to strive for. Is that valid?

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To be honest think fasting insulin is measured so rarely that no-one really knows what a "healthy" level would be. I also think it will be volatile during the day depending on what we have eaten the day before timing of eating etc just like blood glucose. I'd guess that the longer you have fasted beforehand the lower your level would be. On the three occasions mine has been measured the lowest was from blood taken at 11.30 am. When I've had it taken earlier in the morning between 8 and 9 am its been higher even though I was further down the keto route.

Hmm. I'm in nutritional ketosis, but ketones are lowest when fasted at 0.5 - 0.9. In the later part if the day, 4 - 5 hours after a meal (as opposed to 12 - 16 hours in the previous case), ketones are 1.4 - 3.0.

It seems like insulin would be inversely correlated with ketones, doesn't it?

JohnH2019 said:

That is my understanding. Insulin in the blood will lower or stop ketone production since the body realizes there is plenty of easy energy glucose available. Since you are in ketosis, perhaps later in the day your body produces more ketones for your extra energy usage. Which would lead me to think your insulin levels are exellent througout the day.

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I think you may be incorrect, because as far as I know there is always insulin present, just as there is always blood glucose present even if you are in nutritional ketosis.

There is a balancing act between blood and tissue glucose, insulin and ketones. I think that ketones are the only ones which can be virtually non-existent.

Limiting your carbohydrate intake will limit your insulin production because less insulin is needed. If you don't eat enough carbohydrates to meet your energy needs then you will produce ketones to make up the difference. If you eat very few carbohydrates then your energy will come mainly from ketones.

However there are still tissues which need glucose, such as parts of the brain, where ketones will not pass the blood/brain barrier. This is produced from whatever is available by the liver if there is no spare carbohydrate. As far as I know this still requires insulin to balance it.

Obviously if your BG drops below 4 then you are in hypo territory so you do require BG at all times, even when water fasting. So your body has to both produce it and regulate it.

So as far as I can see a non-diabetic who has successfully moved excess BG into fat and muscle and has no ketones in the blood is likely to have a similar insulin level to a diabetic in nutritional ketosis with loads of ketones in the blood.

Your insulin level can also be raised in nutritional ketosis if you have insulin resistance. The body has to maintain a higher background level of insulin to force the glucose out of the blood regardless of how much or how little ketones are present.

So I don't think that the level of ketones can be relied on to show the level of insulin in the blood.

JohnH2019 said:

Thank you LittleGreyCat! It makes sense that there is always some level of production (pancreas damage permitting) and it is not on or off completely. I did notice that until I had my insulin and BG under better control I was not able to drop my fat percentage level. There is some signalling whereby the body will lower the usage of adipose fat energy storage when there is a higher amount of insulin in the blood. At what exact level this is will likely vary from person to person. But it might explain why it is so extra hard to maintain optimal fat percentage when diabetic.

I guess I will still just have to just go to the doctor once in a while for the fasted insulin blood test that I was trying to shortcut. I hate going to the doc.

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Just be thankful that your medical team will test for insulin levels in a pre-diabetic.
Not many in the UK will do this.
I paid for an IR test but the surgery drew the blood for me.