Type 2 LCHF Issues

@32Alpha68 I've been on the LCHF/ketogenic diet for 15 months, no medication. Started with an A1c of 9.9%, last one was 5.4%. I crossed over into T2D in 2005 and have severe insulin resistance - (as confirmed by a higher carb dinner last night that resulted in a 3-hour post meal BG of 10.4 mmol/L (187 mg/dL), sigh...).

If I eat breakfast within 30 to 60 minutes of getting out of bed my liver doesn't release glucose - (referred to as a "liver dump") - and I'm fine. If I delay, it messes up my blood glucose for the rest of the day, so I just don't do it.

Also, I stop eating 3 hours before going to bed, and typically don't eat again for 12 hours, this gives my body a 12 hour fast each day. If I wake up early, I will lay in bed and read before getting up to make breakfast, (and if I can't, I'll break my fast earlier).

Your fasting blood glucose of 4.6 mmol/L (83 mg/dL) to 5.4 mmol/L (97 mg/dL) is good.

And while your 2-hour post awakening blood glucose is with or without breakfast - (this is my estimate based on your description) - 6.8 mmol/L (122 mg/dL) to 7.3 mmol/L (131 mg/dL), that's not too awful, but I'd want to lower too.

My other thought, is if you don't want to eat breakfast, delay your lunch until 3 to 4 hours after awakening. If you do that, perhaps then your BG's will be fine for the rest of the day.

If you eat breakfast soon after awakening to prevent your liver from releasing glucose:

What is your awakening BG?
What is your pre-breakfast BG?
What is your 2-hour post breakfast BG?
What is your pre-lunch BG?
What is your 2-hour post lunch BG?

Knowing all five of those BG readings would help me understand better if you have a problem or not (because my understanding is that Dawn Phenomenon, if not treated, will result in higher blood glucose levels for the rest of the day).

I think one of the challenges of working with your doctor on these issues is that their training is primarily based on working with patients who are taking diabetes medications and/or insulin. A benefit of not using any medication is no risk of hypos.

I wonder what would happen if you stopped the medication completely for a month so you can get a clear picture of what's happening? I suggest a month because that's how long it took for my body to completely respond to the LCHF/ketogenic diet. That said, you're doing so well, even 2 weeks might provide helpful information.

You're asking interesting questions. I also am interested in hearing other's experiences.

This article, though not written from a LCHF/ketogenic diet perspective is interesting in that it describes the differences between dawn phenomenon, the Somogyi effect, or waning insulin... http://www.diabetesforecast.org/2008/sep/rocky-morning-highs.html

This weekend, I'm monitoring my BG closely: Awakening BG, pre-meal BG, 1-hour post meal BG, more at 15 minute intervals until I peak and BG begins dropping. Then I repeat with each meal, pre and post meal. I also am checking my pre-walking BG, post-walking BG, and 30 minute post-walking BG.

I'm trying to figure out how eating and light exercise affects the peaks and valleys of my BG. It's interesting. (And it helps that I use really cheap test strips).

One of the things that I love about the LCHF/ketogenic diet is that if I get a really high post dinner blood glucose level, I can drop it by up to 4.5 mmol/L (80 mg/dL) with 20 minutes of walking to minimize the damage.

@32Alpha68 eventually you'll get this sorted out. Sometimes solutions are entirely accidental. My BG was higher than I wanted it to be for a longer than I wanted. It can be frustrating.

My thinking now is it takes a long time to develop diabetes, and we need to be patient with the knowledge that the low carb diet is helping our body heal. We just need to stay the course, monitor for changes, make adjustments as we go.

I'm interested in following your progress.

Walking (exercise) usually makes us more insulin sensative. Not always immediately. It will generally lower us some right away but if it was a brisk walk or higher intensity it could have triggered some cortisol release so bs didn't come down as low but caught up later in the day as cortisol reduced making you more sensative at dinner.

As a type 2 I found a slow to moderate walk lowered me more than a brisk walk. Hence no cortisol dump. Now, as type 1 any kind of exercises raises me a lot and I would need extra insulin.

Kristin251 said:

Walking (exercise) usually makes us more insulin sensative. Not always immediately. It will generally lower us some right away but if it was a brisk walk or higher intensity it could have triggered some cortisol release so bs didn't come down as low but caught up later in the day as cortisol reduced making you more sensative at dinner.

As a type 2 I found a slow to moderate walk lowered me more than a brisk walk. Hence no cortisol dump. Now, as type 1 any kind of exercises raises me a lot and I would need extra insulin.

Click to expand...

That's interesting Kristin as somebody who has migrated from. t1 to t2.

As you know is early days for me, but in finding a hard run of 1 mile each morning drops my BG and causes my BP to drop consistently after a 20 mins rest. BP down from 169/95 to 112/64 regularly now.

I'll watch with interest my pattern as time strolls by


Diagnosed 13/4/16: T2, no meds, HbA1c 53, FBG 12.6, Trigs 3.6, HDL .75, LDL 4.0, BP 169/95, 13st 8lbs, waist 34" (2012 - 17st 7lbs, w 42").

2/6/16: FBG AV 4.6, Trigs 1.5, HDL 2.0, LDL 3.0, BP 120/72, 11st 11lbs, waist 30" (2012 - 17st 7lbs, w 42").

Regime: 20g LCHF, run 1 mile daily, weekly fasting.

5/6/16: Two BP readings now 112/64 & 112/66

@Kristin251 I too have to watch my walking speed. I bounce in and out of a condition called subclinical hyperthyroid which means I'm vulnerable to cortisol surges. For me, as a type 2, if I have a really high blood glucose, a short, brisk walk is fine or a long, more relaxed walk is fine, but if my blood glucose is within 30 points of my "normal", a more relaxed pace is better. It helps that I read a book as I walk.

@32Alpha68 the results you posted are helpful. At first I was concerned, but as I continued to read your results, I see you did recover, in part at least to that well timed walk. That's good. Not only that, but your 2-hour post dinner BG matched your morning fasting glucose. I'd be quite pleased with that result.

Woke up late this morning at 9.53am BS 5.3 (93 mg/dL)
Skipped breakfast, but at 11.51am BS 7.1 (128 mg/dL)
Had hamburger mince and egg at 12.15pm and at 2.15pm BS 8.0 (144 mg/dL) (compare this with evening meal result).
Took half hour brisk walk (instead of 1/2 tablet) 3.10pm BS 6.4 (115 mg/dL)
Random check approx. 2 hours from last reading 5.15pm BS 5.9 (106 mg/dL)
Prior to evening meal (meat, capsicum, onion and cheese sauce) BS 5.7 (103 mg/dL)
Two hours after evening meal BS 5.3 (95 mg/dL)

I have to say, after converting your numbers to mg/dL, your numbers are highly similar to my numbers on a good day, and as you may recall, I've been on the low carb diet for 15 months. I could be wrong about this, sincerest apologies if I am, but I rarely see people who have been on medication for years switch to managing with diet and exercise alone. Not only that but you've achieved in a short period of time what took me more than a year to accomplish. Well done.

@KevinPotts if you don't have an autoimmune condition or food sensitivities or intolerances to things like gluten (found in wheat, rye, and barley, perhaps oats) or casein (milk protein) for example, you likely will never cross over into the autoimmune type of diabetes, which is good. I have two, possibly three autoimmune conditions, so unfortunately, it's possible that I will cross over eventually. That said, Kristin and a few other T1.5's and T1's here reassure me that if I do cross over, I can still maintain excellent control. That gives me hope.

I read your results for the first time today. Wow Kevin, you're the man! (In the US, that's a big compliment).

It is interesting to me as well to see the differences as type 2 , progressing to type 1 and finally landing on insulin.
The one constant thing is LCHF was the best diet for all 3. As a 1 and while I was progressing protein became a bigger part of the equation so lowering it helped a lot. Early days of type 2 I could eat much more but I now take into consideration the mTOR pathway and am fine where I am but I'd love a half pound rare burger but I settle for the slider.

Exercise was another story. I used to run and take classes at the gym everyday and kept my numbers great for years. Then they started going higher after exercise and I slowed it all down and they got better. I would also take a brisk walk after every meal. Even 10 minutes helped. I could either take a longer more relaxing or shorter brisk as Winnie said. Now as type 1 a brisk walk raises me quite a bit. In comes the insulin to lower me and the insulin sensativity from the walk and I could hypo. I don't like the roller coaster so for now the most I do is a leisurely stroll. Weight lifting sends me soaring. Yoga can too and it's sad because I love working out but I finally have as perfect of a routine as I can with rock steady numbers and don't want to change it.
I also thought when I went on insulin I would be able to eat more, like a little sweet potato or apple but can't get the timing right getting insulin and food there at the same time so I would generally go low then pop up. Felt awful. So i could eat more by taking extra injections and extra finger sticks but not interested in that either. At the end of the day I feel good on my mini meals and small snacks in between and my digestion appreciates it too. I have Maintained my weight, other than dropping a few pounds a few months ago which I wanted to and as an added bonus I lowered insulin too. Win win.

Winnie53 said:

@KevinPotts if you don't have an autoimmune condition or food sensitivities or intolerances to things like gluten (found in wheat, rye, and barley, perhaps oats) or casein (milk protein) for example, you likely will never cross over into the autoimmune type of diabetes, which is good. I have two, possibly three autoimmune conditions, so unfortunately, it's possible that I will cross over eventually. That said, Kristen and a few other T1.5's and T1's here reassure me that if I do cross over, I can still maintain excellent control. That gives me hope.

I read your results for the first time today. Wow Kevin, you're the man! (In the US, that's a big compliment).

Click to expand...

I really am not....I'm calling it beginners luck... but i'll take any it and bank up for the future

Thanks anyway ....much appreciated


Diagnosed 13/4/16: T2, no meds, HbA1c 53, FBG 12.6, Trigs 3.6, HDL .75, LDL 4.0, BP 169/95, 13st 8lbs, waist 34" (2012 - 17st 7lbs, w 42").

2/6/16: FBG AV 4.6, Trigs 1.5, HDL 2.0, LDL 3.0, BP 120/72, 11st 11lbs, waist 30" (2012 - 17st 7lbs, w 42").

Regime: 20g LCHF, run 1 mile daily, weekly fasting.

5/6/16: Two BP readings now 112/64 & 112/66

@38Alpha68 Following a 187 mg/dL (10.4 mmol/L) 3-hour post dinner BG Friday evening due to eating too many carbs, I decided to intensely monitor my blood glucose this weekend. It typically takes me two to three days to recover.

Here's my results from Friday, yesterday (Saturday) and today (Sunday morning):

Friday
9 am (6.2) 111 FBG

9:02 pm 187 3-hr post D
10:07 pm 173 4-hr post D/pre-bed (Friday nite)

Saturday
8:04 am 117 (6.5) FBG

8:55 am ? pre-B
9:58 am 143 (8.0) 1:03 hr post-B
10:15 am 148 (8.2) 1:20 hr post-B PEAK
10:31 am 142 (7.9) 1:36 hr post-B
10:48 am 121 (6.7) 1:53 hr post-B
11:05 am 132 (7.4) 2:10 hr post-B
11:22 am 127 (7.1) 2:27 hr post-B
11:38 am 123 (6.9) 2:43 hr post-B
11:55 am 111 (6.2) 3-hr post-B
12:12 pm 128 (7.1) 3:17 hr post-B
12:28 pm 121 (6.7) 3:33 hr post-B

12:28 pm 121 (6.7) 3:33 pre-L
1:30 pm 119 (6.6) 1:02 hr post-L
1:47 pm 114 (6.4) 1:19 hr post-L
2:04 pm 121 (6.7) 1:36 hr post-L PEAK
2:19 pm 115 (6.4) 1:51 hr post-L
2:38 pm 122 (6.8) 2:10 hr post-L/pre-walk
3:19 pm 113 (6.3) 2:51 hr post-L/post-walk (30 min)
3:36 pm 114 (6.4) 3:08 hr post-L
4:52 pm 112 (6.2) 3:24 hr post-L
5:55 pm 102 (5.7) 5:27 hr post-L
7:18 pm 98 (5.5) 6:50 hr post-L

7:18 pm 98 (5.5) 6:50 hr pre-D
8:19 pm 138 (7.7) 1:01 hr post -D PEAK
8:40 pm 133 (7.4) 1:21 hr post-D/pre-walk
9:13 pm 114 (6.4) 1:55 hr post-D/post-walk (30 min)
10:56 pm 121 (6.7) 3:38 hr post-D

10:56 pm 121 (6.7) 3:38 hr pre-bed (Saturday nite)

Sunday
9:10 am 99 FBG

9:41 am 105 (5.9) pre-B
10:44 am 136 (7.6) 1:03 hr post-B
11:00 am 138 (7.7) 1:19 hr post-B PEAK
11:17 am 134 (7.5) 1:36 hr post-B
11:33 am 128 (7.1) 1:52 hr post-B
11:49 am 116 (6.5) 2:08 hr post-B
12:04 pm 117 (6.5) 2:23 hr post-B
12:20 pm 110 (6.1) 2:39 hr post-B
12:44 pm 110 (6.1) 3:03 hr post-B
2:34 pm 95 (5.3) 4:53 hr post-B

2:34 pm 95 (5.3) 4:53 hr pre-L
3:37 pm 108 (6) 1:03 hr post-L PEAK
3:56 pm 109 (6.1) 1:22 hr post-L
4:18 pm 111 (6.2) 1:44 hr post-L
4:58 pm 111 (6.2) 2:24 hr post-L
7:04 pm 106 (5.9) 5 hr post-L
7:49 pm 95 (5.3) 5:45 hr post-L

7:49 pm 95 (5.3) 5:45 hr pre-D
8:55 pm 158 (8.8) 1:06 hr post-D PEAK
9:09 pm 141 (7.9) 1:20 hr post-D/pre-walk
9:31 pm 133 (7.4) 1:42 hr post-D/mid-walk
9:48 pm 114 (6.4) 2 hr post-D/post-walk
10:03 pm 125 (7) 2:14 hr post-D
10:51 pm 134 (7.5) 3 hr post-D
11:04 pm 124 (6.9) 3:15 hr post-D

11:04 pm 124 (6.9) 3:15 hr pre-bed (Sunday nite)

Monday
8:27 am 106 (5.9) FBG

9:10 am 97 (5.4) pre-B (This looks to me like the beginnings of a "liver dump"; I could feel the cortisol surge)
10:10 am 142 (7.9) 1 hr post-B PEAK? (Breakfast consisted of my usual, butter, slice of onion, 1/5 each of a green and red pepper, 2 mushrooms, a single layer of spinach, 1 egg, and 1 small strawberry)
12:40 pm 108 (6) 3:30 hr post-B

So far peak BG ranges from 1 hour 1 minute to 1 hour 36 minutes. My meter varies by 16 points when I take 5 readings in a row, so that may explain some of the up and down readings.

Strawberries just came into season. For a week or so, I've been having up to 3 small strawberries with each meal. It's worsened my blood glucose levels. Normally, I only have a 1/3 cup mixed berries with breakfast. I tolerate that well, though not always.

Tonight for dinner (Sunday), I had 2 oz. of chicken, steamed vegetables, 2 tablespoons of sweet potato, and 3 strawberries sliced with 1 oz heavy cream. Blood glucose levels were all over the place. The walk seemed to help. It's been 80 degrees F here for two days. It was good to walk in the evening air, but it took an hour to cool back down.

@Kristin251 I find your attention to what's happening with your body so interesting, particularly in regards to meals, snacks, and exercise now that you've crossed over into T1.5/T1 and are on insulin. Not sure what to think about the protein, but even though I'm a T2, I think I do better on less protein too (which makes the more expensive cuts of meat more affordable).

We have one Type 1 and one Type 1.5/1 in our group. The first is doing really well on LCHF-vegan, the other only recently crossed over so she's still trying to figure out how to use the LCHF-vegan diet and insulin. Our T1 member loves the LCHF-vegan diet. He's healthier and losing weight. Based on Bernstein's story and his many T1 patient testimonials (which I read yesterday), I really think LCHF works very well for most diabetics too.

Winnie, I do seem to do better on less of everything lol but I need to eat. If I eat too much protein ( or food in general) in a sitting I get very unbalanced. I love my protein but it has a very profound effect on me. I am fine with smaller portions. Now if I don't have enough fat everything goes crazy and I am ravenous. I need my avocado

I am curious as to how vegans get complete proteins without the carbs.

I realize lots of people are vegans or vegetarians because animal protein doesn't make them feel well but we all need complete proteins.

Where do they get it? Please don't say soy haha

@32Alpha68 I forgot to mention that I'm not disciplined enough to walk as much as I need to. And as soon as I get out of the habit, it's a really hard push to get started again. Thankfully, my local diabetes group walks 2 to 3 miles together every two weeks, sometimes three times a month, which gets me walking again if I've fallen behind in frequency. Another member commented last week that the group walks serve the same purpose for him. While I'm an introvert and am happiest walking alone, I'm so grateful to have the walking group.

Kristin251 said:

Winnie, I do seem to do better on less of everything lol but I need to eat. If I eat too much protein ( or food in general) in a sitting I get very unbalanced. I love my protein but it has a very profound effect on me. I am fine with smaller portions. Now if I don't have enough fat everything goes crazy and I am ravenous. I need my avocado

I am curious as to how vegans get complete proteins without the carbs.

I realize lots of people are vegans or vegetarians because animal protein doesn't make them feel well but we all need complete proteins.

Where do they get it? Please don't say soy haha

Click to expand...

This is a question that I have too. It took me a long time to learn how to do the LCHF/ketogenic diet well. I can't imagine doing it vegan. I want to learn more about this too because grains, legumes, peas, starchy root vegetables, and fruit really spike my blood glucose levels. Interestingly, some people, and I've found evidence of this in my wanderings through antidotal reports, do fine on a vegan diet or one of its many variations throughout their lifetime, but then there are others who a few years or twenty years down the road find that they don't. I think it has to do with what the ancestors in their lineage ate. That's why we respect all diets in our diabetes group, so long as it's working of course.

I can't imagine getting through the day without my half avocado. It's one of my favorite foods now.

I do like my protein but I can't seem to get my insulin there when it needs to be. I eat the same macros at every meal. Avocado is so good to me I just want to live on it haha. When did you start eating it ? I need it at all meals and even snack on it if it's big. Never too much avocado as far as I'm co concerned and since eating it my lipids have been great.

As I get older everything seems to feel better the less I do. Less food in general, less protein, less insulin, less walking

I told my daughter I needed a hobby and she suggested I reopen my interior design business. I simply said it would be too much work but thought of taking a meditation class lol. How my life has changed....

How much protein do we really need? Lots say 4-6 oz is enough for most adults. Well I am 125 pounds and my husband is 225. So how does that equate? I get size and muscle mass come in to play but if I am half his size with 1/4 his muscle mass couldn't 4 oz be too much for me and 6 not enough for him? I guess I'll keep doing what I'm doing until things change and then I will change things. As far as vegan working for years and then not, I understand that. I used to eat mostly all protein and fat and then that stopped working. Now protein messes me up. I think vegetable protein works better but as you said, from where? I can't/don't/ won't do soy so I'm out of options. Have you ever asked your vegan friend? Some people who are vegan or vegetarians don't do it right. They just don't eat animal protein but eat tons of grains and starch but they're still alive. I know I would struggle without any but the smaller the better. I also would ah e issues with digestion if all I ate was plants. Delicate balance again.

Do you find you feel 'off' when you eat protein ? Or do you just think you are better with less because your bs is better?.

@Kristin251 I feel better when I eat animal protein and fat with all meals, but smaller amounts are better for my blood glucose levels. I also eat a lot of vegetables so that may be why less protein works better for me. I need to remember where I learned how to calculate protein intake. Will post it if I can find it. This might be helpful for @32Alpha68 too.

Here's the article... http://articles.mercola.com/sites/a...7/too-much-protein-triggers-aging-cancer.aspx Read the section: "Excessive Protein Shuts Down Autophagy and Increases Cancer Risk by Stimulating mTOR". Also the last couple of minutes of Dr. Rosedale's lecture in the video included in the article includes his recommendations for protein intake.

Dr. Mercola writes "The specific formula is one gram of protein for every kilogram of lean body mass," Ron Rosedale, MD now recommends 0.75 grams or 0.6 grams of protein for every kilogram of lean body mass if diabetic.

And here's the calculators:
Lean Body Mass Calculator - (use US Units or Metric Units tabs)... http://www.calculator.net/lean-body-mass-calculator.html
Pounds to Kilograms Calculator (if in US)... https://www.google.com/?gws_rd=ssl#q=pounds+to+kilo+grams

To calculate grams of protein intake per day: 1) use link to calculator to determine your lean body mass; 2) if in US, use link to calculator to convert lean body mass from pounds to kilograms; 3) multiply [your lean body mass in kilograms] x 1 gram or 0.75 grams or 0.6 grams.

Examples:
If your lean body mass is 100 pounds and 100 pounds equals 45 kilograms, then...
45 kilograms lean body mass x 1 gram = 45 grams* protein intake per day
45 kilograms lean body mass x 0.75 gram = 33.75 grams* protein intake per day
45 kilograms lean body mass x 0.6 gram = 27 grams* protein intake per day

*He's referring to grams of protein, not how much the food weighs.

In the "Protein Sources" section of Dr. Mercola's article he provides numerous examples of how many grams of protein are in various For example, red meat, pork, poultry, and seafood average 6 to 9 grams of protein per ounce and an egg has 6 to 8 grams of protein. So if I eat an egg for breakfast, 2 ounces of chicken for lunch and another 3 ounces chicken for dinner, that would be 7 g + 7.5g(2) + 7.5g(3) = 44.5 g protein.

For more information, read Dr. Mercola's article and listen to Dr. Rosedale's lecture here... http://articles.mercola.com/sites/a...7/too-much-protein-triggers-aging-cancer.aspx

Kristin, This is way off topic but I participated in a women's art journaling group for many years. I love layering colors and textures, also paper engineering - (making pockets with card inserts, small booklets, etc.) - so it was a good creative outlet for me... http://artjournaling.ning.com/ As you pointed out, interior designers lead busy lives, but we did have a few members who did design work. PM me if you want to talk more about this.

I have done all the calculators and settled best on 30-40 g and it seems to suit me but seems so small. I do love my veggies but they can spike me too very easily. I feel best when bs is steady and I can eat or give up ant foods to achieve that. But very day is different. Depends on which way the wind blows. Sometimes just get tired of trying to figure it out and IT running my life. Then throw in digestion. For someone who loves all food it really messes with me

I will find a hobby at some point. I am creative and have 'an eye' for things. I should get back into reading novel. They are very relaxing and takes the mind off this junk. I started a great book on our trip to Arizona but it's stil sitting there. We have a beautiful patio with lots of flower pots. I think I'll go out there for BF IF the weather is good.

I took a stro

Matter each meal today. Felt good.