Low carb & insulin sensitivity / carb tolerance

[finsit]

This is a very recent and interesting study on how low-carb affects your insulin secretion, sensitivity and affects your carbohydrate tolerance. Thought would be helpful to understand for those who are on low-carb. Also points out how a high-carb or OGTT test will affect in even non-diabetics who are on low-carb.

https://academic.oup.com/jes/article/5/5/bvab049/6199842

 

[BravoKilo]

Interesting

 

[MrsA2]

Think I understood some of it! Looking forward to reading others comments

 

[Ronancastled]

I've really noticed it through my remission.
If I'm bold for a number of days I start seeing lower numbers & especially much lower 1 hour spikes.

 

[finsit]

I am doing my CGM experiments this week so had this Sparkle chocolate cake from Costa today with some milk coffee so overall about 65 grams of carbs load. Never had sugar since months. My a1c is early 30s since 9 months and I try to remain below 6.7 in my peaks. This is just to give you a background of this test. So upon eating this pure sugar load that was at 2 pm, here were my sugar readings:

2:00 - 5.5 mmol
3:00 - 12 mmol
3:30 - 14.5 mmol
4:00 - 13 mmol
5: 00 - 9 mmol (I had my usual dinner here meat and veggies, salad)
6: 00 - 6.5 mmol
7:00 - 5 mmol

I didn't feel anything though. But i guess my pancreas was taken by a surprise! and once insulin was release, it didn't cause any spike at my dinner which usually takes me about 2 mmol higher.

I could try this in a row three days or add 150 gm of carbs and i am positive, 4th day the same cake will have a different response, but i don't think its worth disturbing my metabolic syndrome, particularly that i don't crave for carby foods any more.

go figure!

 

[DEBBIESCOTT]

I’ve read through the article, quite interesting.
I had an ogtt when I was pregnant (sugar in urine) this is how I was diagnosed with gestational diabetes, at the time I was still suffering from morning sickness which lasted all day every day, this was at 5.5 months & you couldn’t even tell I was pregnant, really don’t think I would have eaten 150g carbs the day before & even if I had it was disposed off very quickly

 

[EllieM]

Interesting article.

So, you need to take >150g a day to get an accurate OGTT?

My husband (2 T2 parents) eats fairly low carb to keep me company (T1 with some insulin resistance). He only gets to 150g if he binges on something bad (which happens but not that often).

There must be plenty of on diabetic people out there for whom an OGTT would not be relevant.

 

[Outlier]

That was very interesting - thank you for the link.

I wonder if any medic has paused to consider how risky the fasting glucose test is for older and vulnerable people? I know a lady in her eighties who was supposed to fast, then had to walk a mile (she doesn't drive) to the clinic for testing, then of course had to walk home. No consideration was ever given about her welfare and the very real danger of her fainting.

Luckily her surgery doesn't do the fasting glucose test any more, only nobody thought to tell her so she has only just found out through another patient mentioning it to her.

 

[Ronancastled]

This is just to give you a background of this test. So upon eating this pure sugar load that was at 2 pm, here were my sugar readings:

2:00 - 5.5 mmol
3:00 - 12 mmol
3:30 - 14.5 mmol
4:00 - 13 mmol
5: 00 - 9 mmol (I had my usual dinner here meat and veggies, salad)
6: 00 - 6.5 mmol
7:00 - 5 mmol

I did something similar post remission.
I used a bowl of Shreddies as my carb load.
I hit 13.3 @ the 1 hour but started to come down after that.

So I repeated the test 5 moths later & only hit 6.2 @ the 1 hour mark.
I graphed the 2 responses to keep a record, see below.
2 things had happened in the intervening period, I'd lost a bit more weight & I'd slowly reintroduced carbs as my meter let me.

Daughter cooked scones the other night, couldn't say no as I loaded one up with butter but then the carb craving hit & I woofed down 3 Jaffa cakes.
Braved the meter @ 1 hour & read a 5.3

Somethings turned back on in my pancreas & I do reckon the reintroduction of carbs has had a part to play.
Not saying it would work for everyone but there is something in the physiological insulin resistance debate.

 

[finsit]

I did something similar post remission.
I used a bowl of Shreddies as my carb load.
I hit 13.3 @ the 1 hour but started to come down after that.

So I repeated the test 5 moths later & only hit 6.2 @ the 1 hour mark.
I graphed the 2 responses to keep a record, see below.
2 things had happened in the intervening period, I'd lost a bit more weight & I'd slowly reintroduced carbs as my meter let me.

Daughter cooked scones the other night, couldn't say no as I loaded one up with butter but then the carb craving hit & I woofed down 3 Jaffa cakes.
Braved the meter @ 1 hour & read a 5.3

Somethings turned back on in my pancreas & I do reckon the reintroduction of carbs has had a part to play.
Not saying it would work for everyone but there is something in the physiological insulin resistance debate.

Thank you for sharing, very interesting. I guess its personal and how much damage you already done to your beta cells, your genetic makeup, ethnicity, and type of fat you store (visceral vs subcutaneous) or the size of fat cells vs number of fat cells. I see you caught the disease at fairly early stage, that could be one of the reasons. I caught it not too late because i am in pretty normal range unless i eat over 20 gm of carbs in a meal. The carb reintroduction has definitely a role in keeping your carb sensitivity low. I have not yet introduced carbs back. HOWEVER, my main concern is less what the BG reading is postprandial and more what happens in the body to keep that BG in check, the insulin surge. So, even if i can manage a very good level of BG after eating a bowel of rice, I am going to avoid it by a barge-pole. The reason of these CGM experiments is mainly to see the curves to understand my own physiology.

 

[Mr_Pot]

my main concern is less what the BG reading is postprandial and more what happens in the body to keep that BG in check, the insulin surge.

Of course a surge of Insulin is exactly what non-diabetics use to regulate their BG.

 

[HSSS]

Last year I considered paying for an extended OGTT with both glucose and insulin readings with the view to assessing my insulin resistance. ( from memory it might have been labelled the Kraft protocol but maybe I’m mixing stuff up here) Unfortunately finances prevented me doing so but that protocol had until that point involved a 3 day carb up to avoid the adaptive glucose sparing suggested in this report. They had just increased that to a week as there was some suggestion 3 days wasn’t enough. I can’t find the reasoning behind this right now but maybe this rings some bells for others.

We really need some decent studies on long term benefits and any problems (ie pathological not physiological adaptation) from this way of managing type 2.

 

[Ronancastled]

THOWEVER, my main concern is less what the BG reading is postprandial and more what happens in the body to keep that BG in check, the insulin surge.

Your approach seems wonderfully thought out & analytical.
I remember coming across the work of Dr. Longo early on my journey, he seemed to claim beta cell regeneration through autophagy brought on by a fast mimicking diet.
It was an avenue I was willing to explore if my quest for normal BG wasn't successful.
I'm still to find anyone online who employed the technique & achieved results.

 

[MrsA2]

Daughter cooked scones the other night, couldn't say no as I loaded one up with butter but then the carb craving hit & I woofed down 3 Jaffa cakes.
Braved the meter @ 1 hour & read a 5.3

And what was the reading after 2 and 3 hours?

 

[Ronancastled]

And what was the reading after 2 and 3 hours?

I never bother with a 2 hour if my 1 hour is normal, I learned from my CGM trial that I'd be wasting strips once I didn't spike.
The few times I'd eat something very carby I go low on the 2nd hour, not reactive hypo territory but low 4s.
For me to see a 6+ @ 2 hours I'd have to eat a fat/protein/carb large meal like a fish supper or a Chinese.
But then I've seen plenty of CGMs of non-diabetics where the pizza affect goes on for hours after a similar meal.

Anyway, I've been stuck on a BMI of 31 for over a year now so avoid that sort of indulgence, perhaps once a month.

 

[finsit]

I consider myself perfectly fine with the food i eat, i enjoy it and it keeps my bgs in check with an a1c of low 30's. I really not fanaticising eating grains or sugars or fructose even if it doesn't spike me. I am more interested in reducing inflammation affect of low-carb diet, which is now being proved as the main reason for arteriosclerosis instead of cholesterol. The CGM trial is just to understand my peaks.

 

[StewM]

I consider myself perfectly fine with the food i eat, i enjoy it and it keeps my bgs in check with an a1c of low 30's. I really not fanaticising eating grains or sugars or fructose even if it doesn't spike me. I am more interested in reducing inflammation affect of low-carb diet, which is now being proved as the main reason for arteriosclerosis instead of cholesterol. The CGM trial is just to understand my peaks.

"Inflammation affect"? I haven't read anything about this. What's the link?

 

[finsit]

"Inflammation affect"? I haven't read anything about this. What's the link?

The Truth About Heart Disease & Cholesterol — Dwight Lundell

the famous cardiologist who went low carb

 

[StewM]

The Truth About Heart Disease & Cholesterol — Dwight Lundell

the famous cardiologist who went low carb

Don't want to drag this off-topic, so all I'll suggest is that there seem to be reasons to be sceptical of Lundell's claims and there are studies that show that Low-Carb can actually improve inflammation.

 

[JohnEGreen]

"Metabolic syndrome is a precursor to diabetes, coronary heart disease, and other serious illnesses. Patients have long been advised to eat a low-fat diet even though carbohydrate restriction has been found to be more effective at reducing specific markers, such as high triglycerides. A new study indicates that a diet low in carbohydrates is also more effective than a diet low in fat in reducing saturated fatty acids in the blood and reducing markers of inflammation."

https://www.sciencedaily.com/releases/2007/12/071203091236.htm