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Low Carbing and Physiological Insulin Resistance

Discussion in 'Diabetes Medication and Drugs' started by AndBreathe, Jan 12, 2017.

  1. Indy51

    Indy51 Type 2 · Expert

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    As an aside, I think there is confusion between PIR and the general glucose intolerance that develops from being consistently low carb. Not a problem if you intend to stay low carb and don't have to take an OGTT. This is advice from Dr Michael Eades on how to prepare for an OGTT if you are following a low carb diet and the reasons why:

    "Following a low-carb diet makes one a little glucose intolerant, which is the reason that the instructions for a glucose tolerance test always include the admonition to eat plenty of carbs in the week before the test. Why? Because all the macronutrients–glucose, fat and protein–are broken down by enzymes during the metabolic process. And all the enzymes necessary for the metabolism of the various macronutrients are made on demand but not immediately.

    If you are on a high carbohydrate diet, then you will have plenty of enzymes on hand to deal with the carbohydrates you consume. If you switch to a low-carbohydrate diet, it takes a while to manufacture the enzymes in the quantities needed to deal with the extra fat and protein that your metabolic system hadn't been exposed to. This deficiency of protein/fat metabolizing enzymes is the reason people starting a low-carb diet become so easily fatigued–they've got plenty of enzymes on hand to break down carbs, they just don't have the carbs to metabolize. Once they produce the enzymes necessary to deal with the load of protein and fat, which takes a few days, they become low-carb adapted and no longer feel fatigued.

    Once people become low-carb adapted then the same thing happens if they go face down in the donuts. They don't have the enzymes on board to deal with the sudden influx of glucose, and, as a consequence, their blood sugar spikes higher than it would on a person eating the same amount of carbohydrate who is already carb adapted."
     
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  2. Kristin251

    Kristin251 LADA · Expert

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    My question, and not at all judging, is those that eat moderate carbs, say 80-130 a day ( extremely high for me) , how many units of basal and bolus are you taking?? And though your A1c' s may be in normal ranges, what are the variances of bs between high school and lows?? Completely just looking to educate myself.
     
  3. tim2000s

    tim2000s Type 1 · Expert
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    That's not really all that relevant to PIR though @Kristin251 as individual insulin amounts vary according to factors other than food, including body type, exercise undertaken, etc. I think that would be better as a new topic than in this thread, as it would be a bit of a derailer.
     
  4. CathP

    CathP Type 1 · Well-Known Member

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    All very interesting thanks. I wondered what these claims of low carb-induced PIR were all about. It's not something I've noticed in my daughter. Fortunately we only 'moderate carbed' for a month or so before finding low carb, but have noticed a very significant drop in her insulin needs (and reduction in glycemic variability, which is the aim obviously).
     
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  5. tim2000s

    tim2000s Type 1 · Expert
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    As I've mentioned, Low Carb PIR isn't something I've experienced either, although I caveat that with the point that I am also active and resistance train, which may be a mitigating factor. In fact going low carb, training and reducing my body fat saw my insulin sensitivity increase rather than decrease.
     
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  6. Jamesuk9

    Jamesuk9 Prediabetes · Well-Known Member

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    I suffer from this, if I eat low carb my fasting levels increase by at least 1.0, same if I refrain from eating at all. If I eat moderate carbs my fasting levels go lower and so does my low before it rises.

    It baffles me and I just don't know how to correct it.
     
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  7. Indy51

    Indy51 Type 2 · Expert

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    It's a perfectly normal and benign physiological state, so there's no need to correct it.
     
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  8. Jamesuk9

    Jamesuk9 Prediabetes · Well-Known Member

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    Wow, OK. It's been driving me mad and turning me away from LCHF. Thanks.
     
  9. Indy51

    Indy51 Type 2 · Expert

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    The links posted earlier in this thread by @Brunneria have lots of good information about it.
     
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  10. xyzzy

    xyzzy Other · Well-Known Member

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    What an interesting thread! I'd think so long as your levels remain in safety it's not anything to worry about. I was always told your insulin response for a meal is based on the recent history of carb intake thus if you suddenly up carbs you'll get a few days of higher readings until your response adjusts. Obviously being able to have an insulin response for the amount of carbs you eat is the limiting factor as is the level of standard IR that stops the insulin response from working.

    My personal experience is my fasting level is always my highest irrespective of average daily carbs. Until my recent relapse I based my carb intake for 4 years solely on the odd fasting test and just adjusted carbs if it started to appear to rise. I then used regular hba1c's as confirmation it was a valid approach for long term monitoring.
     
    #30 xyzzy, Jan 14, 2017 at 8:39 AM
    Last edited: Jan 14, 2017
  11. hooha

    hooha Type 2 · Well-Known Member

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    Hello @Brunneria I am glad I found this post. I should have found it 2 + years ago. Having reversed my type 2 db in Dec. 2016 with the Newcastle Prof Taylor diet and later with LCHF, I became depressed at my later tests, with higher than expected Fasting Blood Sugars. Recent low HbA1c 's however have restored my mood and researching this curious phenomenon of Physiological Insulin Resistance , I came across this post. I have also looked at the Dr Kraft insulin curves and noted that the low insulin response of Type 1 diabetics can be mimicked by people on low carb / keto diets. I have not found a clear explanation of whether this insulin resistance is happening mainly at the muscle mitochondria , or if it is mainly the pancreas going to sleep , producing less insulin . The flat insulin curve of Kraft type 5 suggests it is a lack of insulin response at least in part. . Why is there no response to the oral glucose taken in ? Does the pancreas really ' go to sleep? I wonder if you know a recent reference which addresses these questions in simple English ? Thanks.
     
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