Nafld and insulin resistance

Hi @Emmy816.

I just did a google, and see it's the ol American mg/dL or miligrams per deciliter trig reading measurement, and yeah, you have a three digit number reading rather than a fraction for mmol/L. And yeah - as you say - 600+ is pretty high!

But yeah - a fasting trig reading is an important one for tracking your health, vis a vis the really big one - cardio vascular health. I take tracking mine really seriously, much to the amusement of my current medical practice, but yes - I diligently get a fasting blood lipid test, and work out and note down my trig/HDL ratio. So that's what made me interested in your post.

I've also had my blood glucose regulation wiped out a couple of big times with one of the contributing factors being severe Vitamin D deficiency ( for me - of sunlight!). I had skin tags for years too, dealing with insulin resistance off and on over the decades also. Also gallstones, but I chose to live with my gallbladder (on discussion with an amazing gallbladder surgeon) and the one big stone I had in there, which must have decreased significantly over the years as a LCHF and Keto eater.

Your HBAIc is poster-person normal. This is very good news! If you are starting to get insulin resistant, you are in a brilliant position to do something about it. And your doc has said that the way to that is by diet.

What I am going to posit may be different to what they say? But you are on a diabetes forum, so, many of us advocate lowering carbs as a way to good or at least better blood glucose and insulin performance health and get your liver nice and healthy. (Too many carbs being about too much excess energy for your body to store in healthier places than your liver, to cut a long story short.)

Also, to not be afraid of plenty of healthy fats, which is not ultra processed vege oils, but the naturally occuring fats humans had been eating for as long as we had been human and then some.

Keep tracking your trigs on a lower carb healthy fats way of eating, and see what happens. I took this challenge in the months after being diagnosed with type two nearly a decade ago now, and my trigs and HDL have been 'lovely' ever since. But you need to find out if that way of eating works for you.

I am a high-LDL-cholesterol person with type two (fats in the blood can be mucked up with type two, and that happens to me) so I won't go there, but there are plenty of folks in this forum that can talk about their blood lipid panels with more glowing health (unmedicated of course) than I can! Because my trigs are good and my HDL is good (and I am relatively fit and active) the medical folk do not hassle me with the offer of statins. There are fabulous online Cardio-Vascular Disease risk factor tests/quizes you can do, which ones medical profs also do for you if they are concerned, in their heads one supposes? And having good trigs and HDL counters a high LDL. There are also weight factors included in those risk factor quizes, and of course - blood glucose regulation.

The wonderful thing for you is livers are marvellously self-repairing. You can get the cells in your liver operating better much easier, is my reckoninig, without diabetes than you would with it.

Cut out fructose including in table sugar (which is half glucose and half fructose), and reduce or cut out alcohol. Both fructose and alcohol cause a fatty liver.
Search Robert Lustig - sugar the bitter truth on Youtube ...

jonathan183 said:

Cut out fructose including in table sugar (which is half glucose and half fructose), and reduce or cut out alcohol. Both fructose and alcohol cause a fatty liver.
Search Robert Lustig - sugar the bitter truth on Youtube ...

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Agree, and also avoid any food products with HFCS ( corn syrup) or emuslified starches.

Emmy816 said:

Hi,

I wondered if anyone might shed some light.

I have nafld (fatty liver) and have had for two years. I had a rescan recently and it’s still there but the doctor gave little advice and just said eat healthy. I have had a gallbladder removal too.

I have vitamin d issues - I was severe deficiency and had treatment for it. I take a regular supplement but it’s now gone to insufficient again even though I am taking a supplement every day.

I am suspicious I have insulin resistance. Historically I’ve had random high triglycerides 600+ which the doctors thought they had solved by changing my pill. I haven’t been tested in ages.

My current symptoms:

Chronic fatigue especially 2-4pm daily
Appearance of skin tags
Frequently hungry after a meal
Frequent infections

However my hba1c level was 32. It has been suggested to me by a friend to use a cgm to see what’s happening.

Any help

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I got my NAFLD diagnosis before the T2, and the thing that helped with T2, took care of the NAFLD as well. So while your HbA1c is absolutely beautiful, you can still hit a low carb way of eating to get your liver back in order. My mom doesn't have diabetes, but her liver was a mess (and sadly is again, as she can't stick with a low carb diet due to other issues), but for a while there she did fix it by going low carb. So here's another vote for giving that a go. Check the link in my signature for a quick how-to, or go to dietdoctor.com for meal ideas. (It's a paid site, but you can get lots of info on there for free!).

JoKalsbeek said:

My mom doesn't have diabetes, but her liver was a mess (and sadly is again, as she can't stick with a low carb diet due to other issues), but for a while there she did fix it by going low carb.

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Avoiding fructose and alcohol may be enough to prevent reoccurance of a fatty liver ...

jonathan183 said:

Avoiding fructose and alcohol may be enough to prevent reoccurance of a fatty liver ...

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I know... But she doesn't drink (even if she wanted to, she can't with the medication she's on), and she's not big on fruit, so... Nothing to cut out there, I'm afraid.

Emmy816 said:

Hi,

Thanks for all of the replies.

I don’t drink and haven’t for three years. My diet is pretty good with a few treats here and there.

I invested in a cgm this week.

I am having low blood sugars in the night intermittently it got down to 2.9 the other night. On the libre graph my blood sugar is all over the place up and down all day. Highest is 11 in the day after lunch always and then within 2 hours in an afternoon I’m down to 4mmol and having symptoms of dizziness, extreme fatigue etc which is rectified with a sugary snack. This happens most days needless of what I eat for lunch!

Things that seem to have had an impact: exercising before bed flattened the graph all night was 6mmol. Eating a high protein dinner again did this too.

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Diet being pretty good very much depends on what advice you are following. Mainstream advice to avid fats and base meals around starchy carbs has a terrible effect on metabolic syndrome. NAFLD, high trigs, high bp and type 2 are all metabolic diseases. Conversely low carb helps them all.

Libre is notorious for something called compression lows. That’s when you lie on it and it thinks you are low as a result. If you have a meter and wake when it’s happening check with a finger prick.

11 is pretty high but not unheard of after a carb heavy meal even for non diabetics. A drop down to 4 within 2hrs is a rapid change and that alone can cause all the symptoms you list. It’s called a false hypo. Sugar brings the level back up to what your body expects it to be at that point in time and you feel better. what is lunch? Is there a common ingredient such as bread, wraps, pastry? All would give a similar carb load.

There’s nothing wrong with being at 4mmol as an unmedicated non diabetic. There are some uncommon conditions that cause hypos that are not diabetes. One you might see in here is called reactive hypoglycaemia which in a nutshell is an overshoot of insulin usually in response to carbs. So high carbs is followed by lows causing big swings in levels. Hba1c looks normal but the graph is anything but Stable.

Hi, I have RH.
I have looked at your graphs and other than the one overnight hypo, your records are not typical RH.
RH is food orientated, carb intolerance, too much insulin, weak hormonal insulin response.

Your graph shows too many spikes. I would say that the low was a blip or a compression reading. We always recommend a finger prick test, if you get a rogue reading.

Lowering your carb intake would be a very good idea anyway.

Emmy816 said:

I haven’t just had one overnight low - apologies that was just a sample from this week across a day and night. I’ve had three lows this week overnight - one I woke up sweating and did something about it!

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Sorry, if I gave that impression.
there must be a reason why you get the lows just overnight! Mainly because any hypoglycaemia is usually to do with dietary or medication, and with RH, overnight hypos are rare, because of timing factors. Most hypos with undiagnosed RH, tend to happen late morning, afternoon and evenings. Because of meal times.

When I get woke up in the night it is because of vivid dreams, the ones that have you sweating etc. I am convinced that it is the sudden highs or lows that are responsible for It. So if you are eating carbs before bed, it could be the reason for the dreams. I personally don't eat after seven in the evening for that reason.
From what I have read, almost everyone has had a sudden sugar crash for whatever reason. Which mostly occur afternoons and evenings as the glucose is kept high all day until excess insulin actually has an effect.

If you keep getting hypos there is a reason for it and it might not be diabetes. Testing and cgm is so important. And finger prick test to go along with the cgm, is necessary.

Best wishes