Physiological Insulin Resistance

chri5 said:

Hi, I have been doing a little reading on this subject but I`m still not sure if I have a handle on it or not and would like a little advice please. My understanding is as follows: A lot of t2`s have Pathological insulin resistance so that when we produce glucose
our pancreas has to produce insulin but we don`t use it very well which means more insulin which causes weight gain and so on...
A low carb diet produces less glucose which calls for less insulin which has to be a good thing presumably. However, carb restriction can also cause Physiological insulin resistance which, if I understand correctly, saves the smaller amount of glucose which is produced for the brain by making the muscles insulin resistant which leads to higher bg readings. Is my understanding anywhere close to correct and will these higher bg levels lead to a higher HBA1C ? Thank you for reading and please reply with your opinions. Chris.

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That is about right, but it only happens in the absence of carbs (ie someone on very low carb diets.) It shouldn't happen otherwise. It is quite different from ordinary diabetic insulin resistance. I've also done a lot of reading on it because it happened to me once. It is only temporary, and can be stopped by eating just a few more carbs for a few days. I did that, and it hasn't come back ... yet!

I have eaten less than 20g of carbs for about 12 months and probably less than 40g of carbs daily for another 12 months before that and have never experienced it.

chri5 said:

Thanks for your reply, I read an article that gave a bulletpoint list of indicators of being in nutritional ketosis and I replied yes to all 8 of them but my bg levels are still high.

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The only way to really tell if you are in nutritional ketosis is to measure blood ketones.

chri5 said:

Hmm, maybe not everyone does, I really don`t understand it that well hence the post.

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To be honest me neither. ..

When we eat, our body tries to predict how much insulin will be needed and the pancreas starts to produce insulin before the meal has been digested. This prediction is based on the effect that recent meals have had on BG. Muscles also get better at using fat (and hence worse at using BG) if they are not allowed any BG for some time.

I think it mainly affects FBG and possibly pre-lunch if you have a zero carb breakfast. By afternoon there is more glucose available because of lunch, and similarly in the evenings. Logically, I can only see it happening if we don't experience significant Dawn Phenomenon, otherwise there would be sufficient glucose available for the brain.

In my case, this is what happened, and it was sudden:

FBG increased
Breakfast - only carbs were dash of milk in tea
Morning levels - increased
Pre-lunch - increased
Post lunch increased but the actual rise was normal
Pre-evening meal - normal
Post evening meal - normal
Bedtime -normal
Overnight rise - increased

So it seems to me that as our glucose/insulin lower overnight, our bodies start the PIR thing for our brains.
If we don't eat carbs for breakfast, glucose/insulin levels stay low so the PIR thing continues
We eat some carbs for lunch, glucose levels rise and the PIR stops
It only starts again overnight.

It never affected my actual rises from before to after eating. I took some advice after it had lasted a few weeks to increase my carbs by a small amount, and within a couple of days I was fully back to normal.

ringi said:

When we eat, our body tries to predict how much insulin will be needed

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How does it do that? Surely the feedback is from the glucose in the bloodstream.

ringi said:

When we eat, our body tries to predict how much insulin will be needed and the pancreas starts to produce insulin before the meal has been digested. This prediction is based on the effect that recent meals have had on BG. Muscles also get better at using fat (and hence worse at using BG) if they are not allowed any BG for some time.

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I believe you are confusing Physiological Insulin Resistance (PIR) with the last meal effect. They are not the same thing.

Excess protein in the ABSENSE of carbs will surely raise my fasting. And all day. I truley believe it all revolves around carbs. NOT the type of diabetes. If you eat carbs you won't gluconeogenisis. If you don't, you will. So low carb people also need to watch protein. IMO!!!!

Kristin251 said:

Excess protein in the ABSENSE of carbs will surely raise my fasting. And all day. I truley believe it all revolves around carbs. NOT the type of diabetes. If you eat carbs you won't gluconeogenisis. If you don't, you will. So low carb people also need to watch protein. IMO!!!!

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I can eat as much protein as I feel like without my BG going out of control as my body can cope with the glocuse that the slow process of gluconeogenisis create. But lot of people needs to limit protain intake as their bodies are not as forgiving..

High fasting BG can be due to what someone had for dinner the day before, but it is often due to a fat filled liver. Once carbs are low, reducing protains (as well as the direct effect the next day) leads to the liver having to use some of the fat from the liver to make glocuse, as there is not enough protain for gluconeogenisis.