Problem only with Fasting blood sugar

[cmatanie]

Hi,
I am diagnosed with type 2 diabetes since December 2012, I am 67 years old, male and my main issue is FBS.
I am following for more than 2 years a low carb/keto diet and intermittent fasting (16:8), I improved my fatty liver condition and my Hb A1c ( from 6.7 to 6.0 but last six month it raised to 6.3). I always had normal postprandial blood sugar but, last few months, my FBS is on a plateau 144-146 mg/dl (8.0-8.1 mmol/L). It used to be last two years around 135 mg/dl (in October 2021 even better:125-128 mg/dl).
Yesterday I made a test: I ate at 6 p.m. an apple and 100 grams of of sweet biscuits. I tested at 8 p.m. my blood sugar and it was 128 mg/dl (normal range up to 140 mg/dl); so, very good. I mention that some time ago I checked also my BS during the night in order to see if dawn phenomenon is the culprit; but it wasn't.
I DON'T KNOW ANYMORE WHAT TO DO TO FIX MY FBS !
I thought even to quit low carb/keto diet. I really don't know what to do !
I would appreciate any advise (maybe from other people with similar issue).
Thank you and I wish you all the best !

 

[Member496333]

Are you eating huge amounts of protein? That can cause elevated fasting glucose problems for some.

 

[cmatanie]

Are you eating huge amounts of protein? That can cause elevated fasting glucose problems for some.

Not at all. I am eating about 100 g protein per day. That means about 1g/kilo weight. I know about gluconeogenesis.

 

[Member496333]

Approximately how many grams of carbohydrate per day?

 

[cmatanie]

Approximately how many grams of carbohydrate per day?

Around 20-50 grams per day. All carbohydrates come from vegetables (I need fiber). I don't eat any sugar, bread, rice, potato, pasta, cereals ... at all. Some day I eat 25-50 grams of berries, but not often.

 

[Hertfordshiremum]

Hi,
I am diagnosed with type 2 diabetes since December 2012, I am 67 years old, male and my main issue is FBS.
I am following for more than 2 years a low carb/keto diet and intermittent fasting (16:8), I improved my fatty liver condition and my Hb A1c ( from 6.7 to 6.0 but last six month it raised to 6.3). I always had normal postprandial blood sugar but, last few months, my FBS is on a plateau 144-146 mg/dl (8.0-8.1 mmol/L). It used to be last two years around 135 mg/dl (in October 2021 even better:125-128 mg/dl).
Yesterday I made a test: I ate at 6 p.m. an apple and 100 grams of of sweet biscuits. I tested at 8 p.m. my blood sugar and it was 128 mg/dl (normal range up to 140 mg/dl); so, very good. I mention that some time ago I checked also my BS during the night in order to see if dawn phenomenon is the culprit; but it wasn't.
I DON'T KNOW ANYMORE WHAT TO DO TO FIX MY FBS !
I thought even to quit low carb/keto diet. I really don't know what to do !
I would appreciate any advise (maybe from other people with similar issue).
Thank you and I wish you all the best !

How about sending for the free Libre trial? Then for 2 weeks you will know exactly what’s going on. FYI as soon as I get up my BG rises by about 3 mmol I am type 1 though so I understand it is different, having a Libre is extremely useful.

 

[Member496333]

Around 20-50 grams per day. All carbohydrates come from vegetables (I need fiber). I don't eat any sugar, bread, rice, potato, pasta, cereals ... at all. Some day I eat 25-50 grams of berries, but not often.

Do you use a blood ketone meter to verify actual dietary ketosis? 50g is borderline and may be too much to keep you firmly in ketosis. It’s a spectrum of course rather than a hard cut-off but it’s possible your body could be manufacturing glucose as a preference to ketone bodies.

 

[cmatanie]

How about sending for the free Libre trial? Then for 2 weeks you will know exactly what’s going on. FYI as soon as I get up my BG rises by about 3 mmol I am type 1 though so I understand it is different, having a Libre is extremely useful.

It's first time I hear about it !!! I don't know if it is available for Romania. I will look for more information. Thank you !

 

[cmatanie]

Do you use a blood ketone meter to verify actual dietary ketosis? 50g is borderline and may be too much to keep you firmly in ketosis. It’s a spectrum of course rather than a hard cut-off but it’s possible your body could be manufacturing glucose as a preference to ketone bodies.

No. I am using at home urine stripes and the result was mild ketosis. On 10-th January this year I tested my urine in a Lab and the result was 15 mg/dl (normal range is < 5). My daily goal for carbohydrate is 20 grams, but it depends on how much and what vegetables I eat.

 

[Member496333]

Interesting. In your shoes I think I would try to reduce protein down to maybe 80g and see if that has any effect. I know 100g isn’t excessive but I used to have problems with that amount when I first set out on keto carnivore. Failing that, you should probably have some tests done to measure your ability to make insulin.

 

[cmatanie]

Interesting. In your shoes I think I would try to reduce protein down to maybe 80g and see if that has any effect. I know 100g isn’t excessive but I used to have problems with that amount when I first set out on keto carnivore. Failing that, you should probably have some tests done to measure your ability to make insulin.

Protein quantity is very important. When calculating macros, the key point is protein: too much leads to gluconeogenesis, too less could affect muscles. It's like going on the edge. I have to take into consideration my age, too. We are all individuals. It seems I am more "particular". My doctor told me not to be concerned about this problem. But doctors in Romania are very reticent regarding keto diet and diabetes remission. Their strategy is to keep you on medication and, finally, to go on insulin.
So, regarding keto (LCHF) diet, intermittent fasting, ketosis... I AM ON MY OWN !!!
All help/support I can (hope) get is from people like you.
God bless you !

 

[Member496333]

Yep. Agree protein is vitally important, and too little is worse than too much. My idea to reduce it slightly is only as a test. If it helps reduce fasting glucose then you were probably consuming more than your body needs for maintenance and repair, regardless of the actual numbers. This effect is very individual and seems to mostly affect those who are very lean and with very little body fat to draw upon.

In any case, if this becomes an increasingly obvious problem for you then you should definitely consider having your insulin tested. Unfortunately your situation in Romania is not unlike the UK. Trying to get a doctor to order insulin testing is often like trying to get blood out of a stone. Many of us here on these forums pay for private testing.

 

[Pasha]

How much fat are you eating ? Have you investigated BG values at the upper and lower extremes of fat intake. I mention this because of personal experience. I felt cornered at one stage and juggling the amount of fat is all that was left as a possibility. So I would suggest you also give it a go and see what happens.You may be surprised.

 

[cmatanie]

How much fat are you eating ? Have you investigated BG values at the upper and lower extremes of fat intake. I mention this because of personal experience. I felt cornered at one stage and juggling the amount of fat is all that was left as a possibility. So I would suggest you also give it a go and see what happens.You may be surprised.

I use Myfitnesspal.app for records and my daily nutrition goals (in this app) are:
- calories 1736
- carbohydrates 5% (22 g)
- fat 70 % (135 g)
- protein 25 % (109 g)
I recognize I never thought to juggle with the fat. So, one day I will reduce the amount of fat (let's say 50 g) and I will see next morning what my FBS is and, another day, I will raise at 200 g the amount of fat and check the FBS next morning.
I will give it a try.
Thank you for your advise !

 

[cmatanie]

Yep. Agree protein is vitally important, and too little is worse than too much. My idea to reduce it slightly is only as a test. If it helps reduce fasting glucose then you were probably consuming more than your body needs for maintenance and repair, regardless of the actual numbers. This effect is very individual and seems to mostly affect those who are very lean and with very little body fat to draw upon.

In any case, if this becomes an increasingly obvious problem for you then you should definitely consider having your insulin tested. Unfortunately your situation in Romania is not unlike the UK. Trying to get a doctor to order insulin testing is often like trying to get blood out of a stone. Many of us here on these forums pay for private testing.

I have to recognize I am not at all a "very lean and with very little body fat" (190 cm high and 105.5 kilos, BMI 29.2)
I do every year HOMA IR test (on my money) to check my insulin level and HOMA IR (insulin resistance ) and, after keto diet and, especially, intermittent fasting they are both now much better. Insulin from 19.8 to 8.4 micro U/mL and HOMA IR from 5.9 to 2.5.
I am very, very concerned about protein. I can reduce protein intake and, as a result, I can have a better FBS (let's suppose ). But how could I know if this would affect my muscle. At my age, I must pay much attention because I am not getting younger and my muscles are no more regenerating.
I have to preserve what I have and not to risk to lose it.
THIS IS LIFE !

 

[Member496333]

I have to recognize I am not at all a "very lean and with very little body fat" (190 cm high and 105.5 kilos, BMI 29.2)
I do every year HOMA IR test (on my money) to check my insulin level and HOMA IR (insulin resistance ) and, after keto diet and, especially, intermittent fasting they are both now much better. Insulin from 19.8 to 8.4 micro U/mL and HOMA IR from 5.9 to 2.5.
I am very, very concerned about protein. I can reduce protein intake and, as a result, I can have a better FBS (let's suppose ). But how could I know if this would affect my muscle. At my age, I must pay much attention because I am not getting younger and my muscles are no more regenerating.
I have to preserve what I have and not to risk to lose it.
THIS IS LIFE !

Well, the theory would be that if you were to reduce your protein intake by a small amount and it helped with your fasting glucose, then that protein was excess to your muscle maintenance requirement and thus was being used only to make glucose. But I’m just thinking out loud and trying to help. You seem very knowledgeable so hopefully you’ll figure out the best way forward for yourself.

 

[Pasha]

I use Myfitnesspal.app for records and my daily nutrition goals (in this app) are:
- calories 1736
- carbohydrates 5% (22 g)
- fat 70 % (135 g)
- protein 25 % (109 g)
I recognize I never thought to juggle with the fat. So, one day I will reduce the amount of fat (let's say 50 g) and I will see next morning what my FBS is and, another day, I will raise at 200 g the amount of fat and check the FBS next morning.
I will give it a try.
Thank you for your advise !

I have noticed that when I fall off the wagon from time to time, it can take me 3-4 days for my BG values to return to normal. With this in mind, I would humbly suggest that when you do your high fat -low fat trials that you consider doing each trial for at least ca 3 days to make sure that you are getting the real results.Especially so, if you are a bit overweight.

 

[cmatanie]

Well, the theory would be that if you were to reduce your protein intake by a small amount and it helped with your fasting glucose, then that protein was excess to your muscle maintenance requirement and thus was being used only to make glucose. But I’m just thinking out loud and trying to help. You seem very knowledgeable so hopefully you’ll figure out the best way forward for yourself.

I hope too. Thank you very much for your advices. I wish you all the best !

 

[cmatanie]

I have noticed that when I fall off the wagon from time to time, it can take me 3-4 days for my BG values to return to normal. With this in mind, I would humbly suggest that when you do your high fat -low fat trials that you consider doing each trial for at least ca 3 days to make sure that you are getting the real results.Especially so, if you are a bit overweight.

I think you're right. I'll do so. Have a very good day !

 

[Member496333]

Just to add, I know I bang on about protein a lot, but only because reducing it helped me beat my stubbornly high fasting glucose, so I speak from personal experience. But the great news is that it needn’t be permanent. Nowadays I eat pretty much whatever I want on a pretty high protein carnivore diet, and my glucose is flatlined whenever I test it, morning, noon or night.