Reintroducing Carbs... Humor me!

[Cocosilk]

My A1c was 5.0% but I had a fasting blood glucose of 5.8 on one lab test. (5.1 and 4.7 on two other tests this past year). No diagnosis. I decided to get a meter and check for myself.

I found that my fasting are were usually around 5 on waking up but rose sometimes over 5.5 after an hour or so still fasting. (I definitely have a dawn phenomenon going on)

I tested after meals to see how high my blood sugar went. Most of the time it didn’t go past 7.8 with lots of carbs - potatoes,sweet potato, oatmeal, beans, etc. (I generally did’t eat much in refined carbs except whole grain bread) I got some surprises that trouble me - two readings up to 9.4 at an hour and two others over 7.8 at one hour but below 7.8 two hours. Those I ate more carbs than normal as a test. Spikes like that aren’t healthy and I want to avoid them.

Since reducing carbs, my fasting are usually in the 4s and were trending down, but the trend down seems to have stalled.

I may have insulin resistance or a weak pancreas. My doctor refused to order a fasting insulin or c-peptide. I am relatively thin and have a small waist. If someone told you that I am diabetic, looking at me you would guess type1 rather than type2.

There is this big grey pre-diabetic area between healthy and diabetic. Healthy with fasting under 4.8 and post-prandial always under 6.7. “Normal” with fasting under 5.6 and post-prandial under 7.8. Pre-diabetic is over normal up to 6.9 fasting on 11.1 peak.

I have definite signs of pre-diabetes but I don’t have extra weight to lose. Actually gaining back some muscle I have lost would probably help if the issue is insulin resistance rather than lack of insulin. Eating low carb is giving me consistently normal, even close to healthy, blood sugars. Not as low as I would like though.

I certainly would like to eat more carbs without my blood sugar reacting unfavorably. I now always have in the back of my mind - what will that do to my blood sugar?

It's good you are being proactive about not letting things get worse. I was just wondering what age you are?

Have you ever done an oral glucose tolerance test?

and what prompted you to have the A1c done?

What was your diet like in the lead up to that test? (Were you like me and eating one too many sweet things or was it carbs in general? Or were you already low carbing when you had the A1c?)

I'm thinking if you can eat a bunch of legumes, root vegetables and oat meal and not spike past 7.8 mmol, you must have enough insulin still to keep the numbers in check. But without a fasting insulin or, is it C- Peptide, it's hard to know whether you are on the hyperinsulinemic early side or on the other side of the curve when your pancreas is burning out. If you are still young, it's more likely to be on the good side of the curve I imagine. That's the side of the curve I'm assuming I'm on.

Do you work out to try to build muscle? I know (not from my own experience of exercising but from hearing others' stories) that building muscle mass must help with insulin resistance as you create new muscle cells and have somewhere for the insulin to put the sugar (if I understand it correctly). (You know this already anyway. Your posts seems to show you've read a lot.) How you go about putting on weight on any diet that restricts either carbs or fats though I am not sure. From the stories of body builders trying to bulk up, I believe they eat tonnes of calories often in carb form, don't they? Kind hard when you are trying to stop your blood sugar from spiking, but maybe you have to look long term vs short term gain.

Are you under stress do you think? Do you tend to be a worrier? I think that is one of my biggest problems and you can't underestimate how that affects your health and metabolism. So when it's not just all about the food, you have to think of ways to get on and enjoy life, laugh when you can, because that will help your blood sugars stabilize as much as anything I think.
If you know you have certain safe foods on low carb, cut yourself some slack and eat just those for a few days without measuring your blood sugar and go back to doing something else you enjoy. (That's the advice I am giving myself at the moment anyway as I try to find work out videos I can do while at home with my kids and baby.)

If you are prediabetic, you probably don't have to watch things quite so closely if you find it's creating more stress. Again, that's what I think my problem is at the moment. Being stuck in the house with my kids (we've all had a virus for the past few weeks and it's miserable weather outside, not to mention it's just too hard to go anywhere with a 4 month old, a 3yo and a not quite 5yo. But that's another story... ha ha) it's easy to obsess. For me it is t least

 

[Cocosilk]

So I pulled back on the carbs before the end of yesterday (Day 3) having only salmon for dinner followed by a late night drink of Lemon juice, coconut water and 1/4 teaspn of Lite Salt and a handful of pepitas.

This morning my fasting level was 5.3 (normal but higher than last week). An hour later it was 5.2 (same same).

Then I ate a small (40g) slice of my husband's fresh sourdough rye bread with a bite of banana, some cheese, some pepitas, sunflower seeds and coffee with cream.

Happily at the 1h I was only 6.6 mol.
Then at 2h, down to 4.7 mmol.

I was properly hungry by the 2h mark and I seem to have actually lost half a kilo over the past few days of having more moderate carbs but less fat and probably less protein.

Happy days!

 

[Sapien]

I tested my carb tolerance last night. I ate a gyro (lamb) sandwich which was in a giant piece of pita bread plus four large falafel.

Result was:

1 hr 8.0 :-(
2 hr 7.2 :-(
3 hr 4.8.

I am not sure what that delayed drop says about the state of my pancreas. Based on experience from when U first started testing and hadn’t yet cut back on carbs much, I had expected something more along the lines of 1hr 7.7, 2 hr 5.4. (If it already dropped below 5.5 at 2hrs, I wouldn’t have tested at 3 hr).

 

[ianf0ster]

I'll perservere through at least today with similar foods. If I'm still seeing 11s, that's probably going to give me my answer, isn't it? But even if I see postprandial 1h 8s that return to 6 mmol by 2 hours, that still won't be a great average if I go on with it, will it? Any idea what HbA1c I would have with numbers between 4s and 11s?

Hi,
In my limited experience it is best to aim not to go over 7.8 at 2hrs post-prandial. However some of the carbs you are eating are High Glycemic Index and so the same would need to apply to a 1hr post-prandial figure.
From what I can glean from the figures that you mention, your figures (apart from the spikes above 7.8) are not too bad - so even if they may not translate to a 'Healthy' Hba1c' they are unlikely to be high enough to be full blown T2 Diabetic - more likely the lower end of the 'Pre-diabetic range'.
Remember that the Hba1c it taking a 2 to 3 month average of your BG numbers as reflected by your Blood Cells, so even if it comes out in the 'Healthy' range, it isn't good if you are having generally great low numbers but having occasional huge spikes!

Personally I would look to non/low carb sources for my potassium etc.

Ian