Spikes don't go down for 3-4 hours

[Rosie9876]

I am T2D on pills. I check my glucose levels with a Freestyle Libre 2 plus. A low carb meal (say 10-20 gms) with protein, fat and fibre typically goes up to about 9 or 10 from say about 5-6. What bothers me is they stay high a long time, not getting back to 5 or 6 for say four hours. When I started my programme to reduce my A1c, 8 months ago, I successfully tolerated more carbs, but I cut down when they began to spike higher than 10. Does this suggest my insulin resistance is increasing?

 

[Melgar]

Hi there @Rosie9876. I am not a knowledgeable person when it comes down to low carb diets. If don't mind me asking what do your typical meals look like? 10-20 gms of carbs is not a lot if it's per day, or is this per meal?

I see from your previous posts you are on Dapagliflozin.

As for your question on insulin resistance, it is hard to say. Generally speaking, in T2 diabetes, insulin resistance plays a significant role along with a pancreas that is unable to compensate for this resistance. That's generally speaking. We can only speak in general as tests for Insulin resistance itself are complex. People with high Insulin resistance generally produce a lot of insulin to compensate for their lack of insulin sensitivity. C- peptide tests are used to see how much insulin is being produced by the pancreas, usually these tests are given when there is a question mark over the type of diabetes.
If C-peptides are high then this could be indicator as to how much insulin the pancreas is producing to compensate, if the figure is high, then possibly IR is the cause.

 

[Rosie9876]

Hi there @Rosie9876. I am not a knowledgeable person when it comes down to low carb diets. If don't mind me asking what do your typical meals look like? 10-20 gms of carbs is not a lot if it's per day, or is this per meal?

I see from your previous posts you are on Dapagliflozin.

As for your question on insulin resistance, it is hard to say. Generally speaking, in T2 diabetes, insulin resistance plays a significant role along with a pancreas that is unable to compensate for this resistance. That's generally speaking. We can only speak in general as tests for Insulin resistance itself are complex. People with high Insulin resistance generally produce a lot of insulin to compensate for their lack of insulin sensitivity. C- peptide tests are used to see how much insulin is being produced by the pancreas, usually these tests are given when there is a question mark over the type of diabetes.
If C-peptides are high then this could be indicator as to how much insulin the pancreas is producing to compensate, if the figure is high, then possibly IR is the cause.

Thanks for your comments @Melgar . At a guestimate, I reckon I have about 50 carbs per day. I would rather not go lower. I don't need to lose weight. BMI about 22. But I would like my A1c lower than the most recent test, when it was 57. (7.4%?)

I expect I have visceral fat around my organs, but little body fat apart from being apple-shape, unfortunately. A typical breakfast would be a 2-egg cheese omelette and a salad with olive oil and cider vinegar, a few walnuts, 2 or 3 savoury oat biscuits (circa 10 net carbs) and afterward, a square or two of 90% Lindt chocolate with coffee. Also sometimes a small tangerine or apple. If I have it handy, I would add kale, cauliflower or similar to the omelette. I used to add some new potato, to make a Spanish omelette, and it didn't raise my glucose level hugely, but that was then. Other meals similarly boring when I prepare them myself. They are mostly vegetarian, but I do eat some fish for Omega 3.

I have to be careful with my diet because of huge uric acid kidney stones, in the process of being treated with surgery. Also kidney disease being investigated. I wanted to have a HOMA IR test, but they are not done on the NHS here in UK. It might be wise to have some tests done privately, if I understood what would be beneficial. The endocrinologist, Dr Robert Lustig, claims (if I understand him) that metabolic syndrome which causes T2D, starts with a fatty liver, though I don't know whether I have one or why I have so much uric acid (don't have gout). Obviously, carbs - especially sucrose - are a huge issue, but it seems much more complicated than that.

I am on Metformin. I was also put on Dapagliflozin, but may need to stop it, as I had an unexplained very severe constipation - can't think of any other reason for it. I would feel happier if my glucose spike went down after 2 hours, the quoted benchmark. Also hoping against hope I don't have CKD.

 

[Kiwigal]

I have very similar issues ie sometimes ate protein only food or low carb food of 25 grams. My glucose sometimes spikes up from 6.5 mmol to 11 mmol fast then curved and very very slow gradually 4 hours + to get down to 7 mmol.

I'm also BMI 24. But I had unintended weightloss since late 2022 (over 30 kg weightloss due to Covid+). My weightloss haven't stablize and I'm not yet in remission for Type 2 Diabetes.

Even though I'm on ozempic. If I reduced ozempic doses down to 0.50mg or 0.25mg - within a week my glucose starts to rise up. To me it look like signs of insulin deficiency as my own producing insulin isn't kicking up to decrease high glucose.

So when I'm unwell or on prednisolone... I get moderate ketones with high glucose of 11mmol to 13 mmol. This is sign of insulin deficiency.

As typical Type 2 Diabetes doesn't get ketones that quick when unwell or on prednisolone as they got insulin resistance plus producing insulin enough beta cells to prevent ketones.

It would take weeks for Type 2 Diabetes to get ketones build up... unless they are on the meds that cause ketones.

I do have characteristics of LADA so will be asking GP for an referral to Endocrinologist (will look up for LADA/complex Diabetes) for 2nd opinion. (Confirmed HLA genes for Type 1 Diabetes autoimmune/other autoimmune diseases by immunologist.)

As my body/organs is going thru immune system attacks.