Started low carb low calorie diet - blood glucose still higher than expected!

[JoeHo]

Hello,

I started on a low carb and low calorie diet (keto, real food - estimate around 1000 calories a day) with a16:8 eating window 4 weeks ago.

My fasting blood glucose is still higher than expected in the mornings - about 6.5 to 7.5.

I was expecting my blood glucose to come down quite quickly once I had started on this diet (change in lifestyle).

My weight has gradually decreased from 93.7kg to 86.9kg over this period so I'm pleased with that.

Any ideas why my blood glucose levels have not decreased?

Thanks for reading.

 

[Goonergal]

Are you only testing first thing in the morning, or at other times too?

The morning ‘fasting’ reading is often the highest reading of the day - look up dawn phenomenon - and many here find it’s the last one to drop in line with other readings.

A better guide would be your pre and post prandial readings.

 

[JoeHo]

I test just before bed (this would be 2 hours post-prandial - usually between 8 and 10) and fasting blood glucose first thing in the morning (between 6.5 to 7.5).

 

[EllieM]

estimate around 1000 calories a day)

I wonder if the issue is that you are counting calories rather than carbs.

T2s are carb intolerant, and vainly produce more and more insulin to process the carbs they eat. If they eat too many then their blood sugars go up, and weight gain is a side effect of high blood sugar and high insulin.

So in your position I'd test before a meal, and then 2 hours after. If you've gone up by more than 2mmol/L then there were too many carbs in that meal....

There is one other possibility, only to be considered after you've give low carb a serious go. Some people are slow onset T1 and don't produce enough insulin. Low carb brings their blood sugars down for a while because they need less insulin if they eat less carbs, but in the long term they need insulin. Most GPs will automatically diagnose you are T2 unless you are young and thin. This is usually correct, but not always.

Good luck. Watch those carbs.

 

[Goonergal]

I test just before bed (this would be 2 hours post-prandial - usually between 8 and 10) and fasting blood glucose first thing in the morning (between 6.5 to 7.5).

Two readings a day won’t give you a very clear picture of what is happening.

A couple more questions, if I may:

- What was your starting HbA1c?
- Can you give some examples of what you’re eating?

 

[JoeHo]

I wonder if the issue is that you are counting calories rather than carbs.

T2s are carb intolerant, and vainly produce more and more insulin to process the carbs they eat. If they eat too many then their blood sugars go up, and weight gain is a side effect of high blood sugar and high insulin.

So in your position I'd test before a meal, and then 2 hours after. If you've gone up by more than 2mmol/L then there were too many carbs in that meal....

There is one other possibility, only to be considered after you've give low carb a serious go. Some people are slow onset T1 and don't produce enough insulin. Low carb brings their blood sugars down for a while because they need less insulin if they eat less carbs, but in the long term they need insulin. Most GPs will automatically diagnose you are T2 unless you are young and thin. This is usually correct, but not always.

Good luck. Watch those carbs.

Hello,

Thanks for reading!

I've been on a keto diet for 4 weeks and low calorie (I don't count calories but I have a rough idea of how many calories I'm consuming)

I'm wondering if my beta cells are very damaged and not producing enough insulin (diagnosed for 10 years - and haven't given it a real go until now!) or I am still over my personal fat threshold and my liver and pancreas are clogged up with fat and not functioning properly.

 

[JoeHo]

Two readings a day won’t give you a very clear picture of what is happening.

A couple more questions, if I may:

- What was your starting HbA1c?
- Can you give some examples of what you’re eating?

HbA1c - 67

- skip breakfast - black coffee and black tea
- lunch (12pm) - veg with or without protein soups, protein with salad (green coloured plus tomatoes)
- early evening meal (finish eating by 7pm) - same as lunch

No high carb foods - no potatoes, bread, pasta etc

 

[Goonergal]

HbA1c - 67

- skip breakfast - black coffee and black tea
- lunch (12pm) - veg with or without protein soups, protein with salad (green coloured plus tomatoes)
- early evening meal (finish eating by 7pm) - same as lunch

No high carb foods - no potatoes, bread, pasta etc

Nothing obvious to remove there. I’d be worried about hunger/getting enough nutrients over the long-term.

Although finger pricks and HbA1c measure very different things, an HbA1c of 67 roughly equates to an average blood glucose level of 10.6 https://www.diabetes.co.uk/hba1c-to-blood-sugar-level-converter.html so you’d be spending time below and above that. In that context the numbers you quote don’t seem unreasonable, but you really do need more data to judge whether progress is being made.

As an example, I didn’t test when first diagnosed and only started keeping a detailed record (spreadsheet) once my HbA1c had dropped significantly, but see from those records that in the month I’d dropped to 57, the overall average was 7. Looks like each month the overall average dropped by about 0.3 - 0.4 mmols (based on over 1,000 readings a month).

 

[JoeHo]

Thanks for the tip. I will enter my HbA1c and finger prick BG results into a spreadsheet to monitor progress.

I don't really feel hungry - I also take a daily multi-vitamin tablet.

The weight is steadily coming down but BG is still higher than expected.

 

[lucylocket61]

Thanks for the tip. I will enter my HbA1c and finger prick BG results into a spreadsheet to monitor progress.

I don't really feel hungry - I also take a daily multi-vitamin tablet.

The weight is steadily coming down but BG is still higher than expected.

It can take a couple of months or so to drop significantly. Some of us are more insulin resistant than others. We are all different.

 

[JoeHo]

It can take a couple of months or so to drop significantly. Some of us are more insulin resistant than others. We are all different.

I was reading about Roy Taylor's Newcastle diet so was expecting BG to come down fairly quickly within a week or two.

 

[lucylocket61]

I was reading about Roy Taylor's Newcastle diet so was expecting BG to come down fairly quickly within a week or two.

How many carbs are you eating? When are you testing?

Despite low carbing for over 9 years, my fasting reading is still around 8 even though my levels are fine the rest of the day. It's just the way my body works. We all react differently.

 

[JoeHo]

How many carbs are you eating? When are you testing?

Despite low carbing for over 9 years, my fasting reading is still around 8 even though my levels are fine the rest of the day. It's just the way my body works. We all react differently.

I will take more BG readings at different times during the day to check.

Finger pricks first thing in the morning and before bed.

I know my diet is keto / low carb but I haven't tried to count the carbs accurately.

 

[JoeHo]

My fasting BG was 7.4 this morning (7am) and now (almost 2pm) it's 8.1.

I haven't eaten since yesterday evening so I guess my BG is constant. It hasn't really gone up or down in 7 hours.

Should my BG be lower or higher?

 

[Goonergal]

My fasting BG was 7.4 this morning (7am) and now (almost 2pm) it's 8.1.

I haven't eaten since yesterday evening so I guess my BG is constant. It hasn't really gone up or down in 7 hours.

Should my BG be lower or higher?

I’d want to be lower than that, but there’s no hurry. You’re only a month into making a big change. Stick at it and things will happen. These are the NICE recommended ranges:

 

[HSSS]

Which veg and what’s in the soups? Other than those uncertain elements it does seem low carb. The way to test if it’s low enough is as explained above. Test immediately before the meals and again 2 hrs later. You want a rise of no more than 2mmol. If the meals are repeated you only need to test each one a few times to ensure consistent results and then just test occasionally to check your response hasn’t changed - not every time you eat that meal.
I’d echo levels probably have dropped from where you started and it takes time, especially fasting readings.
And prof Taylor’s regime and theories about personal fat thresholds work for some, but not all. There is almost certainly more than one cause of type 2 (think of it as a cluster of similar diagnoses) and this only addresses the visceral fat cause.

 

[JoeHo]

Which veg and what’s in the soups? Other than those uncertain elements it does seem low carb. The way to test if it’s low enough is as explained above. Test immediately before the meals and again 2 hrs later. You want a rise of no more than 2mmol. If the meals are repeated you only need to test each one a few times to ensure consistent results and then just test occasionally to check your response hasn’t changed - not every time you eat that meal.
I’d echo levels probably have dropped from where you started and it takes time, especially fasting readings.
And prof Taylor’s regime and theories about personal fat thresholds work for some, but not all. There is almost certainly more than one cause of type 2 (think of it as a cluster of similar diagnoses) and this only addresses the visceral fat cause.

Thank you for reading.

I put cabbage, leeks, mushrooms, broccoli, onions, tinned tomatoes, limited carrots in my soups (only low carb veg - no potatoes, grains).

I usually add a stock cube too. Also add chillies, herbs, spices, salt and pepper for flavour / seasoning.

For protein I put some cubed beef or a couple of chicken drumsticks / thighs with skin on into the soup. I also use olive oil / coconut oil for cooking.

I will do more BG testing pre- and post-prandial.

I am also part way into a fast (30 hours and counting) and so far my BG has fallen to 5.

 

[HSSS]

Thank you for reading.

I put cabbage, leeks, mushrooms, broccoli, onions, tinned tomatoes, limited carrots in my soups (only low carb veg - no potatoes, grains).

I usually add a stock cube too. Also add chillies, herbs, spices, salt and pepper for flavour / seasoning.

For protein I put some cubed beef or a couple of chicken drumsticks / thighs with skin on into the soup. I also use olive oil / coconut oil for cooking.

I will do more BG testing pre- and post-prandial.

I am also part way into a fast (30 hours and counting) and so far my BG has fallen to 5.

This sounds pretty low to me too. Honestly. Just stick with it. I think you’re getting there. Be aware these very low calorie diets are designed to be short term then replaced with something more sustainable to meet your metabolic and nutritional needs

 

[JoeHo]

This sounds pretty low to me too. Honestly. Just stick with it. I think you’re getting there. Be aware these very low calorie diets are designed to be short term then replaced with something more sustainable to meet your metabolic and nutritional needs

Thanks!

I am trying to lose the weight quickly and then transition to longterm keto / carni maintenance.

 

[bulkbiker]

Thanks!

I am trying to lose the weight quickly and then transition to longterm keto / carni maintenance.

Just be slightly careful about undereating.
Personally I'd up my food quantities
Slowing your metabolism by not eating enough isn't really the best way to start a new eating regime especially if you intend to stick to it long term.