Trying to make sense of what the BG Meter is telling me.

[Alineden]

Sorry, I appreciate it can be difficult testing around work breaks but I don't think you can make a judgement about what is high at 40 mins when you did not test before the meal.

If you want us to check the paste for you just ask by telling us the brand details and approx portion used.

Hi Alison Campbell. I checked the paste and the estimate of 5g of carbs won't be far out for the quantity I ate.

 

[Member496333]

I believe Jim is giving a fair representation of the book.

A “decade’s worth” isn’t literal glucose but overall impact including the pancreas and the sensitivity that will take time to recover.

This doctor is getting results.

I could be misinterpreting parts of the book. As I remember it, once glycogen stores are full and the fat cells throughout the body are fully engorged, if glucose continues to enter the system, then it has nowhere to go other than blood, organs and tissues. Hypoglycaemics and exogenous insulin then force it out of the blood and further into those tissues. They don’t dissolve the glucose, they simply move it somewhere else. According to Fung, this is reflected in data that shows that these medications, despite lowering blood glucose, don’t by themselves improve complication outcomes. Whether or don’t this is true I can’t say.

This is certainly how it’s all explained in the book, but for sure he could be simplifying for the audience, and I could have misunderstood some finer details. In any case, it’s a fascinating read for sure. Might give it a third listen

 

[Alineden]

I believe Jim is giving a fair representation of the book.

A “decade’s worth” isn’t literal glucose but overall impact including the pancreas and the sensitivity that will take time to recover.

This doctor is getting results.

So can insulin resistance be reversed. I thought it could only be managed.

 

[Alineden]

Sorry, I appreciate it can be difficult testing around work breaks but I don't think you can make a judgement about what is high at 40 mins when you did not test before the meal.

If you want us to check the paste for you just ask by telling us the brand details and approx portion used.

Hi Alison Campbell. I checked the paste and the estimate of 5g of carbs won't be far out for the quantity I ate.

 

[Member496333]

There a two things springing to mind here Jim. Firstly despite usually eating LCHF quite strictly my weight loss has been satisfactory but I've never seen even a trace of ketones when using a pee stick. Perhaps my body still has access to too much glucose regardless of what I eat.

Secondly perhaps I need to up my efforts to fast to reduce the stored glucose quicker.

Pee sticks only indicate waste ketones. Those that are not used as a source of energy in the blood. As your body switches to ketone bodies as it’s primary energy source, it will become more adept at using them, and you’ll see less excreted in the urine. Pee sticks are also not especially accurate to begin with. But, if you’re losing stored body fat then for sure you will be generating some ketones. At least periodically.

 

[Member496333]

So can insulin resistance be reversed. I thought it could only be managed.

According to Fung, yes. Once the fatty deposits have been cleared from the pancreas and liver. Certainly my own insulin sensitivity continues to steadily improve. It’s worth remembering of course that none of this is an overnight process, and could take a very long time to achieve maximum results. Severely limiting glucose ingestion, and intermittent fasting, will help speed it along though

 

[kokhongw]

I could be misinterpreting parts of the book. As I remember it, once glycogen stores are full and the fat cells throughout the body are fully engorged, if glucose continues to enter the system, then it has nowhere to go other than blood, organs and tissues. Hypoglycaemics and exogenous insulin then force it out of the blood and further into those tissues. They don’t dissolve the glucose, they simply move it somewhere else. According to Fung, this is reflected in data that shows that these medications, despite lowering blood glucose, don’t by themselves improve complication outcomes. Whether or don’t this is true I can’t say.

This is certainly how it’s all explained in the book, but for sure he could be simplifying for the audience, and I could have misunderstood some finer details. In any case, it’s a fascinating read for sure. Might give it a third listen

This was how he phrased it in his blog

However, if insulin becomes excessive, then the body is always trying to store glycogen and fat. Since there’s not much room for glycogen, it produces fat. (Note – this is normal. This process reverses during fasting) The liver exports this fat out as triglycerides along with very low density lipoprotein (VLDL) to other organs but particularly to fat cells called adipocytes.

Now, adipocytes are specialized cells to store fat. Having more fat cells is not particularly dangerous. That’s what it does. Other than taking up room, it doesn’t really matter. The fat cell is designed to hold fat, so you don’t get sick from from it. Obesity itself is not the cause of the problem. The critical problem occurs when you get fat where it’s not supposed to be.

 

[Member496333]

He definitely talks about glucose in the tissues and organs in the book, The Diabetes Code. I’m going to have to listen to the whole thing again. Happy to admit if I’ve misunderstood. It’s certainly not a chore to listen to anyway


This link is worth a read for those still interested. Scroll down to the sugar bowl bit if you’re short of time;
https://idmprogram.com/reverse-type-2-diabetes-the-quick-start-guide/


Further reading on the glucose overflow hypothesis;
https://idmprogram.com/new-paradigm-insulin-resistance-t2d/


More. Scroll down to Insulin Resistance;
https://idmprogram.com/insulin-resistance-good-t2d-7/

 

[Brunneria]

Hi everyone

I'm still struggling a bit to understand what sometimes causes raised BG and today has been typical.

I've actually given up testing first thing in the morning as it always seems to be high with liver dump and it's quite frustrating but I still test after meals (2 hours usually). Today due to work I only got chance to test for the first time 40 minutes after lunch. I then went for a 20 walk, tested again, then after the usual 2 hours.

The first test was a bit of a 1 off. I don't usually test that soon after eating. The reading was 9.6 mmol/l which I thought was high for what I had eaten. After a walk I tested again and as expected it had dropped, 6.7 mmol/l. But when I tested at the usual 2 hours it had gone up to 8 mmol/l. What's that all about?

I had scrambled eggs and 3 rashes of bacon for breakfast and lunch was a thai curry that I reckon had 5g of carbs in the curry paste plus whatever was in the chicken thighs, onion, coconut cream and coconut oil.

The only thing I'd had after lunch was a black coffee and a glass of water.

Doesn't that seem high for what I've eaten?

Hi @Alineden

There are a some other factors that may be in play, as well as the glycogen stuff mentioned above.

Exercise will cause dips in blood glucose as the muscles use up glucose in the blood.
This is why exercise is often quoted as a good way of dropping bg after food. Post prandial walks, running up the stairs a few times. That kind of thing.

But that is only temporary, while the muscles are using the glucose to work.
If the burst of exercise is short, and the glucose from the food is continuing to be released, then the bg may well bounce up again afterwards.

There are also additional factors that may affect what is going on.

Firstly, exercise of sufficient intensity will lower insulin resistance, allowing the muscles to draw in glucose more easily. If the exercise is long enough, and intense enough, then that lowered insulin resistance may continue for some time after the exercise has ended. This is one of the reasons why regular exercise (especially High Intensity Interval Training) is touted as good for T2s with insulin resistance.

Secondly, when the body detects glucose dropping in the bloodstream (as it enters the muscles), it will try to top up that glucose from glycogen stores, so that more glucose is available if needed. The amount of glycogen available varies a lot from person to person, and is affected by whether they eat high carb, low carb, keto, and their own personal storage capacity. Part of becoming Keto Adapted involves running your glycogen stores down.

The point at which these different processes are triggered will largely depend on your own fitness level, the amount and intensity of the exercise, other factors (such as stress), and the amount of glycogen reserve you have. Also how 'hair trigger' your body is at liver dumping (aka releasing glycogen).

Sorry about the complexity, but it is quite a complex subject.
What it really boils down to, is that lots of variables make bg quite variable.
- and I haven't even mentioned the fact that meters have an acceptable leeway of +/- 10% which means that a small variation from the true figure is considered likely.

Bottom line, it is better to look at blood glucose reading trends over several days, rather than worry about small variations on a daily basis.

Hope that helps.

 

[briped]

Certainly my own insulin sensitivity continues to steadily improve.

How do you know? Better ability to cope with carbs, or did you have any tests done? I'm genuinely curious as I'm wondering if mine ever will ...

 

[Member496333]

How do you know? Better ability to cope with carbs, or did you have any tests done? I'm genuinely curious as I'm wondering if mine ever will ...

Just generally improving glucose stability. Irrespective of whether or not I’ve eaten, my glucose stays steady in a very narrow band all day long. Can’t specifically comment on carbohydrate as I don’t wish to consume any, but ingested carbohydrate isn’t the only factor in determining blood glucose, and you don’t attain rock solid stability without a decent degree of insulin sensitivity

 

[briped]

Just generally improving glucose stability. Irrespective of whether or not I’ve eaten, my glucose stays steady in a very narrow band all day long. Can’t specifically comment on carbohydrate as I don’t wish to consume any, but carbohydrate isn’t the only factor in determining blood glucose, and you don’t attain rock solid stability without a decent degree of insulin sensitivity

Well done, and without meds too! I'm in ketosis too. Last night I measured 1,3, but I'm still waiting for miracles (major weight loss) to happen. My BGs are mostly within 4,5 - 6,5, but would rather see them under 6 all the time. I'm still on metformin and 12ml of victoza, and wonder if that'll ever change, as I was diagnosed in 2005 + I'm an old bat too. Not complaining, though. I've done ok, everything taken into consideration.
Thanks for replying.

 

[Member496333]

Well done, and without meds too! I'm in ketosis too. Last night I measured 1,3, but I'm still waiting for miracles (major weight loss) to happen. My BGs are mostly within 4,5 - 6,5, but would rather see them under 6 all the time. I'm still on metformin and 12ml of victoza, and wonder if that'll ever change, as I was diagnosed in 2005 + I'm an old bat too. Not complaining, though. I've done ok, everything taken into consideration.
Thanks for replying.

Thanks. Yes. I’m between 4.5-5.5mmol/L irrespective of food, and without any medications at all. This was from a position of chronic hyperglycaemia, diabetic retinopathy, macular edema, and peripheral neuropathy. Mostly I achieved this by intense self-education into the research of pioneers such as Jason Fung, Tim Noakes etc. so I’m naturally going to have the view that they know what they’re talking about

EDIT: current projected HbA1c is 29mmol/mol but I’m not sure I’ll be having another actual test anytime soon. Certainly not for another year or so. Takeaway lesson - listen to Jason Fung. The guy is a trailblazer in diabetes treatment

 

[Alineden]

Thanks for a great reply Brunneria. I get what you mean about looking at a trend but isn't it good to also look out for what individual foods can cause a higher than normal post meal raise.

 

[Mr_Pot]

Thanks. Yes. I’m between 4.5-5.5mmol/L irrespective of food, and without any medications at all. This was from a position of chronic hyperglycaemia, diabetic retinopathy, macular edema, and peripheral neuropathy. Mostly I achieved this by intense self-education into the research of pioneers such as Jason Fung, Tim Noakes etc. so I’m naturally going to have the view that they know what they’re talking about

EDIT: current projected HbA1c is 29mmol/mol but I’m not sure I’ll be having another actual test anytime soon. Certainly not for another year or so. Takeaway lesson - listen to Jason Fung. The guy is a trailblazer in diabetes treatment

Have you ever considered that your problem all along might not have been insulin resistance but lack of insulin? Insulin resistance is often associated with being overweight but you were very light when diagnosed. If you now keep to very low carb diet then perhaps the insulin you can produce is sufficient to keep your BG under control. I think the jury is out on whether beta cells can recover when they are not being overused but that is another possibility.

 

[Brunneria]

Thanks for a great reply Brunneria. I get what you mean about looking at a trend but isn't it good to also look out for what individual foods can cause a higher than normal post meal raise.

Absolutely!
But I just wouldn't take a single reaction to a single meal or food as 'gospel'.
I can get some really different readings for the same food, in the same portion sizes, depending on stuff like whether it was eaten early or late in the day (insulin resistance can vary during the day), the amount of stress and activity I have before and after... and so on.

As an example, I know perfectly well that a meal of pub burger and chips is going to affect my bg significantly. Probably spike me to 12+ on a normal day.
Not something I would eat regularly, although I have been known to do so.
I usually stick to extremely low (or no) carbs.

About 18 months ago we went on holiday and took a long, fairly strenuous walk along the Northumbrian coast, including exploring a castle, the tower, and clambering about. Significntly more exercise than usually fits into my sedentary(ish) life.
By the end of the walk, my legs had reached the wobbly stage, and my husband was carrying one of the dogs (haha!)

My bg normally runs in the 5s and 6s, but partway through that trek it dropped like a stone down into the low 4s and stayed there (presumably due to exercise induced reduced insulin resistance).

We ended up trundling cheerfully into a pub and I ate an ENORMOUS burger and chips. Delicious.
And my bg hardly shifted. I think it rose to the early 5s and stayed there for a while.

The next day, everything was back to normal, insulin resistance had bobbed back up like a cork, and I DIDN'T eat another burger and chips.

So yes, individual readings are always useful to know.
But they don't always add to your overall management. Better to do a few tests on a particular food or meal, in typical circumstances, and see what the general trend is.

I would love my 'typical circumstances' to include daily coastal walks and pub meals, but sadly I have a desk job, a fairly sedentary life, and my daily exercise is a dog walk at lunchtime on local streets or local parks. On the flat. With pauses for dog sniffs and chats to aquaintances.

 

[Alineden]

Absolutely!
But I just wouldn't take a single reaction to a single meal or food as 'gospel'.
I can get some really different readings for the same food, in the same portion sizes, depending on stuff like whether it was eaten early or late in the day (insulin resistance can vary during the day), the amount of stress and activity I have before and after... and so on.

As an example, I know perfectly well that a meal of pub burger and chips is going to affect my bg significantly. Probably spike me to 12+ on a normal day.
Not something I would eat regularly, although I have been known to do so.
I usually stick to extremely low (or no) carbs.

About 18 months ago we went on holiday and took a long, fairly strenuous walk along the Northumbrian coast, including exploring a castle, the tower, and clambering about. Significntly more exercise than usually fits into my sedentary(ish) life.
By the end of the walk, my legs had reached the wobbly stage, and my husband was carrying one of the dogs (haha!)

My bg normally runs in the 5s and 6s, but partway through that trek it dropped like a stone down into the low 4s and stayed there (presumably due to exercise induced reduced insulin resistance).

We ended up trundling cheerfully into a pub and I ate an ENORMOUS burger and chips. Delicious.
And my bg hardly shifted. I think it rose to the early 5s and stayed there for a while.

The next day, everything was back to normal, insulin resistance had bobbed back up like a cork, and I DIDN'T eat another burger and chips.

So yes, individual readings are always useful to know.
But they don't always add to your overall management. Better to do a few tests on a particular food or meal, in typical circumstances, and see what the general trend is.

I would love my 'typical circumstances' to include daily coastal walks and pub meals, but sadly I have a desk job, a fairly sedentary life, and my daily exercise is a dog walk at lunchtime on local streets or local parks. On the flat. With pauses for dog sniffs and chats to aquaintances.

Does insulin resistance actually vary? Or is the insulin resistance a relatively constant thing with the glucose being the variant. Does the exercise affect how resistant your cells are to the insulin or are you just burning up more of the excess glucose produced or consumed?

 

[Alineden]

Does insulin resistance actually vary? Or is the insulin resistance a relatively constant thing with the glucose being the variant. Does the exercise affect how resistant your cells are to the insulin or are you just burning up more of the excess glucose produced or consumed?

You know, this subject is fascinating. I know diabetes is a terrible thing and obviously very dangerous to my health but I am really enjoying learning about it. You'll probably get sick of me asking questions soon

 

[Member496333]

Have you ever considered that your problem all along might not have been insulin resistance but lack of insulin? Insulin resistance is often associated with being overweight but you were very light when diagnosed. If you now keep to very low carb diet then perhaps the insulin you can produce is sufficient to keep your BG under control. I think the jury is out on whether beta cells can recover when they are not being overused but that is another possibility.

Nope. I was diagnosed type 2 in a hospital and definitely had accute hyperinsulinemia. I’ve aleady explained the hypothesis by which myself, and many many many other type 2 are not obese. We don’t have sufficient fat cells in which de novo lipogenesis can safely lock away the excess energy

 

[Brunneria]

Does insulin resistance actually vary? Or is the insulin resistance a relatively constant thing with the glucose being the variant. Does the exercise affect how resistant your cells are to the insulin or are you just burning up more of the excess glucose produced or consumed?

Oh yes, insulin resistance may vary significantly, in comparatively short time periods.
Exercise is a big factor.
Also hormones, which fluctuate during the day in cycles (circadian rhythmns) and due to various stimuli (food, stress, dawn phenomenon).

It is quite common for insulin users to calculate their insulin doses according to the time of day or exercise, due to varying insulin resistance.

There is, of course, the usual, ‘background’ insulin resistance that T2s have as a large factor, but different factors (exercise, drugs like metformin, obesity), also affect things. As I said, complicated

Re your question as to whether IR varies due to glucose burn or lower IR, the effect is the same.
Once glucose can get into the cell, the energy can be used.

You will no doubt be delighted to also discover that different cells (in the organs, muscles and fat cells) all have different levels of insulin resistance. So when we raise and lower our IR, different body parts react differently, as they ‘come online’* at different points. This is why sometimes our muscles are starved of glucose, while our fat cells continue to tuck that energy away as stored fat - when muscles have higher IR than fat cells.

* VERY clumsy description I have used, sorry. Better to think of IR as a dial, not a switch.

Ed. To add the last bit.