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Was Told By A Doctor To Increase My Carbs

Okay, let me elaborate...I feel like this discussion is going to be useful for people.

Before onset of symptoms, which were actually not caused by diabetes, I Dr, Googled it wrong. I have gone on keto diet because Internet told me to until I find out if it is diabetes. I was tested via HbA1c, fasting, fructosamine, OGTT, antibodies. OGTT came out bad. The only thing that was diabetic. Endocrinologist even put me in hospital for two days, to see what is going on. He measured my BG and other things and it came out to be okay. He said to consult with dietician on how to reintroduce carbs. Dietician was useless - they told me to eat standard food pyramid lol. So, since then I did not trust them. I made a few attempts to add some carbs, but was not happy with numbers. I never stuck out with the change in diet because of being afraid ,... and feeling unwell when attempting changes.

So, I kind of coasted with a conviction of being glucose intolerant despite endocrinologist thinking otherwise. Now, I did go to my doctor for other issues, and she suggested to attempt more carbs. Reason for it is because I show little evidence for diabetes, maybe some insulin resistance, but c-peptide being in low normal range kind of threw me off. It was low during endo consultation, but he still said it is insulin resistance ... I honestly felt like there is something else - I don't produce enough insulin, rather than being resistant. Why would I be resistance with below range c-peptide. Makes no sense. I am honestly disappointed buy medical professionals - why do they tell me to not Google things when their decisions can be verified to be very counterintuitive to what science says? c-peptide high = insulin resistance, c-peptide normal = normal sensitivity. My circumstances were of course unusual because I practiced low carbing and frankly not eating enough calories. This could have made my c-peptide quite low, so endo thought it was not a pathology.

Why I want to reintroduce carbs? Mostly my energy levels. They are low. My libido is low despite caloric surplus. I have sensitivities to things like eggs, nuts which are big source of calories. I also don't digest fats very well, causes me diarhea sometimes...But the end goal, is to find out if I am actually pre-, pre-pre, diabetic. Will my blood sugar change to something reasonable over the weeks as I increase carbs, (physiological resistance), or will it stay elevated (pathology of some sort). This question was not answered by endocrinologist, me, or any other doctor. It was my fear of finding out the truth, it still is.

I have read a lot about how pancreas stores and outputs insulin depending on glycemic load of previous meals. If you practice low carb, then pancreas will not produce much insulin. If you increase carbs, healthy pancreas will increase insulin production. If you fast, your c-peptide will be very low because you only use basal insulin with no calories. If you dump OGTT to a fasting person, they probably will fail it. So, I want to find out what happens to me when I increase carbs. Will I find out a pathology or not? I will consult with local doctor before attempting this.
 
Thank you for expanding on your situation. That helps !
On low carb diet and low insulin output, sodium, magnesium and potassium salts are lost through the urine more than when insulin levels/ carb intake are higher.
A number of us on low carb or keto diet find we need more salt and magnesium in particular. Many docs and dietitians are unaware of this. Youtube Dr Phinney on keto diets and ketoadaption explains it well.
Of course as a type 1 diabetic totally reliant on injected insulin my loss of these salts maybe higher than when ine still has one's own insulin supply.
But the tiredness certainly improves with adding salt and either mahnesium containing foods or supplements. Coconut cream contains potassium. And blood tests may not help much as there is heaps of sodium in the body and most of the potassium and magnesium is in the bidy cells nit the blood so a level in the normal range may not rule out depletion in the body cells. However i have read that a magnesium and/or potassium blood level near the lower end of the range is suggestive of low kevels in the bidy cells.
You may wish to consider all this before trying increased carbs as a way of improving your energy levels.

Of course you wish to grasp the nettle and settle the question of what your glucose metabolism status is, but OGTT does have limitations which a continuous glucose monitoring might answer better with both low carb and higher carb diet.

Some can get diahoorea from over doing fat intake but from my reading the pancreas gland also produces the digestive enzymes that breakdown fats and the gallbladder produces the bile that also helps breakdown fats. It may be helpful to raise the general state of health of your pancreas and gallbladder with your doctor, just to cover that base.

Best Wishes, and i am glad you do look things up and think about them and call a doctor out for stating something that is a non sequiter or not congruent the up to date data and interpretation in physiology and pathology.
 
CrumblingWall said:
I noticed anything above 6.5 mmol/l after a meal makes me experience symptoms like: sweating, feeling hot, headache and face pressure (don't know how else to describe it), and feeling slightly thirsty. It always comes down but
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Just curious to know why you are testing your blood when you are not even prediabetic. The way you feel at over 6.5 would not be anything to do with your blood levels they are normal as your tests show so it must be something else causing them. I think you may be overthinking it a bit relax and forget the testing and try to look for other reasons why you feel like you do
 

Great documentary.
 

Well, we just had confirmations from way less neurotic people in first page that they feel unwell with highish glucose, not diabetic levels. I think it is body's response to unusual homeotasis state, because it just NEVER went there. Type 2 diabetics get used to high glucose over time. Or type 1s who ran high, they report feeliong hypo at something like 8 mmol/l because their bodies got used to being high all the time. It then takes time to feel normal at 5.x mmol/l.

I usually don't test unless feeling really out of it. Usually, it is above 6.5 mmol/l when I feel that way. I feel thirsty when reaching above 8.x mmol/l. I am not sure what is the cause. I need to find out if insulin resistance AND/OR lack of insulin is the real problem. My c-peptide is tested always on low normal boudnary, so it does not seem to iomply insulin resistance. But what happens after ingestion of carbs, who knows. Do I not produce enough insulin to deal with high carb diet? Or is my body at resistance stage due to low carbing and should revert back to normal glucose-based energy metabolism? ... only 2 weeks of honest carb up can tell.
 
What also interests me if the following - if one takes OGTT during low carb diet, what happens? Will BG rise sharply upwards because of 1) or 2), or both

1) Actual insulin resistance induced by ketogenic state - glucose is spared for essential organs while all other cells run on ketones. So, glucose clearance is significantly slowed down, hence we see large peak, and then delayed glucose clearance at say 3 hours mark instead of 2.

2) Insulin deficiency. Caused by pancreas being in park mode - no demand for glucose clearing means pancreas is putting out bare minimum, and does not have much stored for phase 1 response. When presented with a dump of glucose, it takes time for it to actually produce required insulin to clear the glucose. It is much slower than just squirting out insulin pre-made, which means glucose builds up in the blood for longer, and looks like insulin resistance. Eventually, phase 2 response happens, and glucose goes back to normal or even hypo because pancreas is working intensely to clear sudden load of glucose it was not expecting...

Endocrinologist mentioned insulin resistance, but am wondering how it can be that. My c-peptide is consistently on low side, not really showing resistance. I am leaning towards 2) ...
 
Well I have a “partial” answer.

I have T2D and undertook an OGTT whilst following a low carb diet and without changing my diet in preparation.

I had a none-diabetic response.

But everyone is different, so the response will always differ.

On the other hand, if I had never been diagnosed as T2D I wouldn’t be testing my BG or undertaking an OGTT.

I would certainly prefer never to have been diagnosed T2D, and I am confused as to why so many people appear to want to be affiliated by it.
 

CrumblingWall - In my experience, things are rarely as binary as apply x condition (non-carbed-up OGTT or whatever) and return x result. Individuals will differ, based ontheir personal physical condition, how many carbs they have actually eaten in preceding days, actual make up of the 75gr carb (some react differently to different types/styles of carbs) and the most recent past, in terms of stress, sleep and other factors.

Like @britishpub , I did an OGTT and returned pretty decent, non-diabetic results, without having carbed up. Maybe I got lucky. Maybe it was an anomoly, but as I really detested the drink, I won't be forming a queue to repeat the proces.

Please don't forget our bodies like to run to routines. In our usual eating and drinking routines, our bodies are ready to kick out the relevant amounts of digestive juices, enzymes and hormones. Doing something very different can trip the body up, as it just isn't ready for whatever it is we throw at at.

This last meal effect isn't just a thing for people with diabetes. An example would be around Christmas, lots of folks have a ginagerous meal, eating more than they normally would, then end up having to retire to the sofa for a couple of hours afterwards, to get over the bloat and indigestion because their body is objecting to the overload it's just had. Repeat that process a few more times and it's likely their digestion would cope better, although it might well put their waistband under pressure!

In terms of pancreatic insufficiency, I won't comment too much. I haven't had a c-peptide test myself, but for those of us still prodcuing natural insulin, exactly how much will vary, depending upon our usual eating patterns. I'm sure some pancreases are better "athletes" than others, in terms of the response to change.

Finally, if your c-peptide is at the lower range, have you had your liver and adrenal glands checked out? Low c-peptide can also be associated with issues with those.
 

Crumbing wall Congratulations on a very well described puzzle. I am a Reversed type 2 , used Prof Roy Taylor's low calorie NEWCASTLE diet , then have continued with Low Carb HF. and some IF...HbA1c is good at 4.95 %DCCT=30.6 IFCC. BUT like you I have worried what's going on.
... because my Fasting Blood Sugars have been a bit high...113 instead of below 100. I have written to various , YouTube Drs but have not got a Definite answer. It is either Physiological Insulin Resistance in muscles , OR
delayed pancreas response.
IF you get a good answer to this puzzle please publish it here. Thanks
 
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Lol, good luck to me. I had zero help from my GP and they are not going to send me to an endo again, maybe except if any values like hba1c are diabetic. But they are not. I don't even need to measure HbA1c, all my codefree showings are always below 6.0 mmol/l most of the time, so average is probably close or lower than that.

The only reason why I got OGTT was because I forced my GP to do one. He clearly knows not much about diabetes because he said it is not going to alter GTT result on low carb. There was zero support for getting back to normal diet, through going to dietician or whatever.

I don't really know what is the cause, I honestly cannot see it being something sinister, but something is broken and even endo could not tell, just that it is not diabetic. Diabetics are supposed to go high and stay high for a long time. I sent my BG down successfully but it happened later. Sounds like resistance, but no one measured insulin levels through GTT, so ... who knows.
 

If you feel seeing an Endo; either the same one or someone else, you could go privately. I would say, the majority of consultants do some private work, and they're very easy to find.
 
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