What are your best tricks to get your fasting blood glucose down?

[Auto E]

My fasting blood glucose remains stubbornly between 5.5 and 6.1mmol/L (on 50 - 75 g/carb/day). My postprandials became very healthy over the past 12 months, but my baseline blood glucose between meals and at night is always around 100 (5.5mmol/L). My CGM shows that my blood glucose remains fairly steady all night.

I've posted this elsewhere, but:
B: coffee w/cream, walnuts, eggs if still hungry (est. carbs = 5)
L: high-fat yogurt w/berries (est. carbs = 30)
D: meat + salad (est. carbs = 10)
decaf coffee w/cream (est. carb = 1)

I walk/jog about 90 minutes a day. Blood glucose goes a bit low during exercise but recovers rapidly to its "set point" (haha) of about 100mg/dL (5.5.mmol/L). That seems to be my liver's happy place. If I eat carbolicious meals, I do have reactive hypoglycemia, but I just mention this for context - I am not regularly eating this way.

So, suggestions to lower this fasting blood glucose? I'd love to hear what kinds of meals, exercise, or other daily routines prove to give you a lower FBG.
And then a sort of theoretical question - I've read that blood glucose of 140mg/dL (7.8mmol) begins vessel damage, so..... do you think my baseline of 5.5 - 6.1 is dangerous to my kidneys, for example? I'm wondering if I should just rejoice in my steadiness (on low carb) and not worry about my elevated FBG. I have chronic kidney disease and am looking to prevent further damage. I'm just looking to hear people's opinions on this topic.

 

[Goonergal]

Hi @Auto E

How long have you been low carbing? FBG is often the last to come down (mine took an absolute age - at least a year). Post prandials and your overall averages are a better guide to BG control, in my opinion. I’d tend to agree with your point that your steadiness on low carb is something to celebrate - your FBG isn't terribly high in the great scheme of things.

Having said that, things that definitely have a favourable impact on my morning levels are - eating an early evening meal and not snacking later; eating fish rather than meat for an evening meal and decent exercise the day before.

 

[Auto E]

Hi @Auto E

How long have you been low carbing? FBG is often the last to come down (mine took an absolute age - at least a year). Post prandials and your overall averages are a better guide to BG control, in my opinion. I’d tend to agree with your point that your steadiness on low carb is something to celebrate - your FBG isn't terribly high in the great scheme of things.

Having said that, things that definitely have a favourable impact on my morning levels are - eating an early evening meal and not snacking later; eating fish rather than meat for an evening meal and decent exercise the day before.

Thank you for these suggestions!! I am going to try all three of these!
I have been low carb (in this 50-75g/day range) since July 2018, so well over a year. However, there is a catch here. Until April 2019 (209 days ago) I drank wine EVERY day. My story is an interesting one about the liver: when high-carb, I had a high FBG (the same as it is now, actually). When I went low carb in July 2018, my FBG came down pretty fast (I think a few months) - I was getting FBGs in the 70's and 80's!!!!! Then I quit drinking in April 2019 --- and zoom!!! up it went to 100-110 again. Fascinating how the alcohol masked my liver's insulin resistance. So perhaps I should give it a year from April 2019 before I huff and puff with frustration. I'm taking good care of myself now, and making the best choices that I can.

Also, your stats are so inspiring!!! What a wonderful story you've shared. When I worry about if I'm doing the right thing for my body with low carb, I am going to remember how it's changed your life so much.

 

[Auto E]

Hi @Auto E

How long have you been low carbing? FBG is often the last to come down (mine took an absolute age - at least a year). Post prandials and your overall averages are a better guide to BG control, in my opinion. I’d tend to agree with your point that your steadiness on low carb is something to celebrate - your FBG isn't terribly high in the great scheme of things.

Having said that, things that definitely have a favourable impact on my morning levels are - eating an early evening meal and not snacking later; eating fish rather than meat for an evening meal and decent exercise the day before.

Guess what?! I ate dinner at 4:30pm yesterday and my BG this morning was an unbelievable/beautiful/delightful 4.9mmol/L!
Also I just have to say that eating earlier seems to "fit" my hunger patterns/circadian rhythm better. So I think this could be a true change for me. We'll see if I can replicate this BG consistently with earlier eating times. Thanks again for encouraging me with that idea.

 

[Alexandra100]

Until April 2019 (209 days ago) I drank wine EVERY day

How many units? I ask because in the hopes of lowering my fasting bg I have recently started drinking the maximum recommended 2 units of alcohol with dinner in the form of dry red wine. The results of the first bottle are inconclusive.

 

[Alexandra100]

I've read that blood glucose of 140mg/dL (7.8mmol) begins vessel damage, so..... do you think my baseline of 5.5 - 6.1 is dangerous to my kidneys, for example?

Maybe have a look at Jenny Ruhl's article on bg levels here:
https://www.bloodsugar101.com/what-is-a-normal-blood-sugar
Here is Dr Bernstein on the subject:
"You will note that in some literature on diabetes, “normal” may be defined as 60–120 mg/dl, or even as high as 140 mg/dl. This “normal” is entirely relative. No nondiabetic will have blood sugar levels as high as 140 mg/dl except after consuming a lot of carbohydrate. “Normal” in this case has more to do with what is considered “cost-effective” for the average physician to treat. Since a postmeal (postprandial) blood sugar under 140 mg/dl is not classified as diabetes, and since the individual who experiences such a value will usually still have adequate insulin production eventually to bring it down to reasonable levels, many physicians would see no reason for treatment. Such an individual may be sent off with the admonition to watch his weight or her sugar intake. Despite the designation “normal,” an individual frequently displaying a blood sugar of 140 mg/dl is a good candidate for full-blown type 2 diabetes. I have seen “nondiabetics” with sustained blood sugars averaging 120 mg/dl develop diabetic complications."
You can read the whole chapter from Dr B's "Diabetes Solution" here:
http://www.diabetes-book.com/nondiabetic-versus-diabetic/

 

[Alexandra100]

I'm wondering if I should just rejoice in my steadiness (on low carb) and not worry about my elevated FBG

It is certainly the case that up to date writing on diabetes emphasises more and more "time in range" (the more the better) and bg variability (as small as possible). Of course what your targeted "range" is will be for you and maybe your Dr to decide. Obviously, the less ambitious one's target range, the more likely one is to keep to it. T1 Adam Brown at Diatribe writes quite a lot about this, using himself as an example:
https://diatribe.org/time-range-whats-achievable-goal-diabetes

 

[Auto E]

It is certainly the case that up to date writing on diabetes emphasises more and more "time in range" (the more the better) and bg variability (as small as possible). Of course what your targeted "range" is will be for you and maybe your Dr to decide. Obviously, the less ambitious one's target range, the more likely one is to keep to it. T1 Adam Brown at Diatribe writes quite a lot about this, using himself as an example:
https://diatribe.org/time-range-whats-achievable-goal-diabetes

Thank you for this link. I enjoyed this article! I actually have read his book, Bright Spots and Landmines. He's great.

 

[Alexandra100]

Thank you for this link. I enjoyed this article! I actually have read his book, Bright Spots and Landmines. He's great.

Agreed! Have you come across his "42 Factors that influence bg"? https://diatribe.org/42factors

 

[Auto E]

How many units? I ask because in the hopes of lowering my fasting bg I have recently started drinking the maximum recommended 2 units of alcohol with dinner in the form of dry red wine. The results of the first bottle are inconclusive.

I drank between 2 and 3 glasses a day. I think this is between 10-15 ounces, or (I had to look this up) I think 6-9 units!
My problem is I can't stop at 2 units. Ah, those lucky people that can moderate.

 

[Alexandra100]

I drank between 2 and 3 glasses a day. I think this is between 10-15 ounces, or (I had to look this up) I think 6-9 units!
My problem is I can't stop at 2 units. Ah, those lucky people that can moderate.

Thanks for sharing the info., though it is a bit discouraging for me, as I fear my modest 2 units will not have the same impact. Yes, I can consume moderate amounts of eg wine and chocolate, but I still have to watch out for sneaky carb creep. Usually just saying no is easier, but then there are so few things left I can eat. Do you read / listen to Gretchen Rubin on Happiness and habits?

 

[Auto E]

Maybe have a look at Jenny Ruhl's article on bg levels here:
https://www.bloodsugar101.com/what-is-a-normal-blood-sugar
Here is Dr Bernstein on the subject:
"You will note that in some literature on diabetes, “normal” may be defined as 60–120 mg/dl, or even as high as 140 mg/dl. This “normal” is entirely relative. No nondiabetic will have blood sugar levels as high as 140 mg/dl except after consuming a lot of carbohydrate. “Normal” in this case has more to do with what is considered “cost-effective” for the average physician to treat. Since a postmeal (postprandial) blood sugar under 140 mg/dl is not classified as diabetes, and since the individual who experiences such a value will usually still have adequate insulin production eventually to bring it down to reasonable levels, many physicians would see no reason for treatment. Such an individual may be sent off with the admonition to watch his weight or her sugar intake. Despite the designation “normal,” an individual frequently displaying a blood sugar of 140 mg/dl is a good candidate for full-blown type 2 diabetes. I have seen “nondiabetics” with sustained blood sugars averaging 120 mg/dl develop diabetic complications."
You can read the whole chapter from Dr B's "Diabetes Solution" here:
http://www.diabetes-book.com/nondiabetic-versus-diabetic/

Ugh. Well, on the bright side I'm keeping my average glucose below 120 right now. On the sad side, I already have chronic kidney disease. The nephrologist says he doesn't know what has caused my damage (since I'm only prediabetic), but it makes me suspect that my slightly elevated BG and reactive hypoglycemia is enough to cause damage for me personally.... we are all different. There is a lot of heart disease in my family, so perhaps we don't necessarily all develop diabetes (some have) but we do suffer the vascular complications.
I'm feeling pretty motivated to eat well and exercise right now. This CGM is really revolutionary for me.

PS I have read Dr. Bernstein's book a couple of times - that might be where I got this idea about even slightly elevated BG leading to complications. And thanks for the link to Jenny Ruhl. I remember seeing her website/materials sometime in the past, but wow - her website is amazing! I haven't looked at in years, and I thank you for pointing me back to it!

 

[Auto E]

Thanks for sharing the info., though it is a bit discouraging for me, as I fear my modest 2 units will not have the same impact. Yes, I can consume moderate amounts of eg wine and chocolate, but I still have to watch out for sneaky carb creep. Usually just saying no is easier, but then there are so few things left I can eat. Do you read / listen to Gretchen Rubin on Happiness and habits?

I've never heard of her. I will look her up now.

 

[Auto E]

I've never heard of her. I will look her up now.

Oooh, she has a podcast! I love podcasts on my walk/jogs!

 

[Alexandra100]

Oooh, she has a podcast! I love podcasts on my walk/jogs!

Me too! The Happiness podcast is great fun. It comes out weekly, with mini episodes in between which I don't like so much. I am now working my way through the whole backlog from podcast no.1 - years and years of it, it is like a superior kind of Soap! I shall be so sad when I finally arrive back at today.

 

[Alexandra100]

Me too! The Happiness podcast is great fun. It comes out weekly, with mini episodes in between which I don't like so much. I am now working my way through the whole backlog from podcast no.1 - years and years of it, it is like a superior kind of Soap! I shall be so sad when I finally arrive back at today.

Btw the Happiness podcast is a duet between Gretchen and her sister Elizabeth. To make things even more interesting, Elizabeth is a T1, diagnosed in adulthood and not brilliant at control!

 

[Alexandra100]

And thanks for the link to Jenny Ruhl. I remember seeing her website/materials sometime in the past, but wow - her website is amazing! I haven't looked at in years,

JR's website had a complete revamp no long ago. I'm so glad you share my respect for her.
Quote: I have read Dr. Bernstein's book a couple of times - that might be where I got this idea about even slightly elevated BG leading to complications.
It is true that Dr B sets a very high (or low!) standard for bg levels:
"I am convinced from my personal experience, from the experiences of my patients, and from reading the scientific literature, that people with normal blood sugars do not develop the long-term complications of diabetes." He goes on to say,
" I am further convinced that diabetics with even slightly elevated blood glucose profiles may eventually experience some of the long-term consequences of diabetes, but they will develop more slowly and likely be less severe than for people with higher blood sugars."
He was himself able to completely reverse his advanced kidney disease:
"I had begun testing my urine for protein and found substantial amounts of it, a sign, I had read, of advanced kidney disease. In those days—the middle and late 1960s—the life expectancy of a type 1 diabetic with proteinuria was five years. Back in engineering school, a classmate had told me how his nondiabetic sister had died of kidney disease. Before her death she had ballooned with retained water, and after I discovered my own proteinuria, I began to have nightmares of blowing up like a balloon.
By 1967 I had these and other diabetic complications and clearly appeared chronically ill and prematurely aged. I had three small children, the oldest only six years old, and with good reason was certain I wouldn’t live to see them grown."
In 2019 he is still alive and full of life, as we can judge from his monthly live Teleseminars.
It frustrates me that if I were a patient of Dr B I would almost certainly be feeling better and seeing better numbers because I would be using small doses of insulin. Some of us have bgs that can be managed perfectly with lifestyle, and some of us don't.

 

[Alexandra100]

things that definitely have a favourable impact on my morning levels are - eating an early evening meal and not snacking later; eating fish rather than meat for an evening meal and decent exercise the day before.

@Goonergal, all good ideas! Do you know why fish instead of meat makes a difference? Would chicken do, do you think?

 

[Auto E]

Btw the Happiness podcast is a duet between Gretchen and her sister Elizabeth. To make things even more interesting, Elizabeth is a T1, diagnosed in adulthood and not brilliant at control!

I'm already on episode 4! Thank you so much for this fun addition to my podcast collection! Also, I have a variety of podcasts I listen to, and I'm with you on not preferring the mini ones. I like longer podcasts. Indeed, my favorite one ever is Peter Attia The Drive. Super long! But great for a long walk!

 

[JohnH2019]

I'm already on episode 4! Thank you so much for this fun addition to my podcast collection! Also, I have a variety of podcasts I listen to, and I'm with you on not preferring the mini ones. I like longer podcasts. Indeed, my favorite one ever is Peter Attia The Drive. Super long! But great for a long walk!

Peter Attia has great info and is also part of the Primal lifestyle movement. I think it was Attia who had written an article about glycogen stores and exercise. Also Jason Fung has some good presentations on how it will take a while for the liver to adapt after changing to a lower carb lifestyle, and thus your glycogen stores impact. Primal Blueprint (Mark Sisson) also has a great set of free podcasts where they interview doctors, researchers, athletes, etc. all to improve quality of life:

https://blog.primalblueprint.com/