What's good BG on Keto?

[Dax40]

So - depending how deep you want to go down the rabbit hole, the 4.7gm sugars sounds great, but I read the ingredients list, and it's full of rapeseed oil, so that's a no-no immediately (as are a depressingly large number of things you find in jars).

I was about your weight - 2 inches taller and at my ideal weight when I was first diagnosed - BMI was fine.. but my triglycerides were off the chart, all my fat was hidden - and (I now know) where it was doing the most damage.

On of the most insidious things about diabetes treatment is the assumption that it's a thing that happens to overweight people, where there is growing evidence that becoming overweight is just one of the possible things that can happen when your hormones are out of balance for long enough.

What that creates is a sense of shock and resistance in the population of people who do not consider themselves overweight, because you get trapped in the thinking of "how can I reverse something I don't exhibit" - whereas once you understand that the problem is excess insulin - that's something you can work with.

Seed oils seem to be hard to avoid. I always try and use pure dairy butter much as I can.

The thing with my height is I have a short torso but long legs. My brother who's 6ft has the same leg size as me but taller longer torso.

My brother is also T2 but he has better numbers to me and even went into remission with just 2x500mg Metformin twice daily.

 

[Chris24Main]

For what it's worth - my kneecaps are in the wrong place..

I did a bit of a study for some department of ergonomics at university - and it turns out I have 95th percentile long thighs and 95th percentile short shins -so my kneecaps are in the wrong place. My daughter is in her late teens and still ribs me about that...

 

[Dax40]

This week down to 81KG but still have a problem with BG post meal. After 2 hours drops to 5s but at hour 3 rises to 6s and stays there for hour or two and then drops to 5s.

Like today ate total carb for meal was 4g.

 

[MrsA2]

This week down to 81KG but still have a problem with BG post meal. After 2 hours drops to 5s but at hour 3 rises to 6s and stays there for hour or two and then drops to 5s.

Like today ate total carb for meal was 4g.

That's not a problem. Well within range.

 

[Dax40]

Also to add ever since been on Keto diet I have seen improvements in other areas.

Drastically reduced Anxiety .

Blood pressure in the 118/75 range, before it was reaching 130/85 or above.

Feeling of mild euphoria.

 

[Dax40]

I have noticed that if I eat a high Protein meal my BG stays in the 6s all day and first time in weeks got 6.4 BG in the morning. I eat a lot of chicken one day and next day large steak. I know now I need to reduce high protein and balance it with fat. I am guessing Protein is causing my BG to stay in the 6s.

 

[Chris24Main]

@Dax40 - protein gets very complicated, and there are multiple viewpoints, so getting a balanced sense of what's important is tricky. Depending on what sources you go to, you may get the sense that, especially as we get older, we need as much protien as possible, or if we are prioritising Keto, then anything above "adequate" protien is problematic. The sources I tend to trust always talk about prioritising protein as being rule number 1, but personally I have yet to figure out exactly how I feel myself.

I think your phrase about reducing high protein and balancing with fat gets it right though. One surprising fact I stumbled across recently is that we are much better at extracting nutrients from protein when there is a balance of fat, quite simply because the bile resultant also helps break down the protein...

That speaks loudly to me that our systems have evolved to deal with protein and fat together.

Similarly, studies of insulin response to high protein (by itself or with carbs) show much higher levels of insulin than when you take in protein and fat together. (meaning, if you are prioritising lowering insulin as I do, then lots of protein on it's own is no good)

So, for me, I find that I'm increasingly steering away from lower fat mince, and chicken breast fillets - things that I would have gravitated toward a year or so ago.

High meat content burgers are something I find myself coming back to... Learning to cook a good steak has been one of the bigger positives for me this last year or so.

 

[Dax40]

@Dax40 - protein gets very complicated, and there are multiple viewpoints, so getting a balanced sense of what's important is tricky. Depending on what sources you go to, you may get the sense that, especially as we get older, we need as much protien as possible, or if we are prioritising Keto, then anything above "adequate" protien is problematic. The sources I tend to trust always talk about prioritising protein as being rule number 1, but personally I have yet to figure out exactly how I feel myself.

I think your phrase about reducing high protein and balancing with fat gets it right though. One surprising fact I stumbled across recently is that we are much better at extracting nutrients from protein when there is a balance of fat, quite simply because the bile resultant also helps break down the protein...

That speaks loudly to me that our systems have evolved to deal with protein and fat together.

Similarly, studies of insulin response to high protein (by itself or with carbs) show much higher levels of insulin than when you take in protein and fat together. (meaning, if you are prioritising lowering insulin as I do, then lots of protein on it's own is no good)

So, for me, I find that I'm increasingly steering away from lower fat mince, and chicken breast fillets - things that I would have gravitated toward a year or so ago.

High meat content burgers are something I find myself coming back to... Learning to cook a good steak has been one of the bigger positives for me this last year or so.

Thank you

I will be restricting high protein meal to once a week and most of the time eat cheese, eggs, bacon, sausages as that was working good for me and lowered my BG to the 4s and 5s most of the day.

The steak I eat is mainly lean as I don't like the biting into the fatty parts.

 

[Dax40]

Also should I get a new BG monitor the one I have True Metrix Air is over 5 years old which I purchased in 2019.

Could having a old monitor give weird results?

 

[Chris24Main]

It sounds like the results you are getting are fine, is there any reason to suspect them?

I get what you mean about biting into the fatty bits of steak though - I'm on something of a journey there too.. I think I would have gagged quite often attempting to eat somethings I do now, it's amazing the ability to alter what we think of as normal.

If you are in the market for a new BG monitor, at least have a think about a ketone monitor rather than buying a new glucose monitor. Speaking only from experience, I think the more you recognise T2DM as in imbalance with insulin, and the whole Keto thing being about Ketosis (which is mainly shut down under elevated insulin) - I'm as much interested in measuring levels of Ketone bodies (as a marker of insulin level).

Just a suggestion though -

 

[Dax40]

It sounds like the results you are getting are fine, is there any reason to suspect them?

I get what you mean about biting into the fatty bits of steak though - I'm on something of a journey there too.. I think I would have gagged quite often attempting to eat somethings I do now, it's amazing the ability to alter what we think of as normal.

If you are in the market for a new BG monitor, at least have a think about a ketone monitor rather than buying a new glucose monitor. Speaking only from experience, I think the more you recognise T2DM as in imbalance with insulin, and the whole Keto thing being about Ketosis (which is mainly shut down under elevated insulin) - I'm as much interested in measuring levels of Ketone bodies (as a marker of insulin level).

Just a suggestion though -

Thanks will think about getting a ketone monitor.
The reason I have little doubts about the results is age of the monitor. I might need to order one of those calibration solutions which are rather cheap from eBay.

 

[Dax40]

Last night before bed BG was 4.4
This morning BG 5.0

Ate
1x egg fried in Butter
2x Cumberland Sausages
3x Bacon
6x Baby Tomatoes covered in olive oil.

90 minutes post meal 6.4
2 hours 5.4
3 hours 5.0

Definitely seeing improvements did not experience the 3 hour post meal spike.

 

[Chris24Main]

So - depending on the ingredients list on the sausages - the only thing there that will have any effect on blood glucose or insulin is the tomatoes, but that's all good (some sausages are loaded with starch).

If you understand that I'm in no way being critical, I was just thinking about your initial question and how we skew towards the things that we're aware of and the things we can measure; the history of the treatment of Diabetes actually tracks along the same lines..

Yet - type 2 diabetes is much more associated with levels of insulin, and Keto lifestyles are much more about levels of ketones. Clearly, the first thing to do is get your blood glucose under control, but once you are generally around 5.5 and not spiking - for me anyway, it's much more about long term health and how fueling your body and brain on ketones more often that glucose.

I'm pressing the point, simply because the things you are saying feel very close to the things I was questioning; this may be of no interest to you whatever, and my obsession with measuring ketones as well as blood glucose is pretty niche, even for this forum; so I don't present it in any way as being mainstream; it just makes sense to me.

But - pretty soon I think you are going to find that the variation in your blood glucose is pretty small. That is a good thing - no question. But - for me, I know that I want to know that I'm still on a good trajectory, and while my blood glucose has plateaued (at a better than "normal" level) - my ketones are getting higher week on week - just a little, but it's there...

and if ketones are increasing, my underlying insulin levels must be low - so my insulin resistance must be reversing; and (at least as I understand the entirety of this condition) - that's the long game.

 

[Dax40]

So - depending on the ingredients list on the sausages - the only thing there that will have any effect on blood glucose or insulin is the tomatoes, but that's all good (some sausages are loaded with starch).

If you understand that I'm in no way being critical, I was just thinking about your initial question and how we skew towards the things that we're aware of and the things we can measure; the history of the treatment of Diabetes actually tracks along the same lines..

Yet - type 2 diabetes is much more associated with levels of insulin, and Keto lifestyles are much more about levels of ketones. Clearly, the first thing to do is get your blood glucose under control, but once you are generally around 5.5 and not spiking - for me anyway, it's much more about long term health and how fueling your body and brain on ketones more often that glucose.

I'm pressing the point, simply because the things you are saying feel very close to the things I was questioning; this may be of no interest to you whatever, and my obsession with measuring ketones as well as blood glucose is pretty niche, even for this forum; so I don't present it in any way as being mainstream; it just makes sense to me.

But - pretty soon I think you are going to find that the variation in your blood glucose is pretty small. That is a good thing - no question. But - for me, I know that I want to know that I'm still on a good trajectory, and while my blood glucose has plateaued (at a better than "normal" level) - my ketones are getting higher week on week - just a little, but it's there...

and if ketones are increasing, my underlying insulin levels must be low - so my insulin resistance must be reversing; and (at least as I understand the entirety of this condition) - that's the long game.

Thank you

I know I still have long way to go and more hard work to do. I know now that I have to avoid high protein meals and add more fat.

In January I have booking with the Diabetic nurse which will also be taking blood for Hba1c.

Should I request a fasting insulin test? Whiles still been on Keto, thinking been on Keto for 3 months at that time might not give realistic results say I were not on Keto.

 

[Chris24Main]

That's a hell of a good question...

Be prepared, though, for the reaction to be closer to panic that you may be inducing Ketoacidosis - But by January you will be so well informed that you can have a perfectly pleasant conversation about it, not like the knuckle-whitening argument I had...

but - if I can drop that neatly for the moment and answer your question...

It's difficult to say what you should be expecting.

If you were a person in top metabolic health, and you embarked on a Ketogenic regime (understanding that this is not just a diet) - you would expect high levels of ketones.

If you were undergoing Ketogenic therapy for a mental disorder, you might expect very high levels of ketones.

But - if your starting point is T2DM diagnosis, then your body is trained to operate on sugar for fuel (by definition you must have elevated insulin, and insulin resistance - that makes ketosis difficult) - so you can substantially reduce your intake of starches and sugars... and your liver just compensates by producing more..

[usual caveat, absent any other pathology that's affecting insulin production in the pancreas]

so - it takes time; you can make rapid progress with blood glucose, but it takes time to "re-train" your body to expect to operate on a lower level of blood glucose, and instead, work with ketones. There are different ways of saying this that are more medical, because of course organs cannot be "trained" like a dog, but it's close enough that the metaphor works.

In other words, I believe that a Ketogenic regime coupled with intermittent fasting is the most effective way to reverse insulin resistance, but you have to be doing it for that reason, not expecting any significant level of Ketosis - for maybe a year, maybe two... but that's ok, because you can relax more about the pace - it doesn't need to happen overnight, and I`ve found that the general improvement in all sorts of other health markers are substantial to the point of being unbelievable.

 

[Dax40]

That's a hell of a good question...

Be prepared, though, for the reaction to be closer to panic that you may be inducing Ketoacidosis - But by January you will be so well informed that you can have a perfectly pleasant conversation about it, not like the knuckle-whitening argument I had...

but - if I can drop that neatly for the moment and answer your question...

It's difficult to say what you should be expecting.

If you were a person in top metabolic health, and you embarked on a Ketogenic regime (understanding that this is not just a diet) - you would expect high levels of ketones.

If you were undergoing Ketogenic therapy for a mental disorder, you might expect very high levels of ketones.

But - if your starting point is T2DM diagnosis, then your body is trained to operate on sugar for fuel (by definition you must have elevated insulin, and insulin resistance - that makes ketosis difficult) - so you can substantially reduce your intake of starches and sugars... and your liver just compensates by producing more..

[usual caveat, absent any other pathology that's affecting insulin production in the pancreas]

so - it takes time; you can make rapid progress with blood glucose, but it takes time to "re-train" your body to expect to operate on a lower level of blood glucose, and instead, work with ketones. There are different ways of saying this that are more medical, because of course organs cannot be "trained" like a dog, but it's close enough that the metaphor works.

In other words, I believe that a Ketogenic regime coupled with intermittent fasting is the most effective way to reverse insulin resistance, but you have to be doing it for that reason, not expecting any significant level of Ketosis - for maybe a year, maybe two... but that's ok, because you can relax more about the pace - it doesn't need to happen overnight, and I`ve found that the general improvement in all sorts of other health markers are substantial to the point of being unbelievable.

Thank you

I have ordered a Ketone blood monitor and see my levels and the ketone strip tests seem to be more expensive than the BG strips.

As long as I stick to mainly balanced fat and protein diet with one meal a day I find my BG to be in the 4s and low 5s most of the day and heading slowly to <74kg goal (81 kg currently).

On a side note my brother got his Hba1c today and he's was 41 I don't understand how he does it considering he is heavier then me (91kg) and on 1x Metformin twice a day and eats the way I use to. I am guessing his height has something to do with it.

He responds very well to Metformin where as for me it did nothing.

 

[lovinglife]

Last night before bed BG was 4.4
This morning BG 5.0

Ate
1x egg fried in Butter
2x Cumberland Sausages
3x Bacon
6x Baby Tomatoes covered in olive oil.

90 minutes post meal 6.4
2 hours 5.4
3 hours 5.0

Definitely seeing improvements did not experience the 3 hour post meal spike.

Those numbers are smashing! - personally I don’t test at 90 minutes as everyone, diabetic or not will get a rise often higher than 6.4, the important number is the 2 hr after first bite ideally you are back to where you were (which you were allowing for meter accuracy) or a rise of less than 2. All those numbers are very much in the none diabetic range which proves it was an excellent meal for you

If I got the result I was expecting at 2 hours and I was happy with that number and was where I expected to be I wouldn’t bother with the 3hr test either. I only test at 3 hours if I’ve had a too high number at 2hrs - but saying that if I’ve tested a meal a couple of times and I’ve had a higher than liked number at 2 hrs I probably wouldn’t eat that meal again anyway

 

[KennyA]

Thank you

I know I still have long way to go and more hard work to do. I know now that I have to avoid high protein meals and add more fat.

In January I have booking with the Diabetic nurse which will also be taking blood for Hba1c.

Should I request a fasting insulin test? Whiles still been on Keto, thinking been on Keto for 3 months at that time might not give realistic results say I were not on Keto.

You'll have to carb up for a few days before an OGTT, if they allow you to have one. The issue with OGTTs is cost - they need several staff for a lengthy period (I understand largely to ensure the testee doesn't eat anything). I've never had one, which is not to say I wouldn't have been very interested in the results.

On ketones and testing - I find the pee sticks are accurate enough (basically results for ketones are no, yes, and "a lot") and much less expensive.

 

[Dax40]

Those numbers are smashing! - personally I don’t test at 90 minutes as everyone, diabetic or not will get a rise often higher than 6.4, the important number is the 2 hr after first bite ideally you are back to where you were (which you were allowing for meter accuracy) or a rise of less than 2. All those numbers are very much in the none diabetic range which proves it was an excellent meal for you

If I got the result I was expecting at 2 hours and I was happy with that number and was where I expected to be I wouldn’t bother with the 3hr test either. I only test at 3 hours if I’ve had a too high number at 2hrs - but saying that if I’ve tested a meal a couple of times and I’ve had a higher than liked number at 2 hrs I probably wouldn’t eat that meal again anyway

Thank you

I check hour 3 becuae it seems to creep up to the 6s after it been in the 5s and at hour 4 dropping to 5s.

Hour 3 spike might indicate the slow absorption of protein or protein been converted to glucose.

 

[lovinglife]

But numbers aren’t linear - there are many reasons our BG goes up & down, even something simple like bumping your elbow can give a rise in BG, and being in the 6s at 3 hrs after food isn’t a spike
I’m going to tag @KennyA who can explain what is and isn’t a spike far better than me