What's good BG on Keto?

Dax40

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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.
If I have to carb up I might have to delay it for a fasting insulin test as I don't want to break my diet and start having carb cravings and still think I have a long way to go. Likely request it for towards end of 2025.

I use to use those pee sticks a decade ago when I was doing keto. I read Ketone monitor is more accurate and likely test few times week.
 

KennyA

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If I have to carb up I might have to delay it for a fasting insulin test as I don't want to break my diet and start having carb cravings and still think I have a long way to go. Likely request it for towards end of 2025.

I use to use those pee sticks a decade ago when I was doing keto. I read Ketone monitor is more accurate and likely test few times week.
I understand that if you're on low carb/keto they want you out of ketosis before the OGTT, so that the insulin response gets into gear and has a bit of practice before the test.

The ketone monitor will be way more accurate than the pee sticks. Even though my glucometer will accept ketone strips, I've never bothered paying for them because the no/yes/a lot is more than good enough for my purposes.
 
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Dax40

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I understand that if you're on low carb/keto they want you out of ketosis before the OGTT, so that the insulin response gets into gear and has a bit of practice before the test.

The ketone monitor will be way more accurate than the pee sticks. Even though my glucometer will accept ketone strips, I've never bothered paying for them because the no/yes/a lot is more than good enough for my purposes.
I did ask on the phone to Diabetic nurse and they made a face to face appointment for the blood test but did not mention I had to carb up.

Maybe they might not do and just do the HbA1c and the cholesterol and ALT test as before.
 

Dax40

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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 :)
Hour 3 seems to be the only time during the day(apart from 90 minutes post meal) that goes up to 6s and after hour 4 it's the 4s or low 5s.

Few days ago for 2 days I ate high protein meal and my BG was in the 6s all day those 2 days.

My goal is to be more insulin sensitive with a healthy weight.
 

KennyA

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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 :)
I dislike using the word "spike" for a normal and expected rise in BG after eating anything carby. My example is that I can go from 5.2 to 9.6 in 30 minutes, and back to 5.2 by 1 hr. That's caused by the lactose in one small latte.

If you look at CGM graphs - there are thousands on the internet - you'll see ups and downs in each, often associated with food but also things like stress, ambient temperature, exercise, illness etc. This applies equally to diabetics and non-diabetics alike. The first graph attached below is from someone who didn't eat anything all day, but had a very stressful day - and whose liver responded to stress by creating and dumping (comparatively) large amounts of glucose. The second is someone without diabetes, and BG goes up and down as expected. Personally, I can find it very hard to consistently tell from a graph whether it's someone with T2 or not. Some are obvious - many much less so.

The body will normally only start to convert protein to glucose once other sources of glucose are exhausted. You'd be in a serious state if that was the case. Third pic shows how the body obtains glucose (image from Bilous and Donnelly's Handbook of Diabetes) - NIMGU is Non-Insulin Mediated Glucose Uptake - ie the cells that don't need insulin to absorb and use glucose. The bit in the bottom left is how the liver produces glucose itself.

Your numbers look OK to me and if they're rising in the third and fourth hour after eating, I'd suspect that it's your liver doing its best to get back to levels it still thinks you should be at. It took about six months for my liver to recognise that something had changed, and I was still getting liver-driven readings in the sixes after a year. After food, I was usually fours or low fives, but after a period without eating my liver was pushing me higher.

Does that help?
 

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Dax40

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Type of diabetes
Type 2
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Diet only
I dislike using the word "spike" for a normal and expected rise in BG after eating anything carby. My example is that I can go from 5.2 to 9.6 in 30 minutes, and back to 5.2 by 1 hr. That's caused by the lactose in one small latte.

If you look at CGM graphs - there are thousands on the internet - you'll see ups and downs in each, often associated with food but also things like stress, ambient temperature, exercise, illness etc. This applies equally to diabetics and non-diabetics alike. The first graph attached below is from someone who didn't eat anything all day, but had a very stressful day - and whose liver responded to stress by creating and dumping (comparatively) large amounts of glucose. The second is someone without diabetes, and BG goes up and down as expected. Personally, I can find it very hard to consistently tell from a graph whether it's someone with T2 or not. Some are obvious - many much less so.

The body will normally only start to convert protein to glucose once other sources of glucose are exhausted. You'd be in a serious state if that was the case. Third pic shows how the body obtains glucose (image from Bilous and Donnelly's Handbook of Diabetes) - NIMGU is Non-Insulin Mediated Glucose Uptake - ie the cells that don't need insulin to absorb and use glucose. The bit in the bottom left is how the liver produces glucose itself.

Your numbers look OK to me and if they're rising in the third and fourth hour after eating, I'd suspect that it's your liver doing its best to get back to levels it still thinks you should be at. It took about six months for my liver to recognise that something had changed, and I was still getting liver-driven readings in the sixes after a year. After food, I was usually fours or low fives, but after a period without eating my liver was pushing me higher.

Does that help?
Thank you for the explanation that helps greatly :)
 
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Dax40

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Today got my Ketone meter and did a test 2 hours after I ate

4x eggs cooked in alot of butter
Coleslaw, 15 grams carb

2 hours
5.8 BG
4.8 Ketones
 

Chris24Main

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Wow - great starting point. Is that a breath meter with ketone bodies in ppm?

Let me say first that there is no "right" way to do this, but I was sure that over time I should expect to see a drop in average blood glucose, and fasting ketones - so I measure both as soon as I get up.
There are lots of good reasons for measuring at other times, I just figure that I'm more likely to be consistent with measuring first thing - so I suspect my level of Ketosis during the day is much higher, but I'm only looking for a trend I can believe in;
1732115554110.png


So - that's me over a period of time between July and now.
Just for reference - you'll have to figure out how best to use your monitor (I was taking results at all sorts of times, but eventually dropped into this habit, which I've kept going).

Also - having been super focused on blood glucose spikes for so long, I was surprised to discover that ketone production doesn't work the same way - for me anyway.. this is what got me into thinking that most of what we think of as our body's glucose control is actually about production of glucose when the body needs it, and that the "removal" phase we associate with is more like a "panic! - bail out this glucose!!" response than what we may think of as "control"... but that's definitely just my opinion.

I'd be fascinated to see where you go from here...
 
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Dax40

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Wow - great starting point. Is that a breath meter with ketone bodies in ppm?

Let me say first that there is no "right" way to do this, but I was sure that over time I should expect to see a drop in average blood glucose, and fasting ketones - so I measure both as soon as I get up.
There are lots of good reasons for measuring at other times, I just figure that I'm more likely to be consistent with measuring first thing - so I suspect my level of Ketosis during the day is much higher, but I'm only looking for a trend I can believe in;
View attachment 70696

So - that's me over a period of time between July and now.
Just for reference - you'll have to figure out how best to use your monitor (I was taking results at all sorts of times, but eventually dropped into this habit, which I've kept going).
The meter I have is a blood ketone meter.
I will likely test it few times a week maybe upon waking?

The strips seem rather pricey a bit pricey 50x for £40 or 100 for £80. I get my BG stripes 100 for around £30-£40 from ebay.

The ketone monitor I have is called, On Call GK Dual
 

Chris24Main

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Right - thanks - yes, I went for a breath monitor for that reason...
So - 4.8 mmol/L ? if that is correct, you are measuring twice as high as my highest measurement...
This is where you can see the massive gulf between T1 and T2 - if that was a T1 - it would be life threatening

[because - just not to appear sensationalist - insulin basically stops ketone production in it's tracks - the kind of ketone production that worries type 1s is when the level of glucose is massively high, but the body cannot "see" it without insulin, so as a survival mechanism it starts to produce ketones to use for energy... but there is nothing to regulate that without insulin, so it keeps going well past the point of what is needed - this is not at all what is happening when the pancreas can produce insulin]
 
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Dax40

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Right - thanks - yes, I went for a breath monitor for that reason...
So - 4.8 mmol/L ? if that is correct, you are measuring twice as high as my highest measurement...
This is where you can see the massive gulf between T1 and T2 - if that was a T1 - it would be life threatening

[because - just not to appear sensationalist - insulin basically stops ketone production in it's tracks - the kind of ketone production that worries type 1s is when the level of glucose is massively high, but the body cannot "see" it without insulin, so as a survival mechanism it starts to produce ketones to use for energy... but there is nothing to regulate that without insulin, so it keeps going well past the point of what is needed - this is not at all what is happening when the pancreas can produce insulin]
It's in mmol. I think it be high as I only eat once a day with 1000 calories or less.
 

Chris24Main

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Ok - got it - and I agree, you would be in very stable ketosis on that regime. That's pretty hard core; but if it works, it works.
But - I'll stop drawing comparisons, you are on a very different trajectory than me; and kudos for that - do your thing.
 
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Dax40

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Ok - got it - and I agree, you would be in very stable ketosis on that regime. That's pretty hard core; but if it works, it works.
But - I'll stop drawing comparisons, you are on a very different trajectory than me; and kudos for that - do your thing.
Thank you.

Because I don't have carb cravings, my appetite has plummeted and can go long time without eating.

I will stick with my goal of getting to <74kg and after stick to a mostly low carb diet and only indulge once in a while. I will also always monitor my weight make sure it's not going up or too low.
 

ianf0ster

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@Dax40 I'm not sure if this has been mentioned already, but it isn't advisable to stay on a very low calorie diet for too long- most of them say just to do it for 8 to 12 weeks otherwise its possible for deficiencies to occur. The fact that you are low carbing and also fasting means that your BG will remain low and you will still lose weight (but slower) without restricting calories.

Very low calories for a longer period of time can also damage you Resting Metabolic Rate, making weight much harder to lose in future. This is the cause of YoYo dieting where weight lost is quickly recovered once the restrictions are eased.

The journey we are on for a healthy weight, blood Glucose, blood pressure, mental state etc. is a marathon, not a sprint - the more it is treated as a sprint, the less likely we are to have good long term results.
 
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Dax40

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@Dax40 I'm not sure if this has been mentioned already, but it isn't advisable to stay on a very low calorie diet for too long- most of them say just to do it for 8 to 12 weeks otherwise its possible for deficiencies to occur. The fact that you are low carbing and also fasting means that your BG will remain low and you will still lose weight (but slower) without restricting calories.

Very low calories for a longer period of time can also damage you Resting Metabolic Rate, making weight much harder to lose in future. This is the cause of YoYo dieting where weight lost is quickly recovered once the restrictions are eased.

The journey we are on for a healthy weight, blood Glucose, blood pressure, mental state etc. is a marathon, not a sprint - the more it is treated as a sprint, the less likely we are to have good long term results.
Thank you

I will likely increase calories a bit and divide it to 2 meals a day in a few weeks time.
 

Dax40

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Today 7th week on Keto
Weight down to 80.4KG

Had a late meal with 16grams carbs, earlier on the day ate some peanuts.
Post 2 hour
BG 4.8
Ketones 5.3mmol
 

Dax40

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Today my BG not dropping below 6 after 6 hours after eating. My morning BG was 4.8

I ate minced beef cooked with some onions and spices then mixed with cheese melted.

My Ketones are high at 5.6 mmol.

Could it be my insulin is not rising enough?
 

Chris24Main

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No idea to be honest, as @ianf0ster said, low carb and low calorie at the same time isn't something I understand ... well, I personally would worry about getting enough nutrition, lowering metabolism, losing muscle, and basically going into starvation mode.

Your liver will produce glucose (from anything, basically, once it has run out of stored glycogen, if it needs to) as well as ketones.. for my money, low-carb high-fat works, because you are aligning your body with energy management based on fat. I don't think I know enough to really say anything useful about your regime, which is not the same because you are restricting energy as well as carbs.

Even when I was fasting every odd day, I was eating totally normally on eating days, though many of my meals would be along the lines you suggest - mince, spices and cheese; fantastic. But I'm having bacon and eggs and sausage for breakfast as well, with some clotted cream and dark chocolate for desert, and usually some salami and cheese for lunch. I often have halloumi "chips" with whatever meat I'm eating. At the moment I'm fasting maybe once a fortnight, and just kind of mixing it up - I'll miss breakfast one day, lunch another, occasionally dinner, but I don't limit myself at all when I'm eating and most days I will have at least two meals - as long as the insulin is low, I'm not storing energy as fat, I'm burning what I need and converting much of the rest into ketones, but my ketone levels are much lower than yours. I'm never really hungry - though I do try to eat in the morning if I wake up hungry.

But - I'm firmly in the camp of "low calorie is just hardship for no benefit"- just to aknowledge my bias. I'm definitely not saying that as if it's fact - only that for me, I followed strict calorie restriction for 3 years - then I was diagnosed as diabetic, so it definitely did not work for me.
 
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Dax40

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No idea to be honest, as @ianf0ster said, low carb and low calorie at the same time isn't something I understand ... well, I personally would worry about getting enough nutrition, lowering metabolism, losing muscle, and basically going into starvation mode.

Your liver will produce glucose (from anything, basically, once it has run out of stored glycogen, if it needs to) as well as ketones.. for my money, low-carb high-fat works, because you are aligning your body with energy management based on fat. I don't think I know enough to really say anything useful about your regime, which is not the same because you are restricting energy as well as carbs.

Even when I was fasting every odd day, I was eating totally normally on eating days, though many of my meals would be along the lines you suggest - mince, spices and cheese; fantastic. But I'm having bacon and eggs and sausage for breakfast as well, with some clotted cream and dark chocolate for desert, and usually some salami and cheese for lunch. I often have halloumi "chips" with whatever meat I'm eating. At the moment I'm fasting maybe once a fortnight, and just kind of mixing it up - I'll miss breakfast one day, lunch another, occasionally dinner, but I don't limit myself at all when I'm eating and most days I will have at least two meals - as long as the insulin is low, I'm not storing energy as fat, I'm burning what I need and converting much of the rest into ketones, but my ketone levels are much lower than yours. I'm never really hungry - though I do try to eat in the morning if I wake up hungry.

But - I'm firmly in the camp of "low calorie is just hardship for no benefit"- just to aknowledge my bias. I'm definitely not saying that as if it's fact - only that for me, I followed strict calorie restriction for 3 years - then I was diagnosed as diabetic, so it definitely did not work for me.
Thank you

I will on the 10th week go back to eating 2,000 calories and see what BG and Ketones look like then. I am currently heading towards the 8th week on Thursday.

The other day I ate the spiced minced beef with spices and onions and put on a bed of half a Aubergine and then covered with cheese and baked to melt cheese. This did not raise my BG much and 4th hour it was in the normal range.