Would you be happy with these numbers?

I've been eating keto/low carb for the last almost 6 months after having gestational diabetes. My baby is just over 3 months old now and I just thought I would try to add a few carbs back to see how my body copes with them.

Whenever I've had anything more than the small amount of carbs that you might have on keto, I was still getting spikes a bit higher than I like to see - I dared to have a couple of pieces of a bacon bread that my husband made - not his usual sourdough but one with a high GI white flour - and my 1h was 10.1 and 2h was 9.7 still. I wasn't happy.

So the past few days I've been intentionally having a few extra carbs but only small quantities with each meal to see if my insulin resistance (to what I think is eating keto) calms down a bit, just to know I can still cope with carbs if I have to.

So I made some steel cut oats. First time in 4 years that I've had porridge after working out that it gives me heartburn and probably was a major trigger for the past 20 years. I always did love porridge though.

Anyway, this time I wanted to eat oats to see if I spike, and if not, I was going to experiment to see if they change my cholesterol levels. (My cholesterol levels are a bit high - doc prescribed statins but I've read enough not to be tempted to take them. Also not 100% convinced either way about what good cholesterol looks like yet. I haven't had my small LDL or particles counted yet, nor have I checked for Lipoprotein a (little a), which I'm hearing are the things that you actually have to worry about more rather than just total cholesterol and LDL anyway.)

So I ate a proper bowl full of the steel cut oats. I was going to have just 100g cooked but it looked so measly in my bowl so I took a chance and had 250g instead. I added cream and half a teaspn of honey even.

My readings were as follows:

1h before eating 4.6 mmol
30mins after 5.4
1h 6.8
1.5h 7.7
2h 7.2
2.5h 5.9

For some reason, both times today when I added carbs today, the spike came later, between 1.5 and 2 hours rather than at the 1h mark. Is that a diabetic response still (in my case probably due to keto eating still) or is that a normal low GI carb response?

And would you be happy with these numbers if you ate some carbs or would you eat a smaller quantity or avoid altogether?

Sorry for those who won't touch oats anymore. I understand they can really spike some people.

HSSS said:

So that looks like a 3mmol rise to me. That means no I wouldn’t eat the porridge or I’d ditch the honey and have half the amount and retest another day. Would it still be worthwhile? Not for me.

You seem to be assuming that any reaction to carbs is physiological due to keto rather than the possibility that you have remained (type 2 now) diabetic post pregnancy. Or are you still trying to test out which it is? I understand from other posts that it takes a few days of increasing carbs to overcome the physiological effects to then be able to see what a “true” reaction is so maybe it’ll take a few more days experimenting and repeating tests to see if the response is consistent or improves before you can answer this for yourself.

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I worried I might have been at least an undiagnosed prediabetic before my last pregnancy so I was half expecting that things would not improve much after giving birth. It's been hard to say what's going on exactly because I was eating keto/low carb and I did increase my carbs for a couple of days before my follow up GTT at 8 weeks postpartum (5 or 6 weeks ago now), but I don't think I ate enough carbs prior so my test results were a bit weird:

Fasting 4.4 mmol (even though that morning on waking I had 5.0 on my own metre and it was another couple of hours of fasting before I got to do the actual test).
1h 12.1 mmol (I got 13.8 on my own metre, which I used during the test)
2h 6.5 mmol (I had 7.5 on my metre).
3h 3.6 mmol (at home on my own metre), so a bit of a post carb crash as well.

Maybe my metre reads higher as well, I dunno...

I had a fasting insulin of 6.3 mU/L on the same day. I'm not sure how high my insulin might have been before I started keto though or whether 5 - 6 month of keto can change your fasting insulin that much. For the first 3 months (while still pregnant) I was on insulin too though.

In Australia they didn't diagnose me with anything with those results but just put a note saying I could be glucose intolerant (because the 12.1 was high) and to test again in a year...

I didn't intend on going back to the carbs I was eating beforehand anyway. I'm just adding a few more carbs as an experiment and also to give myself a break from the constant dehydration while I am eating keto and breastfeeding.

But as you say, you really don't want more than a 2 mmol rise after a meal, right? And being up in the 7s is not something you want to do everyday either if you can keep it between 4 and 6 mmol, right?

I also wonder about the later spike too. That doesn't seem like the healthiest response since it allows the levels to remain elevated a bit longer as well.

I guess a HbA1c will tell me more whenever I get around to do my first one.

Sapien said:

FG 4.4 (79) and FI 6.3 is a HOMA-IR of 1.2. Reasonably healthy but ideal is below 1.0.

https://www.thebloodcode.com/homa-ir-calculator/

I would be concerned about the spikes and try to avoid eating a quantity of specific carbs that sent my BG over 6.7 at one hour or 6 at two hours. CGM studies seem to show the the healthiest people see rises up to 120 (6.7) with high carbs but drop back to baseline rather quickly. That your meter might read high gives a nice margin of error.

My experience is that fats (like the cream on your oatmeal) lower the rise but also lengthen it, so the peak could be at two hours instead of one hour.

My experience is the rise is usually much larger in the morning than evening. I have tested eating leftovers from dinner for breakfast and will see a bigger rise after breakfast. I do much better with carbs at lunch or dinner than at breakfast.

Exercise also makes a dramatic favorable difference whether the exercise is before eating or after eating. When I exercise before eating, I find that my BG will barely rise and sometimes fall after eating. Exercise after eating usually brings a drop. Exercise on an empty stomach sometimes causes s small rise in BG.

I simply limit portion size of carbs (except non-starchy vegetables). I now treat starchy carbs as a side dish rather than as part of the main course.

Saturated fat seems to worsen insulin resistance and also raise LDL (Apo B particles as well). LDL might not be that important but particle count seems to be.

https://peterattiamd.com/the-straight-dope-on-cholesterol-part-vi/

I have heard lots of people say that Substituting olive oil for butter, avocado for cheese, salmon and sardines for beef, etc. make a huge improvement in their cholesterol profile.

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I've heard that Peter Attia podcast just recently actually. I'm not sure whose theory to go with. Have you seen Ken Sikaris?

HSSS said:

So that looks like a 3mmol rise to me. That means no I wouldn’t eat the porridge or I’d ditch the honey and have half the amount and retest another day. Would it still be worthwhile? Not for me.

You seem to be assuming that any reaction to carbs is physiological due to keto rather than the possibility that you have remained (type 2 now) diabetic post pregnancy. Or are you still trying to test out which it is? I understand from other posts that it takes a few days of increasing carbs to overcome the physiological effects to then be able to see what a “true” reaction is so maybe it’ll take a few more days experimenting and repeating tests to see if the response is consistent or improves before you can answer this for yourself.

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How about this rise today?
I tried again with a smaller amount of oats (maybe 100g instead of 250g) and this is the same lot I made the other day and I reheated it. Not sure if it becomes resistant starch and makes it any better for the blood sugar. I didn't wait the full two hours before eating the rest of my usual breakfast of 2 eggs, 1/4 avocado, cheese and sauerkraut because I never intended to have a breakfast of only carbs since I get too hungry too soon again (breastfeeding).

But here's what happened:

Oh yeah, since I have been eating a few carbs again the past few days, I notice it hits my morning fasting levels, which I am also unhappy about.

9am 5.3 mmol fasting
9:30am I ate about 100g of reheated steel cut oats (with milk and the smallest amount of honey had been mixed through)
10am 7.5 mmol at 30 mins post (this is already higher than some would accept, isn't it?)
10:15am I ate 2 eggs, 1/4 avocado, cheese, sauerkraut,
10:30am 5.3 mmol 1h post
11am 4.8 mmol 1.5h post
11:30am 4.9 mmol 2h post

So again, into the 7s but an early spike at 30 mins.
The difference was that I ate the oats by themselves and only ate the eggs 45 mins later.
And I may have more insulin hanging around now, or a slightly faster insulin response to the carbs since it's day 3 of eating these oats.

I'm not sure I like the rise into the 7s or the 5.3 morning fasting with the introduction of more carbs...

Should Ijust stick with the carbs that only put me into the 6s to be on the safe side?

Sapien said:

The one and two hour readings look just fine. Maybe that says you can have a moderate amount of oatmeal if you combine it with the rest of your breakfast.

I find that I can stay under 5.6 if I eat a moderate side of starchy carbs with other food (protein, non-starchy vegetable, fat).

I find that the fasting number doesn’t always correlate with the previous day’s carbs. How well I slept and the previous day’s activity/exercise level both have a sizable influence.

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I'm on day 3 of adding a few extra carbs but since I'm not carefully carb counting and breastfeeding a 3 month old seems to slip me into ketosis more readily, I can't tell exactly whether my normal is slightly more insulin resistant than it should be or not.

Today my spikes were definitely shorter than a two days ago, but I also got scared and pulled back on the amount of carbs I included compared to a couple of days ago when I started this thread so really I was still fairly low carb today I think...

I ate a cup of cooked steel cut oats before my usual breakfast of eggs. (7.5 mmol at 1h / 4.8 mmol at 2h)

Then I had about one medium-sized potato of mashed potato with some slow cooked chicken gizzards (my husband was experimenting). (6.3 mmol at 1h / 5.3 mmol at 2h)

And I made some fairly low carb "pancakes" from a tin of kidney beans / almond meal / eggs and ate some fruit today as well:

a bite of banana; 1/3 apple, 1/2 orange / 6 prunes. (7.2 mmol at 1h / 5.3 mmol at 2h).

Not sure if being in the 7s is great when I'm still eating fairly low carb though. I wonder if I really do have a glucose intolerance as my last GTT notes said (I was 12.1 mmol at 1h after drinking that stuff).

I went a bit overboard with the measuring today so I thought I would make a graph

Have to experiment more with food combining to see if I can keep the spikes slightly lower I think.