Does a healthy ketogenic diet cause irreversible insulin resistance?

(SunnyNC) #107

Thanks. My blood ketone when I wake up is at least 0.5. usually between 0.5 and 1.
It used to be higher the first few months. According to what I have researched, after being fat adapted, body learns not to waste ketones so 0.5 to 1 is the norm and indicates fat adaptation.

Regarding I don’t have enough ketones so liver puts out sugar via GNG, I would not argue with that because I know that my BG is high because my liver is dumping out sugar. I cannot control ketone amounts, I can only cut out all carbs. I am not interested in taking exogenous ketone supplements. The fact that my liver is dumping glucose via GNG but my muscles are not using it coz of physiological IR, my fasting BG, average BG and A1C are all going up. My only question is why this high BG ok when it is driving up my average BG and A1C. High BG is toxic to organs regardless of the reason why BG is high. I have probably repeated this question a dozen times and no body is able to directly answer my specific question. Perhaps it because we have all been repeatedly brain washed to believe high BG is OK in keto. There never say how higher A1C as a result will not cause glycation and associated damages

(SunnyNC) #108

Thanks, I had ready that article before. I read the comments section now and it does not answer my question unfortunately. The solution that worked as per the comments are not really applicable in my situation :frowning:

  1. Lose weight - I don’t have any weight to lose. I am already at 15-20% body fat and very lean. I am athletic so weight has never been a problem.
  2. Combine keto and IF: I already am. I do 18:6 usually. I have done 48 hrs fast here and there for longevity purpose. Right when I started keto a year ago, I did FMD to get I into ketosis quickly. Everything was great the first 9 months.
(Laura) #109

My numbers drive me crazy too. My fasting BG is always over 100. The last test a few weeks ago was 105. My a1c is 6.1, but when I test my BG all day long, it never goes above 126 and usually hangs around down in the low 100’s and mid 90’s.

My doctor knows that I follow low carb/keto and he approves of that and he is unconcerned by my numbers. It makes no sense to me what is going on, but if he says that I am fine, then I am not going to worry about it. I would feel better if the numbers were all lower though.

(Butter Withaspoon) #110

Hi Sunny, it sounds frustrating and I hope you can figure it out. I have some thoughts but no data or studies so maybe not helpful… but here I go.

You said you are lean and athletic with low body fat. I’m in the same category. I had an initial period of keto diet with very low carbs, to experience it fully and see how my body responded. I became leaner and my muscles seemed to grow a bit, or at least be more visible. I felt great.

Some months passed then I found that
my blood pressure had gone up a bit which was worrying me. How could that happen when I look and feel healthy and lean? I considered that I was possibly pushing a little too hard from more than one direction, thus raising cortisol and adrenaline. When eating mainly meat and fat it can be hard to eat enough after a 6hour hard hike. Maybe my body was having a mild stress response. :woman_shrugging:

Longer term, I’ve added some fresh unprocessed carbs back in, and somehow this feels relaxing, easy, comfortable. My blood pressure was better recently. But since I haven’t had BP tracking at home with more data I’m only guessing.

So my thought is- for a lean athletic type who exercises- consider eating more, aiming for a higher level of carbs with plenty of variety. Consider a stress response

(Butter Withaspoon) #111

Also: I don’t fast anymore. A pretty generous Time Restricted Eating pattern is all.

(Michael - When reality fails to meet expectations, the problem is not reality.) #112

I’m starting my CGM ‘adventure’ part 2 - now! 2 weeks of data coming your way. I’ve posted today’s meals and summary as start data. For reference, I’ve been in continuous ketosis for 5 consecutive years as of Jan 03, 2022.

(Michael - When reality fails to meet expectations, the problem is not reality.) #113

I’ll be posting today’s glucose plot either in the evening or tomorrow morning here, although I will post a partial plot in this topic later today.

Just to keep anyone who’s interested up-to-date, though, I charged the CGM reader overnight, activated the sensor at 07:10 this morning and just took my first reading. This 1.25 hours after getting out of bed after a 13 hour overnight fast:

2022:01:09::08:14 = 3.2 mmol/L.

Mike’s Excellent Glucose Monitor Adventure 2
(Michael - When reality fails to meet expectations, the problem is not reality.) #114

As promised:

2022:01:09 glucose plot (partial)

(SunnyNC) #115
  1. A1C is BAD if you are not diabetic. I would change my doc is he or she says 6.1 is ok for a non diabetic. If your A1C was lot higher preketo and came down to 6.1 post keto then its OK as keto is helping… maybe you can ask your doc why 6.1 is ok on LC/keto, wont it cause same glycation damage as 6.1 on SAD…?
(SunnyNC) #116

Hi Hallie - thanks for sharing! that is also my guess. Along with physiological IR, it exuberates my fasting/baseline BG . This is why I am planning on changing my diet after getting my blood work done. Luckily I had full lab done each time I changed my diet, so I will at least know what works for me. the issue is it takes time to adapt, so it takes time and $.
Regarding blood pressure, mine dropped after keto. It used to be slightly above normal the year before I started Keto as I was eating crap and not at all exercising much of 2018/19. Its almost normal now, not sure if its due to me getting back to working out several times a week and eating 100% healthy or due to Keto. I have a feeling my BP would have normalized on any any healthy diet and working out. All I know is keto did not make my BP worse! I think over all keto has been great, it simplified my shopping/cooking. I am never hungry. That is why I am desperately trying to find out why I can continue on keto and justify high BG. So far, I have been biased towards keto. That’s starting to change because in my books and speaking for myself, high BG is so bad and damaging in the long term, that it offsets all the other positive changes that Keto diet brings. I envy folks who are on keto and have normal FBG! Still trying to figure out my next lifestyle/diet, maybe CKD/TKD or just LC. Suggestions welcome!

(SunnyNC) #117

Thanks again Hallie. I am glad you found something that works for you. I have been considering adding breakfast back, I tried a few times and I find that I over consume calories. BTW, I love BF, it is my favorite meal of the day so it was pretty hard to give up. So no bias there :slight_smile: I don’t miss BF now. I can easily eat 2000 calories in 2 hours and feel great and go for a walk or a jog. So eating 3 meals, I tend to over eat. I was doing 20:4 for 3 months, then I changed it to 18: 6 on a more liberal side, meaning I will eat after 16 if I work out or feel like it. I am going to try your suggestion and make my eating window even more generous (maybe 14:10) and track my BG response. Thank God for CMG technology!

(Bob M) #118

Be very careful with A1c. It’s not an actual measure of blood glucose, it’s a measure of glycation of red blood cells, which depends at least on how long your blood cells live. See this for instance:

He recommends fructosamine, which I have had done in the past. Maybe I should get it again?

But the best really is a CGM. They are, sadly, too dang expensive.

Edit1: Also, he likes post-meal glucose, but for me when I’m eating keto, my post meal glucose = my pre meal glucose. It’s a useless measure.

Edit2: Also, I have the theory that red blood cells can liver longer on keto over time, at least for some, leading to a misleading “increase” in HbA1c, when one does not exist.

(SunnyNC) #119

Hi James, I love Satchin Panda. I have been following him ever since I saw him on Rhonda Patrick’s Found My Fitness channel.
Its going to be hard but I am going to try to stop eating after sun set for a couple of weeks and track the results. I have a feeling it will definitely work. But then why on earth I am doing a diet that increasing my BG and then do all these other things just to bring it back to normal when it was normal to begin it, before I went keto :slight_smile: See my dilemma here, lol!
P.S: Regardless of keto or SAD or vegan or whatever lifestyle, I think Satchin Panda’s research is very convincing. Circadian rhythm is so important and under appreciated. So maybe this is an opportunity for me to start implementing some of his suggestions. :slight_smile:

(Bob M) #120

Whoa, your blood sugar varies much more than mine does. Consider these random 3 days:

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Pretty much dead flat, except for a rise in the morning.

Edit, one more since this month had my oral glucose tolerance test:

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The big hump in the morning is my response to 75 gram glucose. I know I ate at least twice that day after my OGTT. When did I eat? Even I can’t tell.

(SunnyNC) #121

So true. My post meal BG = pre meal, so I am 100% with you on why that is useless for keto folks. In my case, I dont think I have any weird hemoglobin issue and A1C trending up or down is still a reasonable indicator of where I am headed. Moreover I use CGM and A1C and CGM data correlate pretty well. I am going to ask my doc to order a fructosamine. Wish me luck, for some reason she seems reluctant to order anything other than standard tests. I had to convince her to order a NMR as I was concerned with LDL going up since starting keto. She said I need to reduce my LDL when going over the results but did not want to order an NMR test but instead “eat more carbohydrates and add a extra meal”. Finally when I got my NMR, it shows that my lipid profile is indeed great and in the top 25 percentile despite LDL-c being higher. When I discussed the results, her response was “I still recommend that you add more carbohydrates to your diet and eat an extra meal”.

It will be interesting is folks can share their A1C vs Fructosamine results to see if Keto does indeed produce falsely higher A1C for them.

(SunnyNC) #122

Thank you for sharing. For some reason my browser is randomly blocking the image hosting website link in your other blog. I will try again from a different computer. Any conclusions you are able to make on how keto is affecting your numbers?

(SunnyNC) #123

Bob, mine is also pretty much a flat line… it starts to rise slightly from when I wake up till I noon. and starts to fall slightly after I eat and reaches my 'base line" and stays there till next morning when I wake up. glucose variability is very low when I am on keto which is another nice thing about keto diet.

(Michael - When reality fails to meet expectations, the problem is not reality.) #124

Yes, I expected my plots to be a lot narrower than they’re turning out to be so far. And further, I’ve been of the opinion for several years that the flatter the better. Still pretty much all within a range of 4-6, though. Even with a few above and below events, my average so far is 5.2 overall. So I’m not too concerned about the amount of variability. LibreView doesn’t indicate anything to be concerned about either, although admittedly their target audience is diabetics where ranges and variability are much higher than where I’m at.

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One interesting event is that partial plot noted above is the big drop in BG between 13:30 and 15:00 when I took a ‘nap’ after eating. My glucose bottomed out at 2.8. I ate a 240 gram bag of Bothwell SqueakRs and 60 grams of double cream for lunch and within half an hour could hardly keep my eyes open. My glucose dropped from 6.7 immediately after the meal to 2.8 in less than 1.5 hours!

(Michael - When reality fails to meet expectations, the problem is not reality.) #125

I have no idea why your browser blocks those files. The directory is open to the internet. Are you getting an error message? If so please post and I will try to figure what’s going on.

No conclusions just yet. Only 2 full days of data so far. Sunday data may very well be off because the sensor just started and several posters in my original CGM Adventure mentioned that the first day’s data is likely screwy. As noted in my previous post, the variability surprises me. I have posted one interesting comparison here.

(SunnyNC) #126

It’s working from my phone browser! My laptop has a security software that thinks the site is not classified. (It’s called Zscaler, of you are IT kind of person) I submitted a request to classify this as legit. Actually your variability of less than 15% looks really great, I think. Even the margin of meter error is 10-15% so having variability of less than 15% doesn’t mean anything, in my view.
One thing I do with CGM is I always install it at evening, let it get acclimated for several hours overnight and then activate it the following morning that way I minimize incorrect data. With that said I think this is no longer an issue according to Abbott. They told me as long as there is no “check via blood” icon next to the reading, it’s good. I still do this just to be on safer side.
Congratulations on 5.1 avg. That was my number prior to keto, LMAO. :sob:
Edit: it’s funny you say you bottomed out your BG after a nap. That’s happened to me few times. I almost always walk (have a machine in my living room, so that helps) because I have read walking after meals reduces post prandial and FBG. In my case it really makes no difference (maybe because I am already active otherwise) In my case, napping after eating is the only way it drops below my “baseline”. The moment I get up and walk, it’s shoots right back to baseline. Sometimes I think CGM is a curse? Makes me question everything :slight_smile: