Does a healthy ketogenic diet cause irreversible insulin resistance?

(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.


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:

(Tim Cee) #127

I don’t know in technical scientific clinical trials. However here is a case where I’m not as concerned based on my own experience. Since going keto my BP is down almost 50 points. It occurred to me that as a person who has been doing keto, I feel more reactive to sugar in terms of symptoms of acute sugar level deviations. However that could be because I am less used to being sick form sugar swings. It may not be increased insulin resistance so much as that I might be dis-acclimated to responding to sugar. We don’t really know if I am just more insulin sensitive than my body expects causing it to overshoot. However I do know that I am healthier now and I used to so accustomed to obesity and severe hypertension that I didn’t even notice.


I found this paper that could interest some of you:

@SunnyNC, my A1c, I had never measured it before keto. While keto, it was 5.5 then climbed to 5.7.

I’ve done a OGTT (ingestion of 75 of sugar) and the results were ok-ish. After 2h it was at 84 mg/dL. It was the first time I’ve done, I think.

My triglycerides/HDL = 48/93.9 = 0.51. But my LDL and total cholesterol are high: 135 and 238 respectively). I’ve been reading that’s not important, but I don’t want it to increase any further and it’s increasing since I started keto. My try/HDL was also very good before keto. CRP is 1.5. It’s decreasing with keto, but I think it was never bad.

I’m 52, sportive and have never been overweight. But I don’t think I look lean, with my fat hips. I’m just back from a cycling/hiking trip (exercise everyday, with mountain climbing by foot, or bike, up to 1300 m with the road bike. Keto and morning blood sugar still above 100 mg/dL.

I don’t know what to do. I’ll try to do more HIIT and less steady-state jogging/walking. Let’s see if that helps.

I’m getting a CGM shortly. I’ll report back.

Please, share anything you find that helps.

I’m eating less proteins. I’ll quantify when I get the CGM.

(Michael - When reality fails to meet expectations, the problem is not reality.) #129

I agree that ketosis tends to make one more sensitive to glucose and more responsive to insulin. Folks who start keto to address T2D report this consistently. Consequently, a rise in glucose post carbs followed by a fairly fast decline back to baseline** indicates a healthy response. The whole point of a glucose tolerance test, after all, is to spike glucose and observe how long it takes to return to normal. With my ongoing CGM test, I see this every day, even though I’m eating very low carbs I still see the glucose rise and return to normal. Although, my daily glucose plots are not as ‘flat’ as I had expected based on my previous experience, I see nothing that suggests anything other than a perfectly normal input/response. One meal that contained a little more than 8 grams of carbs ‘spiked’ my glucose from 5.0 mmol/L to 7.1 mmol/L within half an hour. That’s certainly a significant increase. However, it was also back down within my normal range less than an hour later. Plus, I have further determined after more testing that probably other components of the meal contributed to the rise in glucose. This stuff is not simple.

  • ‘Baseline’ - ‘Normal’ can mean different absolute values for different folks. There is, after all, a range of ‘normal’, ‘healthy’ glucose and insulin concentrations.

I’m not saying the folks here who are worried about their absolute values and an apparent rise in their ‘baseline’ values over time shouldn’t be worried about them. I don’t know. But I would be really surprised if eating a ketogenic diet makes anyone more insulin resistant over time. If it’s actually happening to those specific individuals, my initial suspicion would be that something else is amiss. How exactly would keto increase insulin resistance when at the same time folks with diabetes, pre-diabetes and high insulin resistance get themselves off meds and reverse their problems eating keto?

(Ronnie) #130

I’m confused too…on what units people are using. I use this:

In UK they give HbA1c results using mmol/mol.
48 or above is diabetic
between 42 and 48 is pre diabetic
blow 42 is normal.
I was 52 before keto, but in 6 months under keto I lost 25 kilos (3.9 Stone or 55.1 Pounds).
My last bloods, my HbA1c was 37…well back into normal.
I don’t bother with on the spot glucose testing…it will vary that much there is no point.

(Ronnie) #131

Hope that table helps

(Bob M) #132

I think what we’re discussing is glucose sparing, not insulin resistance. The only 2 ways I know of to determine your “insulin resistance” are via a Kraft test (oral glucose tolerance test with insulin and glucose, 2+ hours) or this:

Just got in a fight with someone who noticed higher morning blood sugar when keto but lower when eating about 100g carbs per day. What does this mean? Not much.

Particularly because while HE might be able to eat 100g carbs per day without blood glucose excursions, some of use cannot.

(Ronnie) #133

Ah, I see…thanks.


I use mg/dL for blood glucose. If I say I had a FBG (fasting blood glucose) of 100 mg/dL, you divide by 18 to get it in the units used in the UK: 100/18=5.5.

Changing the subject, I need to tell the world that I’ve just got my first CGM! I’m so happy! In the 2h it’s been working, my my BG is going up and down between 87 and 120 mg/dL. I had eaten a meal with about 16 g of total carbs 2h before, about. My OMAD. It was chicken, coconut milk and cheese.

I’ll talk as if it was BG, but I suppose it isn’t exactly accurate, since it is a CGM (interstitial…).


So, his BG is in the healthier range when he’s eating more carbs? It could be relevant for him. He could be transitioning from someone with 0 BG issues to one who is resistant to insulin.

Call that rose by any name you want: glucose sparing, insuling resistance… the fact is that there’s an amount of glucose in your blood that shouldn’t be there and it is. And before, it wasn’t.

Perhaps for healthy BG people, like your lucky acquaintance (I wish I was the same!), keto isn’t a good idea.

If my BG was below 100 eating carbs, no way I’d want to risk messing up with it. I’d not eat junk, processed foods, not go crazy on carbs, but I’d also definitely not adopt a diet that would increase my BG. The name one gives to it is of no importance: it’s still in your blood, damaging your kidneys, etc.


@SunnyNC, I’m sorry to be posting again when nobody did after my last posts, but I wanted to share the results of my first hours with the CGM, because it is nothing like I was expecting! It is much worse.

I’ve received it yesterday, after my OMAD. By the time it was ready to be scanned, I had finished eating about 2h prior. My OMADs are below 20g carbs.

Well, my BG has been jumping up and down and I haven’t eaten again. Only drank water. No coffee, no tea. No pills. No exercise. I haven’t even left the house, as I’m working from home these few days.

Whenever I move, like now I was washing my showerbox and washbasin, it went all the way up to 154 mg/dL. I stop washing, it goes down. I start washing again, it goes back up.

I go up the stairs, my BG jumps up to 120s. I brush my teeth. I wake up to pee. If I move, my BG moves. Up, then down. No food involved. I’m laying down now, trying to calm it down from the 154!

So, my problem isn’t just upon waking up, the dawn phenomenon thing. It is much worse.

I had written already about the fear that I just can’t adapt to using fat as energy. That’s the reason I had become a carnivore: I wanted to force my mitochondria into doing something. Getting more of it, or whatever. I want to do anything I can to get my FBG sorted. There’s no food I can’t stop eating. But I still felt miserable a few months into carnivore. Weak. Like with keto.

Then I spent summer traveling by bicycle and I just had to eat carbs. For the record, it was a super hilly country and I was mostly on trails rather than asphalt, carrying all of my gear to survive on the bike. I didn’t go crazy on carbs either, as they scare me. I lost weight, because I couldn’t eat enough (far from food, small places without options, on the trail) and CICO always works with me. It wasn’t a bad thing, because carnivore had made me put the most weight I had in my whole life.

Anyway. What I’m thinking: I’m very low carb. My weight is stable, so I’m probably eating enough. Most days, OMAD. I eat to satiety as we tell everybody to do in this forum.

But if I’m right, my body just can’t use fat as fuel, or super inefficiently, therefore, whatever I do that requires a little energy, it throws glucose in my blood to keep my muscles moving, my heart beating.

I don’t know what to do.

A few words about something I think it is related.
My heartbeat also jumps up. My heart has always been like this. I’m a fit person with the heart of a sedentary one. Last time I ran 20k, my average heartbeat was 182. My blood pressure is always between 100 and 60 (on the lowish side). My cardiologist agrees that that’s just the way I am.

(Michael - When reality fails to meet expectations, the problem is not reality.) #137

Stop keto now - start eating your preferred variation of SAD. Continue for the two weeks your CGM sensor lasts. Let us know what happens to your glucose. If you think that would be very inaccurate due to readaptation to high carbs, then continue SAD for a month then purchase another sensor and try again.

During my current CGM episode, the first week or so my glucose varied quite a lot - not like what you’re experiencing, admittedly - but more than I thought it would based on my previous experience. I discovered that 99 Liqueurs apparently contain lots of sugar. Stopped those and within a day my glucose plots got much more uniform and averaging lower overall.

My bet is, based only on what you’ve described so far, there is something amiss with your metabolism and going high carb will make it worse than what you’re seeing now. That’s the hypothesis. You can disprove by testing.

(SunnyNC) #138

Thanks for sharing your experience Corals! Give CGM a day to acclimated. It seems like you are having a similar experience as me, but much worse. There is so much controversy with too much protein, whether it can cause high BG. Extra Protein after muscle synthesis cannot be stored and is converted to sugar via GNG but lot of gurus out there that is not a concern. I think it does matter in my case.

You are right, high BG is harmful no matter the reason and if it’s easily reversibly or not. Most people don’t get this simple concept so it’s scary to think they insist it’s ok and provide useless references that talk about physiological IR, benevolent IR, glucose sparing etc. BS. These people are worse then than the vegan snobs. Keto only worked for me when I had 20lbs to lose, now that I am fit and athletic it’s causing high average BG. Sprinting has become hard too.
Thomas DeLauer has a new video that talks about this. He says take a break from Keto every 3 months, for 2 weeks. Check that out.
I am either getting on low dose metformin or stop keto by end of the month. I will keep you posted about my BG once I do.

(SunnyNC) #139

“few words about something I think it is related.
My heartbeat also jumps up. My heart has always been like this”

This will definitely cause liver to dump glucose, I have noticed when my heart rate goes up due to stress, or sprinting etc my BG spikes. And due to the so called physiological IR, my muscles don’t use the glucose and BG is high. In absence of diabetes/IR this is a sign of fat adaptation.

(SunnyNC) #140

The baseline for diabetics is much higher than normal folks. Their true IR is much worse and keto helps reverse it. In some healthy folks, once they get fat adapted, several months to a year after starting Keto, fat is the preferred fuel. So any glucose liver dumps via GNG is now not being used by muscle. You said you just started back on keto? If so give it a few months and then do GTT. It will falsely indicate diabetes. If you are carb cycling then this might not happen. That’s another reason I am considering doing carb cycling.

(Michael - When reality fails to meet expectations, the problem is not reality.) #141

You may have me mixed up with someone else. I’ve been in ketosis 5 consecutive years as of Jan 3. My current glucose is within the healthy range of normal folks and I have to try hard to get it above that range. Since I eat very little carbs, pretty much all of my glucose is derived from GNC.

I’m currently observing an interesting phenomenon while doing my second CGM experiment. I haven’t really said anything about it yet, but I will likely start a separate topic/discussion to explore it more fully. I may even buy another sensor for my FreeStyle Libre to get some data.

The initial observation is that consuming vinegar (I’m using red wine vinegar) seems to reduce glucose for several hours after consumption. I’m currently drinking about 2 tablespoons of vinegar prior to bedtime and find that my overnight glucose goes lower than previously. I’m also drinking citrate in the form of unsweetened lime juice daily, which may reinforce or confound the vinegar effect. To be determined.

Mike’s Excellent Glucose Monitor Adventure 2