Elevated blood sugar...help

(Ellen ) #1

I’ve been on the keto diet for 6 weeks. Lost 7lbs as of this morning which makes me happy but my blood sugar is 120. I’m not diabetic and have never been this high. I’m very concerned. What’s happening? I’ve gone on the internet with this question and see sites that say keto can cause diabetes. Is this true??

(Carl Keller) #2

If this is within 2 hours of having eaten, 120 is not abnormal. Also, blood meters are allowed a +/- 15% accuracy tolerance per FDA standards so it may not be as high as you think. Other things that can cause a higher blood glucose level are stress and medications.

You can also find internet sites that say the earth is flat… that doesn’t mean it’s true. Diabetes is a problem with insulin regulation. Eating low-glycemic foods improves insulin function. LCHF has clinically proven it can reverse diabetes

(Ellen ) #3

Thanks Carl. That makes me feel better. The reading was before any meals and sent me into a panic.

(Cathy) #4

I believe that blood sugar first thing in the morning may appear higher than usual because of the down regulation of insulin. This is normal. It is called physiologic insulin resistance. Your body is doing what it should be doing in terms of becoming adapted to keto.

The measure that you really want to pay attention to is an A1c (HbA1c) which is a measure that your doctor can order which measures your blood sugars over a 3 month period.

I use to measure blood glucose and am not diabetic or even prediabetic. I did it as a way of seeing that things were going well. I too had a higher than expected read first thing in the morning. My A1c is measured once a year and has been consistently really good. I no longer measure b.g. at home.

(Ellen ) #5

Thanks Cathy. I agree that the A1c is most important. I also check yearly and have never been above 5.7. I need to schedule my next physical but want to wait and lose a few more pounds. So you think this is a good sign that I may becoming fat adapted? The only time I’ve cheating in the past 6 weeks was 2-3 beers every couple of weeks.

#6

To the contrary. Because of keto, I no longer need to take any diabetes medications for my Type 2 diabetes. I used to use metformin and used insulin.

Having said that, since starting keto over 2 years ago, I do now have “Dawn Phenomenon”, where my fasting blood glucose in the morning is often 10 to 20 points higher than my blood glucose reading at night before bed, even if I’ve had nothing to eat in between. That’s due to a surge of hormones that the body produces in the early morning hours before someone wakes up.

(Bob M) #7

I have seen arguments that insulin is lower, and liver’s glucose output is higher in the morning, and that fat cells are insulin sensitive. But that doesn’t make sense to me. I think fat cells are insulin resistant in the morning, otherwise the higher blood sugar would go into the fat cells. As for down regulation of insulin, my fasting (morning) insulin has been all over the map, from “<3” to 33+, yet I’m at the lowest weight I’ve been in decades and my HbA1c is lower over that time too. I don’t understand what affects insulin well enough to know why my fasting/morning insulin has been like this.

But Peter from Hyperlipid thinks it’s a FFA (free fatty acid) issue caused by GH (growth hormone) that then cause insulin resistance (in your fat cells, I believe):

I think his theory is this: GH goes up, resulting in lipolysis (fat burning), which releases FFAs, which causes insulin resistance for at least muscle cells (and I think fat cells), which then causes blood sugar to go up.

Not sure what’s the correct theory.

(Bob M) #8

My blood sugar hits a nadir around midnight, then goes up all day until about noon, then goes down again. This happens regardless of what I do, even fasting (fasting just lowers the whole curve, i.e., I’ll get lower blood sugar in the morning, but it still goes up all day). I learned this using a continuous glucose monitor.

(Bacon is a many-splendoured thing) #9

Whatever is going on, it seems to be normal for people in ketosis, so I wouldn’t worry about it. If it keeps rising, that would be worrisome.

(Ellen ) #10

Thank you all so much. I will read all the links provided when I’m off work later. I’ll also take my blood sugar again.

(Bob M) #11

I’ve reached the opposite conclusion. For some people, who are exercising and getting close to “ideal” (low?) weight, I think fasting morning glucose going up is to be expected. If you’re lifting weights, running, etc., your body wants to replace muscle glycogen. It needs to get the blood sugar to do so from somewhere. And it does it by raising your morning blood sugar (by making you more insulin resistant in the morning).

I also think this is why some people who eat more protein have higher morning blood sugar (assuming they do, that is - sometimes I wonder, due to the notoriously poor accuracy of meters). Since gluconeogenesis is (primarily) demand-driven, if you eat lower protein, your body cannot get the demand it wants. If you eat higher protein, your body finally gets what it needs and your blood sugar goes up, e.g., to support glycogen replacement.

This is why I don’t think rising morning fasting blood sugar is necessarily bad for low carb “athletes”. And why HbA1c might also – gasp! – go up too, and that might not be a bad thing.

These are my theories, based on my reading of the evidence I know about so far. This could and should change based on any study refuting them. Sadly, studies of people on keto diets are few and far between, and even rarer are studies designed to ferret out what I just hypothesized.

(Cathy) #12

I am a big fan of Peter and think his arguments make a lot of sense.

(Ellen ) #13

Just a follow up from this morning’s freakout. My blood sugar is now 90 after a days work and a brisk 3 mile walk at lunch. Again, I can’t thank you guys enough for bringing me down off the ledge.

(Ellen ) #14

I don’t want to sound dumb but I thought Peter’s link was a little wordy. Maybe I need to re-read it with a cup of tea tonight.

(Full Metal KETO AF) #15

How on earth are you testing fasting insulin at home Bob? Is that even a thing?

#16

One human study (FASTER by Volek et. al.) used ultra endurance athletes to measure muscle glycogen status compared to traditional high carb athletes. I’ve no doubt this differs from weight lifting needs, but it’s a starting point. There is some data included in the pdf link about what they ate and blood markers etc.

Compared to highly trained ultra-endurance athletes consuming an HC diet, long-term keto-adaptation results in extraordinarily high rates of fat oxidation, whereas muscle glycogen utilization and repletion patterns during and after a 3 hour run are similar. …

Protein, g/kg 1.7 g/kg (LBM??) for high carb, 2.1 g/kg for keto

The thing I found most interesting was the large difference in lactate levels. Lactate recycling is done through the GNG pathway in the liver. It would be fun to do a similar experiment with weight lifters and varying protein intakes, also measuring nitrogen balance. I suspect there’s a “sweet spot” for optimum glycogen replenishment based on several variables.

FASTER1

(Bacon is a many-splendoured thing) #17

Just to add one point: I believe that, in the absence of sufficient protein to fuel gluconeogenesis, the liver can also lipolyze triglycerides for their glycerol backbone.

I love how the body has evolved multiple pathways to achieve its goals.

(Rossi Luo) #18

I know this is a very old post, but I’d like to post my situation to discuss! I have had the same issue, my blood sugar had elevated from 6.0 mmol/L (before keto) to 7.3 mmol/L (7 months in keto) in the morning after 12+ hours fasting.
About weeks ago, I went to hospital to get my yearly body check, and my blood result was 7.12 mmol/L in the morning (12+ hours fasting), I thought that must be an exception, I thought it’s not accurate due to fluctuation. But today morning, I did a check again with my own device, I tested twice this morning, one is 8.1 mmol/L, and another one is 7.3 mmol/L.

Yesterday, I didn’t eat any refined carbs (but I ate kale, broccoli and purple cabbage every meal), so the result of this morning made me surprised, then I come to forum to search to see people with same issue like my problem.
I know that there is something called Dawn Phenomenon, and I am still a little bit concerned, because my blood sugar was in normal range before keto, and now it’s out of range after 7 months keto, I will do more blood checks in the upcoming days.

(Bacon is a many-splendoured thing) #19

What is your diet like? Depending on what you are eating, hidden carbs can sometimes be a problem, as can what we call “carb creep.” So give us an idea of what a typical day looks like, including quantities, and we might be able to spot a potential problem.

It is possible that you are insulin-resistant enough that you may need to be eating less than 20 g of carbohydrate a day. (Eventually, of course, the insulin resistance will heal, and at that point more carbohydrate will be an option.) The question is not the amount of refined carbohydrate, so much as the amount of digestible carbohydrate. The kale, broccoli, and purple cabbage contain a lot of fibre, but if you eat enough of them, it is possible to get enough digestible carbohydrate to raise serum glucose significantly.

Another possibility is that you might not be eating enough fat to supply your body’s energy needs, so it is making extra glucose.

(KM) #20

“Creep” can definitely be an issue. I started weighing food and keeping a diary after stalling out. My “1 oz.” cheese snack has stealthily snuck up to almost 3 oz. My “1/4 c” blueberries are half a cup or more. I’d recommend a week of close scrutiny.