I’ve been on keto now for over 4 months now, and I’ve lost about 10 kgs. Looking good, and feeling healthy and fine.
I’ve been testing myself every other month for HbA1C , and Fasting and PP. The results have me slightly confused and a bit worried.
When I started in Sep19, I was at HbA1C = 5.2, Fasting = 87 and PP = 120
By Nov 19 HbA1C = 5.4 , Fasting = 100 and PP = 117
Now in Jan20 HbA1C = 5.7, Fasting 108 and PP = 116.
All other tests including Lipid profile & BP seem to be in prescribed ranges.
I’m a Hypertension patient and take the regular medication of
Telmistran 40mg
HCTZ 12.5 mg
Metoprolol 25mg
Ecosprin 75mg & Atrovastalin 10mg all once a day!!!
Vegetables : Cabbage, Cauliflower, Spinach , Bell Peppers, Tomatoes a little Green Chillies, Some garlic and ginger
Non Veg : Predominantly Eggs 6-8, Mutton (lamb) and chicken
Fats : Ghee, Butter and Cheese
Nuts : Fried Peanuts, Raw Walnuts and Raw Almonds .
Medications have been steady and not changed for a very long time.
The diet Ingredients look good. Nothing jumps out to me.
I will ask about Fried peanuts? What are they fried in? Potential oxidative factor.
I was wondering if you had taken a ketocarnivore approach and we would have had an answer.
It’s also good that you are measuring blood glucose directly and that seemed to increase with the HbA1c.
There is still the medication to consider and reasons for increased oxidation level in the red blood cells and increased blood glucose. They can include outside of dietary factors creating or supporting inflammation or oxidative stress.
The numbers are still ok and you feel healthy. The increase is hard to pin down from the information presented. You are 4 months into the process and measured during the main adaptation process.
Are you tracking your macros? If not, you should probably start. You want to make sure that your carbs are under 20 grams and your protein moderate for your body size.
High protein can in itself lead to increased insulin resistance and elevating blood glucose in some individuals, especially those who already have significant metabolic dysfunction.
If I were you I’d use a keto calculator to get an idea of what these macros should be looking like. You don’t have to be exact on protein, but you don’t want to be way overshooting it either.
I agree with @FrankoBear. Monitoring your blood ketones may prove useful. You should try increasing the ratio of calories from fat in your diet to reduce the impact of carbs and protein on insulin. Doing this should elevate your ketones and control your glucose.
My own diet is now about 80% calories from fats and my glucose, even unfasted, is rarely ever above 75 and fasted it’s always sub 70.
The other tests to consider are inflammation markers. Inflammation may cause oxidative stress on the red blood cells. That increases the HbA1c.
WBC - White blood cell count and patterns. ESR - erythrocyte sedimentation rate, high sensitivity C reactive protein (hsCRP), fibrinogen, homocysteine, I’m just rattling of the results of an Internet search.
We still need a knowledgeable ketonian to swing by this thread.
Normal inflammation can be attributed to an increase in physical activity or planned exercise, for example. The exercise and Keto peeps will let us know if that may be reflected in an increase in biomarkers.
Did your exercise regimen change over the same time period?
The other path to investigate is the side effects of the list of prescribed medications.
I’m still interested in those fried peanuts and what oil is used to fry them? The peanut oil inside the legume is quite high in linoleic acid (omega 6), which can be quite pro-inflammation.
Wow. All this is so medically intensive.
I’m a layman who stumbled upon keto, gave it a try and it worked.
As mentioned in my first post, other than my bp, i was reasonably healthy, except for the weight which was on the higher side.
Now the weight is in control, but this new issue has cropped up.
I’m sorry but I don’t really understand the medical jargon. My simple question is,
“Should i be worried, should I go to a doc, a medical specialist, an endocrinologist, or is it nothing to be worried about?”
“…In people with type 2 diabetes, a blood sugar reading taken two hours after the beginning of a meal is most frequently used as a post-meal measure. According to the American Diabetes Association, a normal post-meal blood sugar reading at one or two hours after beginning a meal is below 140 mg/dL (7.8 mmol/L). …” …More
According to them that’s normal on a low carb diet!
Hey VB. Yep, I’m a layperson as well. For what it’s worth, I think: You shouldn’t be worried. Probably be a bit curious. The results aren’t expected. That’s what makes them interesting. But you are lean, so that is a specific metabolic state.
Consider going to a low carb friendly doctor to chat about it. If those are 2 hour post eating blood glucose tests, maybe they are a bit high?
I think lean people on a ketogenic diet without any excess body fat may generate slightly higher blood glucose results on a ketogenic diet, if they are not eating much fat in ratio to protein and are not fully fat adapted. But that may be getting a bit deep in the physiology again.
HbA1c is usually measured every 3 months. Measuring it 2 monthly is not the usual protocol. You could wait until the end of April and test again to see the trend.
Are there similar posts in the women’s health threads?
Print out this thread. Ask for a fasting insulin test, if the doctor is curious.
I am just a lay person who has been successful at halting prediabetes and improving my over all health with keto/lchf/fasting. Since you have BP issues as well this is critical for you, please find a low carb friendly dr. in your area to work with and get your meds in line with your current needs.
Fung and Phinney both have addressed how your blood Glucose numbers will go up while losing weight, sorry don’t have links handy but a search should bring up several videos by with them discussing that. Also your body is still healing, so your A1C number is going to be moving around a bit.
The thing that really hit me is the fried peanuts. First, they are not nuts at all, they are legumes. Legumes are not good on low carb. Some can tolerate them in small amounts but they usually don’t do anyone any favors. I would stop eating those immediately.
Mark’s comments on home A1C tests are spot on, we tried using that, my DH has T2D, he would test at home then go to the lab for a test on the same day, and there was a wide variation, so we don’t trust those home tests anymore.
All the best to you, hope you get yourself sorted out successfully.
Are you talking about higher fasting blood glucose due to adaptive glucose sparing? That only applies to early morning numbers and doesn’t have to do with actively losing weight but rather being fat adapted. It should not affect you Hba1c nor glucose measurements taken later in the day.
I’ve noticed this myself. My early morning glucose can be as high as 85 but will settle into the 60’s and 70’s by noon.
If there is some other mechanism by which glucose is increased with weight loss I’ve not heard of it, and I’ve listened to a lot of Phinney and Fung. I also just did a search and found nothing other than what I mentioned above. But if there is something, I’d love to know about it.
I experienced something similar a rise in blood sugar during my first few months of rapid weight loss. Though in my case I wasn’t keto I just cut out processed foods, grains and legumes. And I wasn’t tracking my blood sugar I just compared lab results of FBG and HbA1c from 6 months prior. And that was what prompted me to get a finger prick blood glucose kit and start tracking which lead me to going keto.
When I went keto my blood sugar rapidly improved but in hindsight I think it wasn’t just the further reduction in dietary carbs. I’ve come to see my blood sugar is heavily impacted by things such as sleep, stress, physical activity and sometimes sicknesses. When I went keto I did a period of more calories and slower weight loss and I think the previous period of rapid weight loss was dropping my insulin and raising stress hormones boosting blood sugar despite the cutback in dietary sugar.
My suggestion would be to give keto more time but ease up on the rate of weight loss for a bit while working on things like sleep, stress reduction and adjusting activity/exercise such as taking a walk after meals all of which might do more to lower blood sugar than tweaking what you eat. Although I have found coconut oil and especially MCT oil at breakfast give a noticeable bump to my ketones and a quicker drop of my dawn effect blood sugar rise.
