Hi
I been on low carb/ keto for 3 years. Try a cgm and have noticed readings of about 6+(uk). Expected the readings to be lower.l have a active job walking about 18k+ steps a day. They do drop to around 5+ on the evening. Don’t normally eat during the day.
Jay
That’s not a bad reading. If this is your fasting reading, taken first thing in the morning, then it’s likely to be the dawn phenomenon at work. The drop over the course of the day fits the pattern.
It’s high in the morning, but also during the day,a bit worried, could it be that the liver is dumping glucose into the blood?
How active are you? I’ve saw that the days I exercised in the morning then worked on my house and was quite active, my blood sugar on those days was higher than days when I worked out and went to my day job (sitting), and those days were higher than when I just went to my day job (sitting).
If you’re active, your liver is kicking out blood sugar – for some reason I’ve yet to figure out. (I’m assuming glycogen repletion, but don’t know.)
That’s what I thought. I’m not sure how to “correct” that, other than maybe eat a (few?) more carbs (which will shut down or limit the amount of carbs produced by the liver). When I had my CGM, I never tested that though. (Not sure I could design a test for that.)
I’m not familiar with the UK metrics (stuck in USA’s measurement system) but if you’ve been fairly diligent in avoiding carbs all these years, then I wouldn’t be surprised at all if your morning glucose readings are drifting higher than they used to be.
It’s extremely common - and not at all troubling. Many physicians have discussed this (yeah, this is one of those cases where YouTube is your friend).
The more relevant question is how large are your intra-day glucose excursions around the average?
Since you have a CGM you can readily see for yourself … does it travel within a fairly narrow band? If so, you’re doing great.
Assuming you’re engaged in meaningful, sustained carb-restriction, your body is producing (through gluconeogenesis) the amount of glucose your activities demand (including the need to wake up - hence the “dawn effect”).
This is what mine looked like, this is about 15 months.
But what can happen is something like this:
If you look at Saturday, 20 Apr, that was a day I think I exercised in the morning and then worked on the house. You can see the day ended up at 106, which is much higher than say Wednesday, 24 Apr, which is much lower and I’m sure had no exercise.
So, if you’re exercising a lot through work, you could get a higher blood sugar level and a higher HbA1c even. I’ve seen people who exercise a ton begin to freak out because their A1c was going up.
Now, you have interpret those with a grain of salt. That was a US FreeStyle Libre, and that was different from the one I got from Sweden. The US one always started high and went lower, whereas the Swedish one did not have that issue. But when I look back, the days I exercised, and particularly exercised on the weekend then worked on my house all day, I had higher blood sugar.
Is that a good or bad thing? I personally don’t think it’s bad, as your body is figuring out what you need. But some people do not like seeing overall blood sugar go up.
And it’s worth mentioning Bikman’s caveat where HbA1C is concerned, that the number is a really accurate 90-day average of serum glucose, only if our red blood corpuscles live for precisely 90 days.
If they live longer, because they are healthier, then the amount of glycation measured is going to be higher simply for that reason, not because there’s any problem with our serum glucose.
And conversely, if they don’t live as long, because they are not as healthy, then the amount of glycation measured is going to be lower, and that lower reading may mask a problem with serum glucose.
So, just like every other blood marker, HbA1C needs to be interpreted judiciously and in the overall context.
I was thinking about this on the car ride into my office. If you look at my curves, they are remarkably flat relative to what they look like when I’m eating high carb, say at Thanksgiving. Let’s say my HbA1c goes up (and it’s accurate), there are still really no highs. If I have the same HbA1c on low carb with a lot of exercise as I do when I was high carb, the high carb would have to be worse, as there will be a ton of super high glucose spikes.
Also, the higher blood glucose when exercising is going to go somewhere – into muscles for replenishment of glycogen, at least. But if I’m not exercising much and eating high carb, that’s when the carbs don’t have anywhere to “go”.
I’d love to have a CGM now, because I’m testing a TKD (targeted keto diet), where I’m eating rice noodles after exercise. Only two days/week. I have stayed producing ketones with 100 g of carbs 2-3 hours after body weight training.
I also tested one day without exercise but with rice noodles (same amount). I was still able to stay producing ketones, but I was much hungrier.
My theory is that the body weight training provides somewhere for the glucose to go – muscles; whereas with no training, there is less of an opportunity for that.
I’d love to have a CGM to test blood sugar too (I theorize less blood sugar excursion after exercise and more after no exercise). Unfortunately, CGMs are so expensive, and doing this with pin prick monitors is – painful. It’s on my list of things to test, but I know my blood sugar goes up and down in 1 hour for high carb meals. That means at least every 15 minutes of pinpricks, and then I have to be concerned that the plus or minus 15% error in pinprick meters means the differences might be hidden in errors.
Hi
Just had a couple days off work, the cgm readings seem to be lower…4.8 to 5.5 .So maybe when l active at work the readings are higher!
Keep in mind that a CGM measures glucose in the interstitial fluid, not blood. When I wore one it consistently read 10-20 (USA) units below my reglar glucose meter.
