High glucose in the morning before eating

#1

Looking for advice/recommendations/commiseration…

I’ve been keto (again) since mid-May. I’ve lost ~25 pounds and inches so I know “things” are working. But, I got a keto mojo because I wanted to start testing foods (especially dairy) to see what I needed to avoid/determine my protein levels. (I’ve especially been confused on how much protein is too much for me.) Since getting the meter, my glucose has been pretty high in the mornings before eating. I usually don’t eat until noon to 1pm. I eat ~1500-1700 calories, 100-120g of protein, 100-140g of fat, and never go over say 18 total carbs in a day (some days as few as 3 grams). I was taking my readings about 3 hours after waking and getting readings in the 130-137 mg/dL range. (ketones from .3 to .7 mmol/L).

I’ve also taken readings 3 hours after eating and have gotten readings from 85-97 mg/dL.

This morning’s experiment was taking my readings 30 minutes after waking (117mg/dL and .4 mmol/L) and then at the 3 hour mark (still no food), and it was 146 mg/dL and .3 mmol/L. (highest glucose reading yet!)

Never diagnosed type 2 diabetic (my mom is), but highly insulin resistant and have PCOS. I’ve researched trying to figure this out…any pointers?

(Joey) #2

Sounds like a classic case of the “dawn effect” … which is your body creating glucose (through gluconeogenesis) to get your brain and muscles going in the morning. Search this forum for plenty of additional details.

But based on everything else you’ve shared, it’s a healthy, natural phenomenon. Your body is doing its normal thing.

BTW, I’m unclear on how testing glucose in the morning is going to tell you whether or not you’re eating an appropriate amount of protein. There’s plenty of other info on this forum re: protein consumption. Have a look.

Keep up the great health progress! :vulcan_salute:

#3

Congratulations you are moving in the right direction. I was diagnosed T2D almost a year ago. I’d already started to reduce carbs and severely reduced the amount of sugar and processed foods. It took another couple of months to fully adopt under 20 carbs.

I lost a lot of weight and my blood glucose lowered significantly, Then the glucose reduction stalled. I found the morning glucose reading was the most recalcitrant. It stayed high even though after meals was often below 120.

It has only been in the last month that my AM readings have dropped below 110 and sometimes even below 100. I have a feeling my insulin resistance may have been worse than yours. It has been a slow but steady decline over the last year.

I also get some very strange results. An identical meal can often give me test results that vary by 20 points. Still the trend is towards normal. I figure since it took me years of eating a sad diet to get me to the point I was, that it is very gratifying to improve my metabolic health as much as I have in just 1 year.

Sometimes it is frustrating but as you noted “things” are working. Give it time.

#4

Really appreciate the input.

Ref testing for appropriate amount of protein, I hadn’t gotten that far yet. I was just trying to get what I thought would be a baseline, but was concerned about what I considered high fasting glucose.

I’ll give it time. Thanks again.

#5

Thanks for your input! I appreciate hearing about your results and experiences.

#6

Your numbers are only SLIGHLY high, willing to bet if you weren’t waiting so long to eat they’d be lower earlier. Your post meal numbers are awesome so I don’t see the issue.

On protein, you’re not going to eat too much, that’s almost not even a thing. You ever have the meat sweats? Feel like you’re about to explode, BO smells like ammonia? That’s when you’ve overdone protein, and most people never do that.

Your highest reading at 146 isn’t even really high. You realize when we wake up our cortisol is through the roof right? That effects BG very much.

My (real) fasting numbers are in the 115-120ish range, and My A1C hovers around 5.0-5.2, it doesn’t matter. Only now since taking Semaglutide to beat my appetite down (it’s original purpose was lowering A1C’s) it’s in the high 70’s-low 80’s. But when I’m off I’ll have no issues if it goes back where it was, because again, doesn’t matter. It doesn’t matter what it is at any one given time is, it matters where it spends most of it’s time.

Yes, check your A1C and get an LP-IR done, see how insulin resistant you really are. Don’t assume. PCOS (may) be a clue there, but not always. You an also somewhat test that on your own if you’re not irrationally afraid of Dextrose. You can’t do a real GTT because being keto your body isn’t used to that anymore and will over react to it, giving you a false view, but you can do a “mini” one.

#7

Thanks for all the information. Lots to think about. I’m planning to get A1C bloodwork (and other things) tested next Friday.

Yes I knew about cortisol, but assumed that dissippated by the 3 hour mark.

I was keto for about 3 years before, but stalled for about a year and eventually when things got busy, I struggled to stay “on the wagon.” I’m just so determined to stay the course this time and not get discouraged again.

Years ago I had a doctor who specialized in PCOS; he had me do a glucose test and told me that my insulin spiked 5 times more than normal. I always took that to mean I’m pretty insulin resistant even though he did not use those exact words.

(Megan) #8

Hi Kyz, good for you for getting back to eating healthy and crongrats on the weight loss and inches loss. Getting rid of processed foods and eating very few carbs is probably the best thing most people can do for their bodies. Hang onto that while you figure out the blood glucose issue. I am no expert on all the crazy stuff that goes on inside but for me, personally, I’d be unhappy if I had a fasting blood glucose of 146 mg/dL and would want to get all relevant tests done by my doc. Ifod is correct, don’t assume you are this or that, get the tests done. One thing to know is the measuring meters are not accurate, the results they give can be +/- 15-25% in accuracy.

Tweaking protein consumption is a tweak some people need to do and protein amounts are very individual. What’s your age, gender, height, current and ideal weight and what kinds and amounts of exercise do you do? Any need for downward protein tweaking can dramatically lessen if you are insulin sensitive tho, so get those blood tests done. But, as Ifod said, as someone who eats very low carbs you will “fail” a glucose tolerance test unless you eat some carbs for a couple of days before the test to get your body used to carbs again. Ben Bikman has a video explaining why, but I haven’t bookmarked it. Maybe someone reading this has and can link it.

The fact your blood glucose drops to 85-97 mg/dL 3 hours after eating is very reassuring. Have you tried having a small meal just after you wake then testing a few hours later?

All the best while you get to know your body and why it does what it does. At first glance tho it sounds like you are very much on the right path!

(Michael) #9

You only need to eat a meal with carbs a few hours before your test, or at most two meals before your test to re-initialize your first response insulin that has been downregulated due to a lack of carb intake. After one or two meals it will again dish out first response insulin when eating, regardless if it contains carbs again, but just in case it does. It is the difference in the curve when missing the first response that throws the test off, with a first response, everything tests fine.

(Megan) #10

Thanks Michael, I wasn’t sure enough about what I remember Ben Bikman saying to risk typing it out to Kyz.

#11

Thanks for the info Megan. I’m 53, female, 5’6, and currently 220 (ish). First, I just want to (finally) get below 200, but an ideal weight at around 165. The protein thing seems to be a bigger debate (research through videos/books) compared to my last time keto. I feel comfortable with around 100 grams a day, but I still see where some recommend more like 60-80/day and that would honestly be a struggle if it was every day.

Honestly not sure about eating carbs again so soon for a test. I’m strong on keto as long as I don’t even think about over eating carbs.

(Michael) #12

While people with IR can have slightly higher blood glucose with higher protein intake, the importance of getting enough protein outweighs the glucose response (for those that have one) in general. In your case, an ideal weight of 55kg would mean that anything around 100g of protein is between 1.5 and 2 g/kg which seems perfect at your age, sex and height. While you could easily go lower, the consensus in general is more protein is better if your body can handle it. I have IR, get a direct increase in blood glucose from protein but manage through fasting. I ate 312 g of protein (and 276 of fat) yesterday and I weigh 59 kg. No one would recommend eating over 5g/kg, but it can be done safely as well if you involve time in your equations.

(Bacon is a many-splendoured thing) #13

Moreover, Bikman and his team have shown that in the context of a low-carb diet, the insulin response to protein is match by an equivalent glucagon response, so that the ratio of insulin to glucagon remains low.

#14

Dr’s appointment this morning… establishing as a new patient, so he did a few tests. I meet with him next Wednesday to discuss the results.

My A1C is 5.7. I’ve been back on keto since mid-May, so that is slightly concerning. In 2017, my A1C was 4.7 (also keto back then). More answers next week hopefully.

(Megan) #15

Keep us posted, Kyz

(Bob M) #16

A1C is not a perfect measure. If you really have a 5.7, that means that your blood sugar is 117 all the time. I highly doubt that’s true.

https://diabeteschart.org/bloodsugarchart.html

#17

Are you saying A1C is unreliable or inaccurate? I understand it to be an average of the last 2 to 3 months.

(Bacon is a many-splendoured thing) #18

HbA1C is a measure of the glycation of your haemoglobin. It is used as a three-month rolling average of your daily serum glucose, on the assumption that your erythrocytes (red blood corpuscles) live for exactly 90 days. If they are really healthy (as they might be in someone on a ketogenic diet) and live longer than that, your HbA1C will be artificially higher than a true average of daily serum glucose readings. If they are unhealthy and do not live for the full 90 days, then the HbA1C reading will be artificially lower than a true average.

There are also the further assumptions that serum glucose is essentially stable (which it might not be, in a carb-burner), and also that the patient scrupulously followed instructions and was neither over- nor under-hydrated at the time of the blood draw.

The moral? Take your HbA1C as a rough indication of your metabolic health, but don’t freak out at every little shift.

#19

My FBG was also high on keto. I had no weight to lose, though. Perhaps in your case, when you lose the weight it’ll become better.

Research on diabetes prevention seem to point in the direction that lifestyle changes, and they mean the ones leading to weightloss, can be effective. Diet and exercise.

Another intervention that was successful for some was metformin.

Good luck!

#20

I forgot to post about my follow up appointment. The doctor stated that a 5.7 A1C is not prediabetic. I saw that it was the beginning of it, but I’m ok with that as long as I can get things straight. He recommended a high quality cinnamon supplement, which I have started to take. My numbers are still 134 to 141 in the mornings so far, but I’ve been away from my own kitchen quite often lately. I’m still eating very low carb/keto, but have used some keto breads occaisionally that probably aren’t the best. I go back at the end of January. All in all, not very helpful so far, but I did not want metforman again. There is another medication he suggested that we could try if needed. He’s on board with low carb, but honestly, I’ve avoided the “k” word with him for now. He does get a sense of just how low carb I am due to my concern with my morning glucose levels.

PS I am losing weight, but VERY slowly. I have also noticed slighlty higher ketone numbers since starting the cinnamon.