Been doing Keto since May. Lost over 55 pounds, A1C went from 7.6 to 5.7. My blood sugar hardly ever goes below 100. Am I still burning off stored sugar at this point, or is this related to what they call dawn syndrome. My average carbs are less than 5g per day on average, my protein to fat ratio tends to run between 40/60 and 60/40 depending on what I eat. And even Calories, which no one cares around used to average 2500 - 2700 per day, and the last week I have reduced some and usually have them around 1700 per day now. I have run into a number of people like me in some facebook groups who have the same issues, we just don’t live in the magical 70-100 range everyone else talks about. My lowest readings might be 95, and go as high as 130, usually higher after I get up, and during work which I always wrote off as stress related. Appreciate an answer, or even better someone to do a video on this issue.
Higher daily BS readings than what people say are normal
I’m in almost identical circumstances. My FBG is consistently higher now, than it was before trying to go keto. I started LCHF around March, and all numbers went down, and lost about the same amount of weight. My macros are closer to 70/25 for fat/protein. A1C dropped over time to 5.4, I started trying further carb restrictions, and trying to fast. I have gone from afternoon BG in the 80’s and 90’s, to never going below 100. I walked 3 miles yesterday, lowered me to 108, but checked again before dinner, and was back to 118. Then DP this morning had me back to 141. My last fasting attempt, at 30 hours, I was up to 188, and after verifying the continued high numbers on a second meter, I broke the fast. I have been looking for podcast, or blogs to guide/help me resolve this, but no joy. At this point I’m just winging it, because beyond trying to break this metabolic syndrome, I have no clue if I’m doing myself any good. I am still losing weight, which is a plus, but I guess i won’t know until my next A1C.
I suspect bad strips or something on your fingers. And actually blood sugar usually goes up (at least for me) after/during exercise.
This is some data I took using a FreeStyle Libre continuous glucose monitory, over the course of a 3+ day fast. Note that my morning blood sugar when eating is usually over 100 and goes up all day until about noon, then goes down all day. My “official” HbA1c last time I had a test was 5.0.
Here’s one month’s of data that shows the pattern better. Multiply by 18 to get US units:
If all you do is take one test per day, you’re getting a terrible view of what your blood sugar is.
Mine are down, I used to get about 160 in the AM, and 120’s at night. I have dropped to 110 - 130 in the AM, and at night 95-110. I listened to a video by Dr. Fung on 2KD’s youtube this AM, and Dr Fung said it takes a long time for someone who was obese for a long time to get all the stored sugar out of their body. But it sure seems by what I record, my body is just going nuts making it these days, but maybe its what he says. I would have been classified as morbidly obese for well over 20 years, topping out at 454 in 2012. I had lost about 90 pounds prior to Keto, but my blood markers were not that good, and my A1C was not in control, even though I was on Janumet and Jardiance. I only take Metformin now, I just was trying to figure this all out. I did not know if my body used to have to do that for me to even just move my 450 pounds around, and even though I have lost almost 1/3 of my body weight now, maybe it has not adjusted. Its crazy that just getting up, going to the kitchen, and hand washing some dishes can send my BS over 150, but it does.
I only came some of whats going on doing constant testing last week. While 22-1/2 hours into a fast, when my BS was 107 the night before, it went as high as 180 the next morning. I did dig my Freestyle Libre out of the drawer this week and got new sensors for it, but frankly, its as innacurate as the other time I tried it. After two days of constant readings of 150-170, I took my BS last night with my Freestyle Light and it said 94, and my Keto Mojo said 110, when the Libra said 160. I am not saying this based on 1 test a day. My BS was 92 last night at 9:23, 74 when I woke up at 5:30 am, 116 at 5:56am, 107 at 8:19AM, and 101 just now using the Light I ate breakfast this AM, 2 eggs fried in coconut oil and 4oz of fresh sausage I made myself, with only Pork, Sage, Salt, Pepper, and Paprika in it. Carb Tracker says I had 0.8g of carbs, 31.6g of protien, 38g of fat today. Yesterday was 8.8g of carbs, which was dairy, 113g of protein, 142.8g of fat. When I had my blood tests done, as I left the office, I tested my BS with both my Light and the Mojo. The Light was dead on with the report I got, the Mojo was 10 high, which it usually reads compared to the light. Don’t think its anything to do with strips or my finger.
I use the continuous glucose monitor of the FreeStyle. I’ve never tried the strips. I cannot vouch for their accuracy or inaccuracy. I do know I’ve had “real” BS tests done and the FreeStyle CGM was spot on once and off once (as was my Contour Next EZ).
So, if your blood sugar is normally much lower, what could have caused the 180 if you’re fasting? I always suspect a monitor if the reading is dramatically different. It could be correct, though, but I always verify.
If you’ve been high carb for years, it takes a while for the liver and pancreas to reset themselves. Intermittent and longer term fasting makes that process faster (relative to keto), but it’s unclear how fast and how much. And, will these ever be the same as they were? No one knows.
The CGM has given me problems, they even sent me a free sensor the first go round. I think the problem centers around the fact that I have lost almost 150 pounds. If I put my arms up to make a muscle like we did when we were young, the bottom of my arms will sag down about 3". Since this is the area they want you to put the readers in, I just don’t think they read the interstitial fluid properly. Every one has their own unique issues. I did intermittent fasting now for 8 months by the way.
I’ve never measured, but people often seem to feel that my BS level is quite high. . . . 
I just read where blood sugar meters can be as much as 10 to 15 percent off. I suspect mine is 20 points higher. Tge kast time I had bloodwork done, my meter read 103 fasting blood sugar and the blood work that I had at the lab was 82 and the readings were within 1/2 hour of each other.
It is worrisome and I am looking around for a better meter. Maybe that is part if the problem?
Dietdoctor.com on high fasting glucose levels while keto.
Hope this eases your mind a bit.
Thank you sharing that article. I have been low carb for close to 10 years, so that may be the cause.
On Saturday, I checked my Blood Sugar every hour and my FBG was the highest it was all day. It was 120 and the rest of day, including after eating, it was around 103. It started to go up again by the time I went to bed and had not eaten for 6 hours. It was 119 at that point. Yesterday morning, it was 113 when I woke up.
My FBG and A1C are always good when the lab tests them, so I just assume that my meter runs high. No doctor has ever told me that I was pre-diabetic.
if you are eating very little carbohydrate, and your HbA1C is 5.5 or under, then don’t worry about your serum glucose. Firstly, there is dawn phenomenon to contend with, and second, once we are fat-adapted, we experience glucose-sparing (also called “physiological insulin resistance”) on the part of the muscles. Peter, the author of the Hyperlipid blog has a great explanation: