I have been doing keto on and off for a while now. I just started doing it strictly again. I bought a glucose meter because Ketone meters are hard to get in Canada. I want to know how to use my glucose meter to know how many ketones I have. Or at least what my glucose level should be at to know that I’m in ketosis. Can anyone help with this? My reader comes out in mmol/l. I have read in between 4.6 mmol/l to 6.6 mmol/l. I think that means I’m not in ketosis yet but its confusing when looking online.
How to use a glucose meter
Shortstuff
(Allie)
#2
Those readings ard fine. Others will be able to explain the science better than I can but my regular non-fasting blood glucose is normally around 4.2 to 4.8mmol (multiply by 18 to get American numbers), and up to 6.9mmol when I’ve chosen to treat myself to something I wouldn’t normally eat - this number does reduce my level of ketones but only temporarily.
ctviggen
(Bob M)
#4
There’s little to no relationship between ketones and blood sugar. That is, by taking blood sugar, you can’t really tell what your ketones are.
My blood sugar readings are much higher. They were 99/5.5 this morning upon awaking, then were 115/6.4 after high intensity interval training and body by science (weight lifting to failure) and a cold shower. I’m usually over 100/5.6 every morning, my blood sugar goes up until around noon, then falls all day long until about midnight (I know this by wearing a continuous glucose monitor).
brownfat
(Todd Allen)
#5
While the glucose meter can’t really tell you ketones it is still very useful. When your blood sugar is up your insulin is up and your fat burning will be suppressed. Ideally you want your blood sugar stable and in the low for you end of the range. If you’ve seen readings from 4.6 to 6.6 I’d aim for staying in the bottom half of that range, say 5.6 or lower. You don’t have to test all the time, just test how you respond to your common meals, especially things with more carbs in them that might be problematic. A good approach is to test before a meal and again at 1 hour and 2 hours later to see if the meal caused much of a rise. If the numbers stay good then that meal and similar meals will likely be fine and you probably don’t need to retest it often. If you get a rise you might try cutting back on the carbiest ingredients next time and retest. I’ve learned that beyond food a lot of other things affect my blood glucose. It tends to run a lot higher when my sleep is poor or I’m stressed. Taking a walk after a meal does wonders for me and keeps my blood sugar stable in situations that might otherwise spike it well beyond my target range.
ctviggen
(Bob M)
#6
Here are my tests, where I got insulin tested with blood sugar. For the 11/14/16, you can just assume my blood sugar would be about 100 (divide by 18 for European units). These are tests taken by an official lab.
You can see that for about the same fasting blood sugar (near 100), I have had fasting insulin from 3.8 to 33.0. A difference of 10 times in fasting insulin where there is basically no difference in fasting blood sugar. (Another anomaly - my HbA1c went DOWN while my fasting insulin went UP.)
It’s unclear to me that the “when your blood sugar is up your insulin is up” is a rule. I think it applies if you’re eating a lot of carbs and you’re susceptible to this, but for someone like me who has been on low carb for almost 5 years, it’s unclear to me what happens with insulin.
Also, I’ve eaten quite a few grams of protein in a single meal (120+, 150+ grams in one meal), and my blood sugar did not budge, but I bet my insulin went up.
Of course, I’d love to have an insulin meter I could use all the time, like the modern ketone/blood sugar meters. That would help a lot.
And this is a typical day of blood glucose for me (taken by a FreeStyle Libre continuous glucose monitor):
You can see that I start high and end low, and it’s the same every day, and has been the same for a while (over a year at least, if not several years). (I ate two meals this day, one at 10:03 and one at dinnertime, which I apparently forgot to record.)
So, when people say we should be aiming for blood sugar within 4.6 to 5.6, my body doesn’t comply with that, even eating keto and fasting. For people who are just starting out, this might be useful advice, but for someone like me, I no longer have much control over my blood sugar.
brownfat
(Todd Allen)
#7
Your lowest glucose corresponds to your lowest insulin as does your highest readings. And all the ones in between too. Not that there is any guarantee of that as insulin is pulsatile. And blood glucose while the strongest stimulator of insulin is not the only factor, as you pointed out protein stimulates insulin as can non-caloric sweeteners.
You can’t expect correlation between HbA1c, essentially an average of glucose over months, and insulin, a momentary value.
I suggested 5.6 as a target for the original poster based on the range of her readings so far. Each person needs to find their own targets and adjust over time. For someone severely diabetic they may rarely if ever drop below 5.6 and it would clearly be an unrealistic target. Someone in good metabolic health might choose a significantly lower target. One also needs to consider the accuracy/noise in their measuring device and not over react to an anomalous reading or two but keep an eye out for trends.
As for your pattern, at least on that one day your rise to 113 is not too high. Most would consider that well controlled blood glucose. Still you might find you could make adjustments to keep it lower. Perhaps shifting carbs such as the 2 slices of cheese to first thing in the morning or later in the day might flatten your curve. Maybe the morning/mid day rise has less to do with food and more to do with a stressful commute or pressures of work? I struggled with a puzzling slow rise in blood glucose over a period of months and wasted a fair bit of effort scrutinizing diet and other factors. I had an infected molar that was missed by my dentist until I got an abcess in my gums. The day after getting a root canal my blood sugar dropped 15 mg/dl and has been quite good since…