Insulin vs ketones

(Barbara Greenwood) #1

Right, I’ve seen in several places (including a thread on here) that, in order to make ketones, insulin levels must be low. Insulin turns off ketosis, is the message. The higher the insulin, the lower the ketones.

I want to query that - in the case of people with T2D. Maybe IR generally, IDK, but definitely T2D. Here’s why…

I bought a ketone meter in October, when I’d been eating keto for 3 months. Ketones were typically high 1’s to low 2’s, up to high 2’s when fasting. Fasting glucose was high 5’s to high 6’s

Now, fasting glucose is low 5’s to low 6’s mostly - weight loss has continued - and ketones are usually between 0.3 and 1.0, up to 1.5 when fasting. You would think, from the weight loss and lower fasting BG, that my IR is improving, and therefore insulin level should be lower. But ketones also lower!

So here’s my theory.

“Insulin prevents ketosis” - not true. What IS true is - dietary carbs prevent ketosis. In people with normal insulin sensitivity, higher insulin = higher carb intake, and that stops ketosis. But it’s not the insulin - it’s the carbs.

In people with T2D who go keto - insulin level will fall, but will still be higher than normal, at least for a while. But, they will produce ketones perfectly well, thank you.

However, as they become more fully keto-adapted, their body gets smarter and they make ketones more efficiently. Hence both ketone and BG levels can fall, as they have with me.

Thoughts?

(Kathy L) #2

Maybe you have something there…

(Scott Shillady) #3

Here is a great post by @richard :richard: that speaks to this Why We Stall

(Barbara Greenwood) #4

Hmmm, thank you… not sure it quite addresses my hypothesis. Or maybe I’m being dense and not seeing it. Still interesting stuff, though.

Is there a way to ask Richard to comment on my post? Oh @richard…

(Bart) #5

You should check this article out…

http://onlinelibrary.wiley.com/doi/10.1002/0470862092.d0308/abstract;jsessionid=7AAEE31311AF7A588A5877458E18606C.f01t03

Here is a quote from it…

“The overarching concern in the hormonal control of ketone body metabolism is the insulin level. In circumstances where insulin levels are relatively high, such as the fed state, both substrate (free fatty acid, [FFA]) availability and FFA oxidation are suppressed, directing FFA to storage and employing glucose to meet the energy needs of the body. In situations of relative insulin deficiency, such as starvation or type I diabetes, FFA oxidation is increased, driving the production of alternative energy-producing substrates, ketone bodies, for use by the brain, as well as peripheral tissues. Insulin influences the activity of three key processes: FFA availability (lipolysis), ketone body production (ketogenesis), and disposal in peripheral tissues.”

Which would lead me to believe that those was insulin resistance who have a higher amount of insulin swimming around in their bloodstream may tend to show lower levels of trig production than those with insulin sensitivity.

#6

My understanding of this is along those lines, but somewhat different.

Initially, in the first 1-3 months of keto, your body is in ketosis and generating ketones. However, all the cells in your body are used to running on glucose, and preferentially still want to use glucose as fuel. So your cells will use the ketones, since that’s all they have available, but they keep sending out signals for fuel since they want glucose. So basically, your body is at an imbalance where you’ve turned on the keto factory to generate fuel but the cells aren’t acknowledging that the fuel exists.

After you become fat-adapted or keto-adapted, your cells have basically acknowledged that ketones are fuel and will stop calling for more energy when there’s enough ketones floating around. So that means the ketone factory doesn’t need to run as much since it’s making enough of what the cells want. In addition to that, like you said, the cells have gotten better at using ketones for fuel and your body is better at making them for fuel.

(Barbara Greenwood) #7

Interesting… can’t see the full article, owing to being too tight to pay for access. It does say things are different in metabolic derangement, including obesity and diabetes.

ISTR Ivor Cummings talking about a study on the. Out recent podcast, comparing insulin sensitive and insulin resistant normal weight people… the insulin resistant ones were shuttling fat all over the place.

Maybe when T2D people fast or eat keto, insulin falls low enough to permit ketogenesis, even though glucose is still higher than normal.

(Kathy L) #8

I like this explanation! Good job!