Is Keto contraproductive in my case against Metabolic Syndrom at this stage

(Patric) #1

Hello,

I try to make it short. Be me, 3 years ago Hba1c 6.7, and very high Triglycerides (>1400)… Diagnosed with Metabolic Syndrom and new onset T2D. My son is T1D, so the world is not new to me, didn’t want to go the syringe route. So I cut sugar, went somewhat lowcarb for 2 years, and be more active (long distance walking). Loose 10kg of weight.

Fallback sometimes to sugar consumption (excessive). Had enough, went strict Keto January last year.
Immediately shed 20kg in 2 months, all the benefits, hba1c now 5.3.

Ok cool, but I think it is becoming contra productive. Indeed my fasting bloodglucose is eleveated, also throughout the day, my level aren’t low. I do strict keto, a lot of meat and fatty cheese, eggs.

My fasting Insulin one year ago, after two months of keto was 11 μU/mL.
Now I am consistently over 15 μU/mL, despite one year keto “healing”, so worse of.

I understand the concept of glucose sparing or physiological insulin resistance, and that it isn’t bad, and I’m very convinced that it is the case with me and that I’m fat adapted, as my endurance is very high and I’m never really getting tired, and ketones are generally low too, despite near zero carb.

Yet I’ve to ask myself if it useful at this point, isn’t it more productive to be flexible, so my muscle starts taking glucose in again better and doesn’t ignore it.

My goal is to actually lower my insulin, so for me it looks like introduction of carbs may help to exit glucose sparing and go on with my journey of improving, or should I just continue keto?

Thanks for reading

(B Creighton) #2

My guess is your diet is causing an increase in IGF-1, which is keeping your insulin up.
I do low-grade keto in the winter and low carb the rest of the year with increased walking. So what this looks like for me is basically doubling my protein in the winter - I switch away from some carbs to a yogurt and egg breakfast, and additional protein from protein smoothies. All the protein keeps me from getting hungry but the idea is to do it in a way to keep IGF-1 no higher than necessary.

This will drop down in my low carb phase of the year when my protein level drops. Also carbs are low enough that I don’t get higher fasted insulin. Using real honey occasionally may help reduce the insulin resistance you are seeing as well. It may be worth a try.

(Chuck) #3

I have hyperglycemia strict keto doesn’t work for me. I do a low carb diet though. What i really do is only eat real food. No processed food, no fast food and not soft drinks not even diet drinks. My body is happy with keeping my sugar levels at about 90. I believe the highest I ever saw was 98.

(Bob M) #4

I personally don’t think it’s counter productive. I think some of us, particularly if we’re exercising (like me) or have lower fat mass (not me, but getting lower) will have higher blood sugar.

For morning fasting insulin, I think this is challenging. You see people who will say that you’re “insulin resistant” if you’re above a certain morning fasting insulin level. I don’t think that until we can measure insulin at home, we’ll figure out what that level is. My morning fasting insulin has been all over the map. It’s normally around 10, but I’ve gotten from below 10 to 33. Since insulin is pulsatile, you can’t really figure out what’s happening. I have the theory that the amount of time between eating and getting the test done will affect this, but there’s no way to do this without testing at home.

If you get lower glucose and/or fasting insulin by eating higher carbs, and that makes you happier, then I’d say that’s what you should do. But I highly doubt the body is trying to do something deleterious by having higher blood sugar with lower carb levels. We just haven’t studied enough people who have higher blood sugar with eating lower carb.

(You've tried everything else; why not try bacon?) #5

The threshold for the metabolic switch from ketolysis into glycolysis is just under 25 μU/mL.

If your fasting glucose seems to be rising, one possibility is that you are not eating enough fat. I am not sure this hypothesis is entirely valid, but you might want to make the experiment. Also be sure to eat enough calories, since short rations is the signal to the body that there’s a famine going on. It’s reaction in that case is to conserve all possible resources for the duration.

The difference between Type I and Type II diabetes is that the former is an auto-immune condition resulting in a total lack of insulin, which is necessary for survival. The latter is, on the other hand, a gross oversupply of insulin, hyperinsulinaemia as a consequence of hyperglycaemia, which is the result of an oversupply of carbohydrate (i.e., glucose) in the diet. You need never go the needle route, so long as you keep your carb intake sufficiently low to keep your serum insulin at ketogenic levels. That is actually the primary purpose of the ketogenic diet: while ketones have many powerful effects in their own right, it is the reduction of serum glucose and consequently serum insulin that allows metabolic healing to occur.

#6

+1

My fasting glucose rises and my ketones go down when I move to more protein,less fat. Happens with our lean meat every now and then. I´m good with 75% fat or so (energy %), total calories must be enough for the individual.

(Patric) #7

Thanks for the feed, before going back to a bit carbs, I test the hypothesis that I’m not eating enough fat. I’ll report back next week.

#8

That’s actually pretty debatable, many of us see that as a positive for some reason (not me) and many of us see that for what it actually is, loss of metabolic flexibility, so we wind up trading being inflexible with fat, and then become inflexible with carbs. Our metabolism is supposed to burn the fuel we throw at it. No lose it’s crap because it got something different.

Bingo, I switched a while back to a TKD/CKD hybrid keto, regained a lot of lost muscle, and since muscle is the best glucose disposal agent we have, that’s made a huge difference. Now I can seamlessly switch in / out of ketosis, never even feel it, no more carb hangovers etc. A1C is usually around 5.1 - 5.2, when I was strict keto it was 4.8 - 5.0. So not much change at all, vs my diabetic numbers of 5yrs years ago.

You can do both, as I and many do, doesn’t have to be 100% one or the other. Stop focusing on thinking Insulin is the problem, it’s not. Chronically high Insulin is, two different things. When I’m done with my workout in an hour or two my protein shake will be spiked with Dextrose to drive everything in, and my glucose levels will be lower for hours because of it.

The way Semaglutide and all the GLP-1’s work is by making you release MORE Insulin when you need it, which lowers overall blood glucose and therefor A1C and fasting Insulin levels. The fear of Insulin is misguided, just as we used to fear protein years ago because we didn’t understand gluconeogenesis correctly.

Without Insulin we’re dead, being afraid of the hormone that lowers blood glucose, when lower blood glucose is something we’re after is nuts. Rather than have a good balance and a good insulin response that does the job, we decide to just NEVER make it go up and avoid “spikes”. Well, glucose spikes are SUPPOSED to happen. The issue is when it takes 5hrs to fix something that should have been corrected in 1. It’s literally the hormone equivalent of the old “hey doc, it hurts when I do this” and then the answer is just “don’t do that”.

Given that your A1C is 5.3, you’re not in bad shape, just sounds like the metabolic inflexibility getting you.

(Patric) #9

Thanks for all the replies, I’ll make an update, for people using the search function.

Now after only 3 days, I can tell it was clearly too much protein.
I was doing mostly carnivore, and it turned out this is too much Protein for me.

I’m now aiming 75% fat 25% Protein, and my dawn phenomenon is negligable, and my ketones are
up to 0.5 -1 throughout the day.

My average bloodglucose is 90, instead of 110, and this after only 3 days.
Too be clear, I did strict keto, never any carbs, yet it didn’t work for me.

Chatgpt suggest I’m still insulin resistant in the liver so the gluconeogenesis is over expressed, maybe, maybe not.

Just wanted you to know, if after 1 year Keto you end up on a plateau, it may be the Protein.