Question on Progress with Blood Sugar

(christian) #1

Morning everybody!

I started Keto and Intermittent Fasting last week, actually did 24-hour fast Black Friday and then have been following keto ever since. For reference, I’ve had blood sugar for several years, but have been in complete denial and have not treated it with metformin or insulin. After Thanksgiving feasting, I felt horrible and my blood sugar was like 364, so I said F@#$ It and decided to dive into keto and fasting.

Four days later, I’m starting to see my blood sugar lower in the tail end of the day, I’ve started seeing more manageable numbers. For instance, I fasted for 25 hours from Sunday night to Monday night, and here are my readings from yesterday:

  • 6:54 AM – 234

  • 1:38 PM – 177

  • 4:53 PM – 148

  • 6:36 PM – 132

Then I broke my fast last night with a plate of sausage (zero carbs) and then restarted my fast at 10.

The problem is, I took my blood sugar again at 6:14 AM this morning and it was 198.

Does it take a while for fasting blood sugar to come down? Should I keep fasting an maybe explore longer fasts?

Any advice would be greatly appreciated.


(Take time to smell the bacon) #2

Welcome to the forums!

With the change in diet, you may want to forget about fasting for a while, until it happens naturally. A ketogenic diet should not restrict calories, so as to avoid causing the metabolism to drop. Your appetite is likely to be quiet high for the first few weeks, as you adapt to the new way of wearing, but then it is likely to drop, as the lack of interference from elevated insulin allows your appetite hormones to start working properly again.

The key is that avoiding carbohydrates helps blood sugar to drop, which in turn lets insulin drop. Given how out of control your blood sugar has been, it may take some time for it to return to a more normal range. You may also be insulin-resistant enough that you may have to be especially strict with your carb intake, until you become more insulin-sensitive again. The metabolic re-regulation promoted by a ketogenic diet takes time; after all, it took years for your metabolism to get so badly messed up, so the cure won’t be instantaneous, either.

It sounds as though you are already seeing good results, so keep calm, and keto on, as we say.

(Robin) #3

Ditto everything Paul said. Work up to fasting, if you want. But they aren’t “necessary”. Good for you getting serious about it. We all have a trigger moment where we suddenly realize we must act NOW… even though we’ve known it for years. Just keep it simple, (try for 20g carbs or below) and stay the course. You got this.

(christian) #4

Thank you for the reply, and encouragement! I hadn’t really thought about dipping my toe into the keto “water” before diving in full bore with keto and fasting. So I will roll back fasting for a bit and focus on keto eating.

I have been staying under 20g of carbs on my eating days, usually a few tablespoons of peanut butter.

And good point on it taking time. There’s that old saying: “13 miles into the woods, 13 miles out.”

Thanks again for the encouragement. I will keep calm and keto on!

(christian) #5

Thank you for the encouragement!

(Bob M) #6

Starting fasting so soon is impressive. It’s probably better to go a bit slower, and add some fasting later, though.

You will most likely have higher morning blood sugar, as that’s common with T2 diabetics.


I’m a long time type II. It took months on keto to get fasting blood sugar consistently below 115. I rarely get overnight numbers below 100. I fasted for 50 hours twice a month, and blood sugar would dip into the 70’s or 80’s a few hours after heavy workout. I was very discouraged for a time, as my fasting numbers soared into the 140 range. The explanation was “adaptive glucose sparing”. I wasn’t sure that was really a “thing”, but people here encouraged me to keep after it, so I did. Eventually my fasting numbers started dropping and the weight started coming off too. Life events drove me out of strict keto for almost a year, but I’m back on board and again seeing positive results. I’m not sure it is a cure, but many of my diabetes related issues are greatly reduced, so I would call it an effective management technique. I guess I’m trying to say, stick with it. Just watch carefully and get guidance about any meds you may be on. One very noticeable side effect for me was a large BP drop.

(christian) #8

Not on any medication at the moment. Wondering if I should get on some Metformin for the time being to help drive my blood sugar down?


I was allergic to Metformin, but was on Glucophage or glucovance. Can’t remember now.

(Take time to smell the bacon) #10

The word “cure” is iffy, in this context. What would constitute a cure? You might be considered “cured” of arsenic poisoning if you stop ingesting it and get better, but that won’t prevent you from getting sick again from arsenic poisoning. The term Dr. Phinney prefers is “reversal” of Type II diabetes, to avoid some of these issues.

You should consult with a physician on this; we can’t advise you here, except to say that Metformin is a drug that has very few side effects, so it’s not likely to do you harm.

However, we are probably okay, whatever our actual level of serum glucose might be, as long as it remains in a fairly narrow range. Dr. Paul Mason, a respected Australian sports physician, says that he no longer worries about patients whose glucose levels might be considered high, if seen in some of his other patients, so long as their glucose isn’t subject to wild swings.

In any case, I’d stay on a well-formulated ketogenic diet for at least six months before worrying about this stuff. By that time, most of your metabolic numbers will likely have improved significantly.

(Bob M) #11

And, if you can get a continuous glucose monitor assigned to you for a while, I highly recommend them. They will let you know much better than pin-prick monitors what’s going on. Even a month can be helpful.

(christian) #12

That would be very nice as pricking ten times a day hasn’t been fun so far!

(christian) #13

Just a general update, I feel off the wagon. Ended up getting sick with a upper respiratory infection, and they gave me a shot of antibiotics and a shot of prednisone. Now I’m talking orals antibiotics and oral steroids and my hunger is out of control.

It’s not an excuse, but I’m taking this as a learning lesson that if I fail to plan on my diet, no matter the circumstances, then I plan to fail. I hope to have the meds wrapped in the next few days and will get back on board with this WOE.

Thanks for all your support to date!

(Bob M) #14

It’s not a big deal. It happens to all of us. Just get back on when you can.

(Ronnie) #15

I have recently ‘reversed’ type 2 diabetes, dropping 3 month glucose HbA1cfrom 52 to 37.

I was taking 500mg Metformin tablets twice daily. The doctor said (over the phone with my blood results) that I could stop taking the Metformin. However I said I would simply reduce the medication to one tablet a day until get my next bloods taken in 6 months time. Note, we get ‘free’ (well, obviously we pay for these and NHS through tax) prescriptions in Northern Ireland, so money was not a factor. I just wanted to play it cool as I lost 23 kilos in about 5 months under keto, and I wanted to make sure it lasted.

(christian) #16

Thank you for sharing! That is awesome news, congrats!

(Michael) #17

My 2 cents which is typically not quite the same as the standard advice on these forums.

Your blood sugars were extremely high, you are definitely very insulin resistant and the lower carbs you can go the better. Zero carbs would be best.

While I agree that you may want to do keto before starting fasting, I fasted very early into my conversion as well (for 10 days), and while it was very hard at first and rough (which is why I agree to probably recommend waiting), I am also glad I did it, and IF you can handle it, not necessarily a bad thing, just very tough for most people. If fasting is a struggle, wait a few months and then try it. If not, a 7, 10 or 14 days fast should really kick start your transition. This is what Jason Fung recommends for people if they are in dire straits, which you just may be.

Do NOT fast if you are on Metformin or were recently. Metformin can stop you from producing glucose as much, but you need to produce when fasting, so do not both fast and take Metformin.

(christian) #18

Just an update here, restarted keto today after some rough holiday eating. Looking forward to making progress!


I’m new and have lots of questions. Will try to stay on topic. Three months ago I was diagnosed with diabetes. I suspect I had it long before but my previous Dr, would just shrug when I asked. I had started an ignorant version of Keto about four months ago, am still learning.

When I started testing glucose I was in the 180’s. Now I’m in the 120-130 range. I use Berberine and Keto.

Here is my question. Why are my fasting levels as high or higher than my 2 hr after meal? I averaged my tests for the last month. After meal is about 130 and fasting is about 131.

(Take time to smell the bacon) #20

And you are probably right. The late Dr. Joseph Kraft, a noted diabetes researcher, certainly thought so. Unfortunately, the diagnostic criterion for Type II diabetes is elevated serum glucose. Dr. Kraft’s research, however, was able to show that the pattern of insulin response could signal a problem as much as two decades earlier.

As to your question about fasting, I suspect that you haven’t been eating a ketogenic diet long enough for your system to have finished re-regulating itself. If you struggle at all to fast, consider not fasting until you are what we call fat-adapted. (This is the point at which the muscles have fully readapted to metabolising fatty acids in place of glucose.) And if you find yourself skipping meals because you forgot to eat, then you are clearly ready to fast.

A further consideration is that the absolute level of serum glucose is not as important as avoiding sharp spikes and deep dips. If it stays in a narrow range, it is better, even if the range is on the high side. If your HbA1C is in the healthy range, that is another sign that all is well.