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I am a Type II diabetic and have been on a low-to-zero carb diet for approximately 2 years and am experiencing high blood glucose levels. Why?

by 0 · July 12, 2014 at 04:25 PM

I eat probably less than 1000 calories per day on average, occasionally up to 1500; abundant healthy fats such as coconut oil, grassfed butter, raw olive oil, avocado oil, bacon, etc. I eat two eggs almost daily, a little meat. I drink 8-12 oz. raw sprouted almond milk daily and I have coffee with heavy cream in the morning. Greens, other non-starchy veggies, occasional glass of red wine in the evening before bed,and that pretty much is my standard dietary intake..

I have been in ketosis for about two years. I am not losing weight. I have managed to get my diabetes medications (metformin and glipizide) down to once per day, usually before supper and my numbers have been hovering around 130-180. Last week they spiked and I am now frequently in the mid-200's and am having to take my medications twice/day. Still I am not losing weight (am currently 170-174lbs but had gotten down to 156 until weight started to climb again over the last year or so).

I have no explanation for my high glucose levels and my inability to lose weight. Literally, the only thing that I consume on occasion that deviates from this diet is an occasional sugar-free (so, Splenda, probably) blended coffee drink from Peet's. This would be once or twice a week. Could this have something to do with it?

Help. I'm lost!

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2297 · July 12, 2014 at 12:12 PM

  • You might consider asking this question over at the Bernstein Diabetes Forum. Bernstein's approach is compatible with Paleo, but the experience level with T2 is much higher.
  • One possible reason for the higher BG levels is a hidden dental infection. Another possibility is histamine intolerance, which can cause inflammation, leading to higher BG levels. Paleo can be higher in histamines and everyone's tolerance level is different. That tolerance level can also vary seasonally and there are hormonal variations for women to consider, which may be less of an issue for you at 55, but perhaps not.

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943 · July 11, 2014 at 05:37 AM

I have had a recent experience similar to yours. Reasonable glucose level for 7 years on Metformin. A couple of months ago, it shot up to 250 or more.

I had two courses of anti-biotics earlier in the year. I had had a long-term sinus infection so I gave in and took them. I normally refuse. I started eating yogurt thinking it would be good for me. (local, organic, whole milk, pastured, lightly sweetened) Not the best idea but I love yogurt and convinced myself it was the right thing to do.

I was told by a nephrologist that I could eat the many, many healthy high oxalate foods if I got calcium AT THE SAME TIME. He said Tums but I started eating even more dairy. I am Primal and my ancestors are all from the British Isles. I do dairy. But I was probably getting too much. I could chug a pint of heavy cream. not a good idea, although I don't buy the conventional wisdom about cholesterol and saturated fat.

When my glucose shot up, I responded by trying to go lower carb. (<50 g/day, sometimes 35) The doc also increased my Metformin.

It was pointed out to me that fat makes cells insulin resistant. Cutting back on fat, especially dairy fat, brought my glucose down to a reasonable level, not great yet but much better. I'm probably getting around 75 g/day carb of heathy veg. More than that DOES increase my glucose. I still believe in Mark's carb curve.

I sometimes have a bit of red wine with dinner. Having it at bedtime is probably a mistake.

I'm not sure if any of this will be useful to you, deblongley, but maybe to someone.

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2318 · July 11, 2014 at 01:35 AM

Paul Jaminet would say that too little glucose can produce the symptoms you describe. His explanation (and someone correct me if I'm wrong) is that too little glucose in the diet results in the body becoming insulin-resistant, because it's trying to conserve glucose for the interior tissues of the brain, where ketone molecules are too big to penetrate. Second, too little insulin causes functional hypothyroidsim, which interferes with fat loss. If you go to perfecthealthdiet.com, you'll find a series of articles on the long-term effects of very-low-carb diets.

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0 · July 11, 2014 at 12:31 AM

My mom eats in a similar fashion and I really think she can't lose weight because she eats too little. I mean, at a certain point, your body is going to hold on to every cell of fat it can because it's starving. If anything, I would try to increase your calories. That little amount of food is not healthy for anyone. Eat a minimum of 1500 calories a day. Also, are you doing any strength exercises? If not, try to add some to your daily routine. Building muscle will help burn calories all the time, not just while you exercise. And they're generally a lot easier to do than cardio (in case you have trouble exercise for longer periods of time). Easy to fit five or ten minutes or a few exercises in here or there during the day. Though I'd imagine that if you're tending a garden, milking goats, etc. you already get quite a workout!

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655 · July 10, 2014 at 04:44 AM

@deblongley

I'm not a proponent of BMI, imo it's nearly useless.

It's a ridiculously simple model based on two easy to measure attributes. It makes no attempt to model "shape". Here's a better model because it makes a crude attempt at shape. It's probably decent for people not too skinny or not too fat. In the text of the webpage there is a reference to some fitness correlation work that a USAF captain did. Target waist should be in the 50%-ish of height or so.

http://home.fuse.net/clymer/bmi/

You're situation is beyond what I can probably intelligently comment on. But I have read accounts of a couple women who calorie restricted compared to physical work done and still had trouble losing fat & not gaining more. A hormonal thing...cortisol, thyroid plus the excessive body fat acting as a hormone producer too. Maybe your fat is keeping you from losing fat. :(

I think you need a very experienced & specialized health care professional.

I had it easy, I lost fat (220 to 190, 6') by cleaning up my diet alone.

This shows how BMI is more than a bit flawed, your BMI=27.5, my BMI=26.5

My waist is 36" , 50% of my height Your waist is 43", 65% of your height

Our BMI's put me in the marginally overweight & you in the overweight range but I think that's not accurate.

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0 · July 10, 2014 at 02:20 AM

Thanks, thhq. Not sure about thyroid function yet. I have scheduled a checkup with the doc because of these recent bg levels. This is one thing I would like to have checked. She'll do an A1C and all the usual battery of tests to see if anything turns up. As for excercise, I live an active life and do physical work much of the day (including heavy earthmoving and pick and shovel in the hot sun--I have gotten dehydrated that way, simply forgetting to drink because, oddly enough, I'm not only not too hungry, but I also often don't get thirsty either), also taking care of livestock. But as for the treadmill or the bicycle--not too much in the summertime. Maybe I will try that and see if it makes a difference.

I'm 55 years old, have never smoked, have excellent blood pressure, good energy even with the low caloric intake, generally feel great. On the other hand, even when my glucose levels are sky-high, I still feel great--no symptoms whatever. I switched to this diet two years ago when I almost killed myself by taking myself off my medication, thinking that if I wasn't eating carbs and was eating all the right things, I would be just fine. But here's the stupid part: I didn't tell my doctor, and I was out of test strips. I visited my parents one day and my dad tested me just on a hunch and I was at 456. Should have been in a hospital or in a coma or both, but I still felt great. This is a problem, because I rarely have symptoms. My doctor is also puzzled with all of this. I just don't seem to fit the diabetic norm at all.

As for the 2000 calories/day, I used to do that. I did a little research a few months ago, because I was having some of these same questions (why isn't the weight just falling off me, why is my diabetes out of control) and read about something called a calorie-restricted ketogenic diet. Couldn't get a lot of details about a specific diet plan, so I just started to try and figure it out for myself. I knew I wanted to stay with the high-fat/moderate-protein/low carb model, and I know all the essential things to keep in my diet, so I just basically reduced intake of all of those things (some things I did eliminate entirely, but not many). Still don't understand why that isn't doing the trick. What is your thinking about increasing calories? I'm curious now.

Thanks for your input. This has given me some things to chew on (yeah, a pun--I have no self-control).

--Deb

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10067 · July 10, 2014 at 12:16 AM

I was type 2 and got rid of the glucose spikes by reducing carbs short term and losing weight long term. I have never been in ketosis, so cannot say what this would do to you over two years. This is baffling to me...you sound like a glucogenesis factory. Your weight is not terribly high, and this doesn't sound like it's driven by obesity. like Here are some thoughts and questions.

How's your thyroid function?

Do you exercise very much? For me exercise is an easy way to burn up blood sugar.

How are your trigs and A1C?

Are you getting glucose spikes post prandial or are you maintaining high fasting levels?

How old are you?

Have you tried eating 2000 calories a day for a week or more?

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0 · July 09, 2014 at 10:58 PM

1418 calories for the day. Like I said, I've been doing this for awhile. I eat this avocado/tomato/bacon salad probably 5 times/week. It is 764 calories, give or take. I would be happy to give you the breakdown if you'd like. The cream in my coffee is probably around 200. Duck eggs are 130 each. Kefir is about 150 (no lactose, since it's cultured). And my daily raw sprouted almond milk is only about 40-60 calories, depending on how much I pour.

And, I'm not losing weight "on the internet." I am attempting to lose weight at home with home-grown veggies, fresh milk from my goats, pastured eggs from my chickens, and tweeking my diet by observing what seems to be happening (or not) with my metabolism. I have never posted a question on any forum prior to this (in part because I have seen the rude and presumptuous replies that other honest questioners have received for their trouble), but I am really at the end of my own knowledge about any of this, so I am reaching out to see if anyone has any ideas about what I might be doing wrong.

Incidentally, I left out a huge category of food that I eat: fermented and cultured foods. I drink home-brewed raw goat milk kefir and kombucha and eat homemade sauerkraut several times a week.

Just to be clear: none of this is a whim for me. I have been experimenting with this ketogenic diet for two years now. It's not perfect (obviously, or it would be working better). But I am doing it consciously and I am recording everything, every single day. I am wondering if my diabetes is the actual monkey-wrench in the works. Sometimes a condition (like diabetes in my case) causes the body to respond differently than it would in someone else. Just a thought.

Thanks for engaging, but now I would like for you to believe what I am telling you about what I have been doing and see if you can come up with something I haven't already thought of.

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0 · July 09, 2014 at 09:11 PM

Well, just typed a long response that did not seem to post, so apologies if this you get this twice.

Here's the thing, Matt 11. It wouldn't do me a whole lot of good if I was posing a sincere question while being insincere about everything else. Right? I keep a detailed daily log of everything that goes down my gullet, so here we go: today, so far nothing (after my morning coffee with cream). Yesterday, coffee with cream at 7:45, two hardboiled duck eggs and a glass of raw almond milk @ 2:45, a tomato/avocado/romain/cuke/broccoli sprout salad topped with lemon juice, balsamic vinegar, olive oil, raw pepitas and sunflower seeds and bacon @ 7:45 and a glass of raw goat milk kefir at 9:00. The day before: coffee w/cream at 8:00am, raw almond milk at 3:00pm and a 2-egg chicken/green bean omelette at 7:00pm.

Shall I go on? Now, while you may be correct that I am consuming more calories than I think I am, it is not going vastly more. It could be somewhat more. But not, I think enough to give me the kind of results I'm getting--or not getting. The three days above are typical (I will eat something later today to get some calories on the board) and I have been doing this for a long time so I am used to it and don't really have much of an appetite anymore.

But maybe you have missed my point. I am at near-starvation levels. I am having trouble losing pounds. I am experiencing higher than normal blood sugar levels. These things do not add up. I mean, you can see that, right? So, not "bullplop." This is really the crux of my whole problem. Doing what I think I should be, and things are still going in the wrong direction.

I suspect there is something going on that is not self-evident. Maybe there are unintended consequences from eating too few carbs, or calories, or eating too much protein (although I try to keep my protein levels moderate, but that can be hard to gauge). Some chemical reaction to all this dietary austerity. So frankly, I find it rather simplistic of you to answer my question by assuming I am being untruthful. Let's move on, shall we?

I am looking for an actual answer. Something useful that I could try. Something that I should stop doing. Something I should do more of. You see what I am looking for?

Thanks.

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40588 · July 09, 2014 at 08:00 PM

Probably eat less than 1000 calories a day? Bullplop. Show me the food logs. Sub-1000 calories is starvation, you will lose weight. You're likely consuming a lot more than you think you are.

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