I finally went into see a doctor and had some tests done. I'll find out what those tests say on the 23rd, but they called me back in to do one of those tests where you drink some orange flavored glucose containing drink because I had a high fasting blood glucose level. Then they called back to tell me I'm insulin resistant. So, I've been weight stable- about 175lb- for over two years now, I think. I lost over 100lbs. I was low carb for a lot of the weight loss, but I've tried upping the carbs in various ways since. Any sustained amount of carbs hurt, especially when I tried eating tubers with regularity, but the fruit/chocolate bar/wine/whatever extra little indulgence never seemed to be too bad, except in retrospect, maybe it is.
I'll know better when I get a blood glucose meter and start testing. I couldn't find a paleo doc anywhere near me, but luckily there was one functional medicine doc in the area. He's not talking medicine, but supplements, exercise, and more vegetables.
Have you gone through something similar? Is there anything I haven't thought of? I'm figuring I'll have to be closer to the ketogenic side of things.
Depending on how long it's been since you started increasing your carb intake, the result of the glucose tolerance test may not truly reflect what your body can do since losing the weight. Check this out for more info: http://www.diabetes-warrior.net/2012/05/03/dear-pancreas-you-may-rest-now-glucose-tolerance-test-results/
This comes up a lot. If you're eating low carb and losing weight, then you may be insulin resistant, but it's the good kind of insulin resistance.
Robb Wolf wrote about it here in the context of gestational diabetes, but it's the same idea: http://robbwolf.com/2010/09/06/gestational-diabetes-what-constitutes-low-blood-sugar/
And I've accumulated my rants on this topic into one page that I just point people to here: https://sites.google.com/site/themikelinks/home/what-s-up-with-insulin-resistance
Short story: insulin resistance is only bad in the context of chronically elevated insulin levels (from eating a high-carb diet). Low-carb insulin resistance is actually ok; some would say beneficial.
I bought a glucometer and have had several blood glucose tests since going paleo and it has told me that:
1) Big meals (even if it's only protein and fat) send my blood sugar up.
2) More than a handful of carbs in a meal containing protein sends my blood sugar up.
3) Eating very little keeps my blood sugar stable.
4) Not eating for more than 16 hours gives me blood sugar crashes.
I have never been overweight but my blood sugar levels have always been a bit dodgy and am still battling with remnants of reactive hypoglycemia from my veggie days.
I've done low carb, medium carb, all macros and it remains the same. Maybe after a year of paleo i'll have more blood sugar stability.
UPDATE: Inspired by this post I tested blood sugar an hour and a half after eggs and sardines today and it was perfect. So i have confirmed what I knew: that a balanced meal of protein and fats works well for me as long as it's not a big meal.
High fasting glucose happens with LC and VLC. I had this issue. Its from Cortisol going up at night is what my ND said
Fasting Bg is no big deal UNLESS your HgA1c is above 5.4
My post meal blood glucose readings are awesome and my HgA1c is fine at 5.4. I added some starches and all is well. Fasting Bg went down a bit and Im not waking up at night.
So... check your post meal Blood glucose levels and Test your HgA1C
I had a bunch of Qs about this and was freaked out about it myself, last month.
If you were 100 lbs overweight, even though you lost it, there is a high likelihood that damage had already been done. Chances are you were more insulin-resistant before losing the weight, but not all problems can be 100% reversable. Exercise, especially heavy lifting and HIIT, has been shown to improve insulin sensitivity. Keep your carb intake low to moderate, and don't do a lot at a time. Meaning, you can have some for breakfast, lunch and dinner, but don't do straight carbs ever, since a mixed meal slows the process a bit. Also always eat your carbs with protein.
You don't say how many carbs you eat per day. However, there are other reasons for being insulin resistant besides being pre-diabetic. Peter at Hyperlipid has said that it can occur because muscle tissue can run on ketones thereby sparing glucose (from carbs) for the brain. See this excellent article here. May be something to look into.
Am I wrong in thinking that it's normal for blood glucose to rise, even from a 100% clean Paleo meal (let's just say meat and green or low starch veggies with some fat), and while we don't want it to rise a ton, the more important issue for long-term health and glucoregulation is not how much it spikes after a meal, but how long it stays elevated?
Like I said -- we don't want it spiking super-high, but a little spike is normal. That's what food does. (Even just protein with no CHO.) But if you have normal glucoregulation and a normal insulin response, it should come back down in a reasonable amount of time. It's the people who stay elevated for an extended time and/or are always walking around slightly hyperglycemic that are gonna have greater implications from glycation, vascular damage, etc.
If I'm wrong, I know miked can come school me. ;-) (And you're welcome to! I really want to get this stuff right.)
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