Paleo Diet and Paleolithic Diet Questions & Answers

Question

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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.

flag	asked Jul 11 at 15:24 August 12.1k●4●16

	how high was your Fasting BG? – Crowlover Jul 11 at 21:42
	They didn't tell me. – August Jul 12 at 14:00

MathGirl72 · Accepted Answer · 2012-07-11 15:37:35Z UTC

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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/

answered Jul 11 at 15:37

MathGirl72
10.7k●1●4●19

	I actually asked about this, and I'll ask the dr. again directly, but I started thinking that my carb habits resemble binges. I brought home a quart of figs and a pint of blueberries from the farmer's market and ate them all. A trip to the health food store is a good excuse to pick up a chocolate bar, and go next door and pick up a bottle of wine too. I didn't worry as long as my weight stayed the same. So, for a few days before the test, my carbs were lower than 75g, but I've certainly had days with more, probably double. Dr's message was that it didn't matter and I that I am IR. – August Jul 11 at 16:18
	Blueberries are definitely safer than figs. I haven't had fresh figs in a while, but 1/4 cup of dried figs have 28 grams of carbs or so. (Sorry, I am doing this from memory - looked at the container a few days ago.) I'm over two months into primal eating (I do so dairy) and my numbers are far better than they were before, but I must still rely on Metformin to keep them where they belong. If I eat more than 50 g of carbs, the my numbers are terrible for at least 24 hours. – MathGirl72 Jul 11 at 16:27

miked · Answer 2 · 2012-07-11 16:45:13Z UTC

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.

Crowlover · Answer 3 · 2012-07-12 06:40:28Z UTC

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.

MrsD · Answer 4 · 2012-07-12 13:52:44Z UTC

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.

RaiseFitness · Answer 5 · 2012-07-11 15:34:51Z UTC

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.

MiMintzer · Answer 6 · 2012-07-11 16:34:17Z UTC

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.

Amy B. · Answer 7 · 2012-07-12 13:01:03Z UTC

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.)

Have You Had A Glucose Response Test Since Going Paleo?

7 Answers