Paleo Diet and Paleolithic Diet Questions & Answers

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I read somewhere that the combo of high glucose and low insulin may indicate that there isn't enought being insulin produced but (again) I can't seem to find the ref so if anyone has anything to share, please do.

My numbers (after a 12 hour fast) :

Insulin - below 2 (range 0-29,1 mE/L)

Glucose 5,5 mmol/L = 99 mg/dl (range 70 to 99 mg/dL (3.9 to 5.5 mmol/L))*

Fasting Blood Glucose

From 70 to 99 mg/dL (3.9 to 5.5 mmol/L) Normal fasting glucose

From 100 to 125 mg/dL (5.6 to 6.9 mmol/L) Impaired fasting glucose (pre-diabetes)

126 mg/dL (7.0 mmol/L) and above on more than one testing occasion Diabetes

flag	asked Nov 10 2010 at 14:50 Ikco 2,615●8●16

Paleo for 4-6 months, 20ish, Vit D @ 60 ng/mL, sedentary lifestyle. – Ikco Nov 10 2010 at 14:52

Dave S. · Accepted Answer · 2010-11-10 19:36:05Z UTC

"Are elevated glucose and low insulin problematic?"

Nope. In fact your numbers are excellent and typical for a low carb eater. For a complete analysis, I defer to Peter at Hyperlipid:

http://high-fat-nutrition.blogspot.com/2008/08/physiological-insulin-resistance.html

A LC eater has a FBG of 5.5mmol/l, technically pre diabetic, but blood insulin is 3.5 IU/ml. This is VERY low. Glucose is in very short supply but blood glucose is maintained by physiological insulin resistance, ie the muscles are full of triglycerides assembled from free fatty acids (NEFA) from lipolysis. The LC eater has breakfast, with enough protein from his eggs or particularly casein from his yoghurt to raise insulin from 3.5 IU/ml to 5.0IU/ml. This inhibits lipolysis enough to reduce NEFA in the bloodstream, intramuscular triglycerides fall and muscle insulin sensitivity returns. There's minimal glucose coming from the gut and so plasma glucose drops to between 4.0 and 5.0mmol/l, probably nearer 4.0mmol/l. It fluctuates between 4.0 and 5.0 after and between each LC meal. In the early hours of the morning there is a growth hormone surge and NEFA from lipolysis peak early morning to give insulin resistant muscles and an elevated FBG.

MEAN glucose over 24h will be in 4 point somethingish, HbA1c will be between 4 and 5%. INSULIN will probably average out around 5-10 IU/ml, averaged out over 24h. ... A high carb eater with FBG of 5.5mmol/l implies chronic hyperinsulinaemia, 24/7 and is looking for something to die from.

A LC, very high fat eater with a FBG of 5.5mmol/l implies they haven't had breakfast yet. They are not going to be hyperinsulinaemic at any stage. Unless they eat a bagel instead of their normal bacon and eggs that is. If they do this their blood glucose will hit 10mmol/l before insulin can shut down lipolysis and get the muscle accepting glucose.

It's NOT the FBG of 5.5mmol/l that matters. It's what that means about insulinaemia if you are eating a rice based diet. It's bad.

Matt · Answer 2 · 2010-11-10 16:01:47Z UTC

If you are worried about it go and see a doctor.

I am a little confused though as your glucose seems within the normal range? Having normal glucose after 12 hours without eating is usually a sign that your blood sugar is well regulated.

Normal ranges are there for a reason, not everyone will have a fasting blood sugar of 70 or 80 whatever they do, it is just natural variability. It seems you have similar fasting insulin levels to Stephen from wholehealthsource: What's the Ideal Fasting Insulin Level?.

Eva · Answer 3 · 2010-11-11 06:10:25Z UTC

If you want to know, you could always try ramping up fruit intake slowly for a week until you are moderate carb, give the body some days to adjust, and then see where your fasting blood glucose is at. Might be an interesting expirement. I understand your concern. Blood glucose close to 100 at fasting and low insulin could be a sign of diabetes. Or it could be just as Dave suggests.

However, I think you need a lot more than those numbers at fasting to be in the danger zone for diabetes. Diabetes is not just about fasting blood glucose. Diabetes is also about what your blood sugar does after eating and where it is all day. My advice would be to do a 12 hour blood glucose curve and see how your numbers do all day in the morning, right after eating, between meals, etc. That will give you a much more accurate picture as to what blood sugar issues you may or may not have. Certainly, I have never heard of paleo giving anyone blood sugar probs, but then again, I have no idea if you ever checked your numbers before paleo either so we have little to compare them too.

Ben · Answer 4 · 2010-11-10 15:17:04Z UTC

What you're describing sounds like a pancreas problem....specifically: Type 1 Diabetes (or Type 2, I suppose. I assume you don't have Type 2 since you're on paleohacks...)

https://health.google.com/health/ref/Type+1+diabetes

http://www.mayoclinic.com/health/type-1-diabetes/DS00329

http://www.nlm.nih.gov/medlineplus/ency/article/000305.htm

Melissa Fritcher · Answer 5 · 2010-11-10 16:10:37Z UTC

I had this issue in December of last year. I've been Type 2 since 2004, so when I asked for my insulin levels we were concerned when they were normal. As my BG was in the 300's at the time, it was indicative of my pancreas crapping out - according to my doctor. I never questioned it, I just used it as incentive to lifestyle my way to better health. I am tempted to have levels retested now that I am Primal, but I have a feeling that the damage is still there because my BG will rise at the least provocation, and I feel that speaks to continued beta cell damage. It is my greatest hope that some recuperating of that will happen, but as I plan to be Primal for life, and keep high-carb indulgence to a minimum, I don't worry overly much about it. I wish I had more information about it, but I just took my doctor at her word. It worked in my favor for getting back to healthier eating. :)

Are elevated glucose and low insulin problematic ?

5 Answers