Low Carb Success May Point to Abnormal Blood Sugars

[nobimbo]

Low Carb Success May Point to Abnormal Blood Sugars
Several popular diet books have publicized fact that by lowering your carb intake you can bring down your blood pressure and cholesterol and many low carb dieters have found this to be true.

But because books don't take further step of explaining why these improvements occur, low carb dieters who experience these results may miss a very important piece of information about their future health prospects--fact that this very improvement means that it is very likely that they have a significant risk of developing serious heart disease and diabetes unless they maintain tight control over their blood sugar for rest of their lives.


Why Improving Cholesterol and High Blood Pressure Point to Previously High Blood Sugars
Why? Because if your cholesterol comes down when you cut carbs, it is likely that before you started your low carb diet you had a higher than normal proportion of LDL that had been damaged by high blood sugar to point where your liver could no longer recognize LDL and remove it from your blood stream. When high LDL cholesterol comes down after a few months of a low carb diet, this too suggests that it was sugars that were causing original cholesterol abnormality.

By same token, if low carbing lowers your blood pressure very quickly, it may be another sign that you were running abnormally high blood sugars before you started diet. Dr. Richard K. Bernstein, M.D., an endocrinologist, explains in his book, Dr. Bernstein's Diabetes Solution, that when there are a lot of hydrophilic [water-attracting] glucose molecules circulating in blood stream they will pull water molecules out of body into that bloodstream, raising blood pressure.

If your blood pressure drops as soon as you lower your carbohydrate intake, before you've lost significant amount of weight, it is quite possible that original pressure rise was caused by swelling in blood volume caused by this sugar-related water.

There are a few other symptoms that may go away when you start low carbing, which also might suggest you were running high blood sugars in past. They are if your eyesight improves suddenly or you suddenly find your regular prescription glasses don't seem to work properly or if you no longer come down with itchy yeast infections or "jock itch" that used to torment you.

If you notice that you've stopped having tingling pains in your feet or legs, or that you no longer need Viagra for that romantic weekend, these resolving symptoms may also point to fact that your blood sugars have been elevated before you started low carbing.

But My Doctor Says My Blood Sugar is Normal!
Unfortunately, most family doctors still screen patients for diabetes using only a fasting plasma glucose test. This is a cheap, simple test usually performed with other blood tests. Unfortunately, it is a very poor way of diagnosing diabetes.

That is because you can walk around for as long as ten or fifteen years with blood sugar shooting up to dangerously high levels after every meal but still have normal values on a fasting blood glucose test. In fact, your fasting plasma glucose may not deteriorate until those high post-meal blood sugar levels have irreversibly destroyed 80% of amount of beta cells in your pancreas that you need to produce enough insulin to keep you from being diabetic.

And that's not all. In past couple years, studies by endocrinologists have found that your after-meal blood sugar levels are more closely related to diabetic complications than fasting blood sugar levels. In fact, studies show that if your blood sugar is higher than 120 mg/dl two hours after a meal you have twice risk of a fatal heart attack than a normal person would. If your post-meal blood sugars are higher than 140 mg/dl, you may also be found to be suffering from "diabetic" nerve damage.

But even so, many family doctors will not even mention that you have anything wrong with your blood sugar until your post-meal levels are above 200 mg/dl and your fasting plasma glucose is above 126 mg/dl, too. Meanwhile, high blood sugars are doing their insidious work or undermining your health.

This is reason that fully one half of all people are found to have serious diabetic complications, like nerve damage or retina damage, at time they are first diagnosed with diabetes. high post-meal blood sugars have been steadily destroying their bodies but their fasting blood sugar level gave no hint of this.

Better Ways of Diagnosing Diabetes and Heart Disease Risk
There are two tests you should demand that your doctor perform in order to determine if you are already heading down long road to diabetes and its terrible complications--impotence, amputation, blindness, dialysis and heart attack death.

Hba1c
Hba1c test measures percentage of blood proteins that have been damaged by glycation. What glycation means in simple English is that sugar has bonded to these proteins with an indestructible bond which makes these particles not only large and "sticky" so that they clog up arteries, but also makes it tougher for receptors in body to recognize and process them properly.

Recent studies, most notably EPIC-Norfolk study, have shown that when Hba1c rises over 5.0% risk of a fatal heart attack doubles. (A truly normal person's Hba1c would be around 4.7%) When it goes up to 7.0%--generally considered "good control" by many old fashioned doctors--risk of a fatal heart attack is five times that of someone with normal blood sugar!

Now add to mix fact that when newly diagnosed, typical person with Type 2 diabetes has an Hba1c of 10% or higher, and you can see how tragic it is that fasting plasma glucose is only blood sugar test they probably ever had before diagnosis. Hba1c tests performed every year might have been able to give a warning that blood sugar was gradually getting worse and that risk of heart disease and diabetic complications was growing.

Testing Your Post-Meal Blood Sugar with a Meter
There is another test that gives you even better information about how your blood sugar is performing: a simple post-meal test using a blood sugar meter and test strip. Your doctor can administer this test in office, or you can buy a meter at Wal-mart for $8 along with a $20 bottle of strips and do it yourself.

To run a post-meal blood sugar test do following: test your blood sugar after not eating for at least 4 hours. Write down result. Then eat something containing at 60 - 70 grams of fast acting carbohydrate and test your blood sugar with meter one hour after you started eating. Write down result. Test your blood sugar again two hours after you started eating and then 3 hours after eating. I call this "Bagel Tolerance Test" because a bagel makes perfect test food as a typical bakery bagel contains about 62 grams of fast-acting carbohydrate.

Now that you have some idea of what your blood sugar does under stress, you need to know what numbers you got mean.

Adjust Your Results to Match Your Meter's Calibration
Be sure to read information that comes with your blood sugar meter to determine what "calibration" it uses. Most modern meters use what is called a "plasma calibration." A meter with this calibration will give you a test result that should match very closely to result you would get from a blood sugar test drawn from a vein and analyzed in lab.

Relion meter, and some other drug store meters use a "whole blood" calibration. To convert result they come up with, you need to multiply reading you get by 1.12. That is because these meters give a result that is 12% lower than a plasma calibrated meter. In rest of our discussion, we'll be using plasma calibration when discussing your blood test results. Remember, if you are using a "whole blood calibrated" meter just multiply your result by 1.12!

Taking Into Account Effects of Low Carbing
If you are currently low carbing, your test result will be slightly higher than it would be if you were eating over 150 grams of carbs a day. If you were going in for an official post-meal test, ordered by your doctor, you would have to eat 150 grams of carbohydrate during 3 days before your test. However, since this is an informal test, and since if you have been successful low carbing you probably don't want to stop your diet for that long, you can make an informal adjustment to your post-meal test results that will account for fact that low carbing temporarily raises your post-meal values when you eat an unaccustomed large dose of carbohydrate.

To make this correction, just subtract 10 mg/dl from any your post-meal result that is over 140 mg/dl at 2 hours if you are currently low carbing.

Understand Your Meter's Margin of Error
Your meter is not as accurate as a lab-drawn test would be. information that comes with your test strips will tell you how meter reading compared to lab test results. Typically with meters currently on market, there is a 5% margin of error plus or minus. That means if you get a reading of 100 mg/dl, a lab-drawn result might fall between 95 and 105 mg/dl.

Continued...

[nobimbo]

Now let's interpret your result.

Normal Blood Sugar
If your blood sugar remained under 100 mg/dl whole time, you have completely normal blood sugar and can stop worrying about it. In fact, many people will not see their blood sugar go above 85 or 90 mg/dl, ever. These are people who are truly normal. Unfortunately, if you have done exceedingly well losing weight on a low carb diet, you probably aren't one of them.

That's because truly normal people are much less likely to gain weight than people with abnormal blood sugars, because they do not get blood sugar-induced hunger cravings. And if they do gain weight, they are folks who can easily lose it on a low fat diet, or for that matter, on any diet that limits calories.

If your blood sugar did not reach 140 mg/dl an hour after taking a large dose of carbohydrates and if it was below 120 mg/dl two hours after this large dose of carbohydrate, most health authorities would also say that you are normal. These numbers, 140 mg/dl at 1 hour and 120 mg/dl at two hours after a meal are what Jostlin Diabetes Clinic of Harvard Medical School defines as upward limit of "normal."

However, this "Normal" number is probably contaminated because a lot of "normal" people used in medical studies are people who, though they have normal fasting plasma glucose numbers. may actually be in early stages of being diabetic. Some very recently published research has found that there is already evidence of impaired beta cell function when test results are over 100 mg/dl 2-hours post consumption of a 75 gram dose of glucose. Remember, beta cells are cells that secrete insulin that keeps you from becoming diabetic.

Impaired Glucose Tolerance
If your blood sugar surged over 140 mg/dl at one hour or stayed above 120 mg/dl at two hours, you may have what doctors will call "impaired glucose tolerance" or IGT. Another name for this condition is "pre-diabetes." For most people what this really is, is simply very early diabetes.

If you ignore your impaired glucose tolerance, glucose molecules that make up those elevated post-meal blood sugars will merrily bond to your body proteins, deposit themselves in your arteries, damage your kidney filtration units, clog up your retinal capillaries, and cause your nerve function to deteriorate leading to, among other things, impotence and pain. Keep this up, and in another five or ten years you'll be one of those people with "new" diabetes who have serious, established, possibly irreversible complications.

But on a more cheerful note, if you catch your blood sugar abnormality at this point, there is a very good chance that by managing your blood sugar through dietary control (i.e. cutting carbohydrates) and exercise, you may never see it deteriorate. Indeed, you may avoid developing any complications at all.

If you suspect you have impaired glucose tolerance, be sure to discuss this finding with your doctor. If he or she tells you it is "nothing to worry about" it's time to find another doctor-- one who is more up-to-date and who will help you manage your blood sugar so you can avoid heart attack and development of diabetic complications.

Studies have shown that people with impaired glucose tolerance who lose weight and start exercising can reverse their blood sugar deterioration and prevent themselves from progressing to full-fledged diabetes. There are also drugs that can help you too. If you wait for a diabetes diagnosis before taking action, it is too late. By time your fasting blood sugar has reached 126 mg/dl (level at which your doctor will diagnose you) at least half of your beta cells will have died and they don't regenerate.

Diabetes
If your blood sugar went over 200 mg/dl in either time period, you just registered a diabetic blood sugar level and should consult with a doctor as soon as possible. Two random tests results of 200 mg/dl are considered diagnostic of diabetes according to highly conservative American Diabetes Association. Again, if your doctor says, "Let's just check it again in a couple months" and does not urge you to take a more aggressive approach, it's time to look for a new doctor, one who has kept up with current approaches to managing diabetes. It's your kidneys, heart, nerves, and vision that are at risk, not his.

Low Blood Sugar
If your blood sugar goes up at one hour and then drops significantly lower than 85 mg/dl at two hour point--to low 70s or less--you have what is called "reactive hypoglycemia." Your blood sugar went up but your body cranked out a huge dose of insulin to bring it back down, too much, in fact, and that resulted in lowered blood sugar. This, too, may be an early warning sign that you might be headed for diabetes, though it may take 20 years until it becomes apparent. Even if you don't progress to diabetes, reactive hypoglycemia is a sure sign that you may be insulin resistant. Insulin resistance, with or without diabetes is a precursor to heart disease. Be sure to discuss this result with your doctor.

Ongoing Vigilance
Once you get a "baseline" post-meal blood sugar test and an Hba1c reading, if they are anything but rock solid normal, you should test your blood sugar response at home using same test food every three months or so to see how it is progressing. Have your doctor run Hba1c at least once a year. Specific values you get on post-meal test will fluctuate--they depend on exactly how much carbohydrate you ingested and what else was in your digestive system at same time, and whether you are fighting off infection--but what will not change is whether you are spiking to dangerous levels or not.

If you see anything that suggests deterioration in your blood sugar response, then it's time to take steps to bring your blood sugars down. For most people this will involve cutting their carbohydrates. Most people with mild blood sugar abnormalities can attain completely normal blood sugars through cutting out excess carbohydrates from their diets, especially fast acting ones from soda, candy, cake, white flour and sugars of any type.

Use your meter to determine how much carbohydrate you can eat without causing a blood sugar spike. Remember that lower your post-meal blood sugar, lower your risk for heart attack and other diabetic complications.

Very recently published research has also found that eating 1 tsp a day of ordinary supermarket cinnamon can make a significant drop in your blood sugars and also lower LDL cholesterol. It takes about a month for result to kick in. If you are only slightly abnormal, cinnamon may help you get your blood sugar back under control, too.

Blood Sugar Targets
blood sugar target that many people with diabetes has found works well for them is "normal" range defined as under 140 mg/dl one hour after a meal and under 120 mg/dl two hours after a meal. Measure time from first bite of meal.

Because we know that people who are truly normal keep their blood sugars closer to 85 mg/dl than 120 mg/dl, if you can get your blood sugar down lower than targets listed in previous paragraph, do it! closer you can get to a truly normal value, better off you will be.

But whatever improvement you are able to make, by actively working to keep your blood sugar under control you are taking steps to prevent your slightly normal blood sugar from progressing to diabetes or sudden heart attack death.

Diabetes is a Progressive Syndrome
For years doctors have treated diabetes as if it were an all or nothing condition. They told you, you were normal, and then one day, they told you, you were diabetic. But a growing body of research suggests that just slightly elevated blood sugar is a large part of what causes damage to cells in pancreas that lead to diabetes. As one writer put it in a discussion on "alt.support.diabetes" newsgroup, "Diabetes itself is a complication of diabetes."

level at which "glucotoxicity" starts to poison these beta cells irreversibly appears to be around 140 mg/dl. So it makes sense to keep your blood sugar under this level.

In addition, if you are eating a lot of carbohydrate, not only is it raising your blood sugar, but that same carbohydrate is being converted by your liver into triglycerides, and there is mounting evidence that combination of these triglycerides and glucose work together to further damage beta cells and other organs.

http://www.geocities.com/jenny_the_bean/risk.htm

[CKjinx'd]

excellent article! something i can relate to! finally!

[angela233]

thank you!!!

angela

[BABSY]

so is that saying that a diabetic person such as me should have
there bs around 2hrs after eating? is there a range? 85 to what?

[MsKimber]

Can you really get a meter and sticks at walmart for that price? I might buy one just to test this on myself. I was concerned that I was pre-diabetic at the end of last year I tested myself several times using a co-workers meter and never registered over 120. If I did the test in the article I would be able to put the worries behind myself.

[nobimbo]

The meters are reasonably priced and usually come with a few strips to get you started; however, the strips are expensive. I use an Acucheck Advantage meter, and the strips costs me $40 for 50.

Here is some info about normal blood sugar readings 2 hours after eating:

By sampling blood sugar levels two hours after eating, you find out if glucose is being removed from your blood in a reasonable period. The goal is to show values less than 7 mmol or 120 mg . (finger test values 8.5mmol or 150 mg) at two hours. Higher values tell you that you must do two things- change the food or meal that caused high sugar level and exercise after the meal to increase glucose utilization.

http://www.nutramed.com/diabetes/diabetesmonitor.htm

Editing this to add that the "finger test values 8.5mmol or 150 mg" is no longer accurate with the newer meters. For the past 5 years or so, the meters now test for plasma readings (same as the labs) and not whole blood readings. So, the "7 mmol or 120 mg" info is the correct one to follow with the finger test (home meter).

Linda