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Old 11-11-2013, 11:21 AM   #1
zeinmr
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High blood fasting glucose on ketogenic adaptation

Hello everyone. I am on ketogenic diet for 2 months. I am not diabetic. My body mass index is 24.7 and my health is very good. I chose the ketogenic diet because I am convinced that this is the healthiest one. But for the last week or so I start by curiosity check my blood sugar and I am really surprised. Just let me tell you I am in full keto adaptation and my blood ketones is around 2.7 as average. My glucose when fasting in the morning is 6 to 6.1 mmnol/l (108 to 110 mg/dl). I read many articles about the insulin physiological resistance but I am little suspecious. I mean high blood sugar increase the risk of cardiovascular disease whether it comes from insulin resistance or physiological insuline resistance. I am little hesitating whether to continue with this diet or return back to regular one. Anyone can help me?
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Old 11-11-2013, 11:33 AM   #2
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If you are concerned about blood glucose, I suggest you see a doctor for an A1C test (levels over 3 months) which is far more accurate than the fasting number.

At the same time, my experience may help you deal with this. I am not diabetic, but my fasting numbers are typically high (low 90s--lab limit is 120), but my A1c is typically about 5.2, well within normal.

I've read that a ketogentic diet will produce higher fasting numbers, and my endo says that this is true--which is why he goes by my A1c. I'm hypothyroid, which is why I get regular blood tests, and since all my siblings are Type 2 diabetics, my endo keeps his eye on my BG.
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Old 11-11-2013, 11:47 AM   #3
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Thx Leo for reply. But high glucose increase the risk of cardiovascular disease whether your A1c is normal or not.
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Old 11-11-2013, 01:22 PM   #4
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zeinmr, I haven't seen anything to indicate that sporadic blood sugar levels in that range cause any harm. it is normal for non-diabetics to be that high after meals and you don't hear about that being dangerous...

in general it's believed that real damage starts at 140 and above.

have you tested at other times of the day? a reading in your range in the morning coupled with low readings at other times is I believe nothing to be excited about. but obviously if you get readings higher than that later in the day regularly, it's a different matter.

I am thinking your issue might be blood sugar dipping a bit low during the night and triggering that cycle where the liver uses the hormone Glucagon to convert fat to glucose so your blood sugar doesn't get too low. A version of the dawn effect diabetics get. You might try eating closer to bedtime to see if this improves your fasting reading.

good luck!
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Old 11-11-2013, 01:49 PM   #5
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zeinmir-
You seem unnecessarily concerned about 'high' blood glucose readings, since your fasting numbers are not really high at all. EVERYONE has temporary spikes after eating that are totally normal and not any cardio risk.

As I've tried to explain (and Ravenrose also explained), the higher fasting number when on a ketogenic diet is a version of the 'dawn phenomenon' that many diabetics experience as the liver tries to keep our blood sugar levels from going too LOW during sleep.

If it disturbs you, I've found that Raven's suggestion of eating something close to bedtime works.

Again, if you have a concern, see a doctor.
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Old 11-11-2013, 02:02 PM   #6
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Thx raverose and Leo I will do an A1C next month and maybe I ll increase my carb to 50mg per day as I am now even lower than 20g . thx
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Old 08-07-2014, 09:24 AM   #7
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Blood Glucose

Remember, your body still needs glucose even if you are in full ketosis. Some tissues (liver, kidney, a minority of centeral nervous system) can only burn glucose. Also, when your body breaks down triglycerides (fat) into ketones it also makes glucose from the glycerol part of the triglyceride. This is normal. In addition, in ketosis your insulin responce is shut down; lower insulin -> higher blood glucose. Also, you have many fewer glucose "customers" as the big energy players, muscles and brain, are burning ketones.

Besides, I don't think it's the glucose that really causes problems, it's the big insulin spike (in response) that causes the problems. When you monitor your BG like I do, you do not measure your insulin response. For a type 2 diabetic, a glucose spike (measured) is followed by an insulin spike (not measured). But in ketosis you may not be getting the insulin spike because that response should be shut down which may lead to a small (<110) glucose rise followed by consumption by the above mentioned glucose only tissues. This is okay.

I'm using ketosis to treat my type 2. I used to have a big dawn effect with 3am BG above 150. But now, i get this weird 8-9am bump to about 110-140; with or without breakfast, which is usually just fat anyway. I also sometimes see a post exercise BG bump. Just my opinion, I think its because the body is breaking down fat to make ketones during morning activity and during exercise and as a result pumps out glucose too. I don't think its a bad thing, really.

Another odd thing I see with my BG, many (LC) meals are follow by a drop in BG.
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Old 02-11-2015, 07:54 AM   #8
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So helpful!

Old thread...I know... But I just recently began testing my blood glucose and blood ketones after about 4 months in nutritional ketosis, was using ketostix prior.

I was so freaked out because my fasting BG is always highest in the AM. (ranges between 111 and 104). I feel so much better knowing it's not an immediate cause for concern. All of your posts have helped me immeasurably!

Thank you!
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Old 11-11-2016, 06:38 PM   #9
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Old thread...I know... But I just recently began testing my blood glucose and blood ketones after about 4 months in nutritional ketosis, was using ketostix prior.

I was so freaked out because my fasting BG is always highest in the AM. (ranges between 111 and 104). I feel so much better knowing it's not an immediate cause for concern. All of your posts have helped me immeasurably!

Thank you!
This old thread has been very helpful to me!
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Old 11-12-2016, 06:38 AM   #10
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So, I've been eating keto since June of this year...feel so much better...measuring from my little monitor, I'm in a good state of ketosis (in the 2.3 area)...but my blood sugar has gone up. It seems to be in the low 100's now...(between 100-113) and when I was checking a couple of months ago, it would range in the 70's-80's)

Should I try and get my BS back down? I don't understand how I can stay in ketosis while my BS is rising. I understand that my BS # isn't THAT high...but the fact that it has risen this much is concerning.
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Old 11-12-2016, 08:04 AM   #11
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Just a thought..How much protein are you eating?
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Old 11-12-2016, 02:59 PM   #12
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Just a thought..How much protein are you eating?
I try to stick with around a fist size...whether it's fish, beef or chicken...but sometimes I do go over that...It's typical for me to eat a 10 count wings from a fast food place called Zaxby's (no breading or sauce)

I also eat a few strips of bacon in the morning if I feel like I need it.

I've not been one to keep up with what I eat, but maybe I should to see if I'm getting too much protein.

Thanks CarolynF!
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Old 11-13-2016, 02:25 AM   #13
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I really doubt that protein is your issue. It is a fact that fasting BG can be elevated with low-carb eating. I'm not exactly sure of the science behind it, but it was explained some time ago by Peter at Hyperlipid.

I asked my endo about that, and he knew it and explained that's why he tests my A1C and ignores my fasting number. I'm hypothyroid and have labs every 4 months. My fasting BG is always in the 90s (range goes to 120), but my A1C is steady at 5.2.
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Old 11-13-2016, 04:21 AM   #14
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I really doubt that protein is your issue. It is a fact that fasting BG can be elevated with low-carb eating. I'm not exactly sure of the science behind it, but it was explained some time ago by Peter at Hyperlipid.

I asked my endo about that, and he knew it and explained that's why he tests my A1C and ignores my fasting number. I'm hypothyroid and have labs every 4 months. My fasting BG is always in the 90s (range goes to 120), but my A1C is steady at 5.2.
Thanks Leo...that sounds familiar to me.
My A1C was 5.4 in August...my glucose that morning was 77... I guess my body is funky cause I'm losing weight?

I just thought it was odd to go up that much when I'm eating the same ...

I do not know of any doc in this area who really checks thyroid, hormones etc...the ones I've heard of and seen just check those main 3 numbers and say, "you're normal." Also, the ones I see (my GP and my gynocologist) don't seem to know anything about the benefits of LC eating...blows my mind.

Thanks again!
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Old 11-13-2016, 05:20 AM   #15
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There's a lot of info available that shows you can have high insulin levels even with normal to high normal blood glucose numbers. Dr. Joseph Kraft has conducted studies that show you can have high insulin for decades before it shows up in your FBG. Google Dr. Joseph Kraft and Dr. Jason Fung for more information.
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Old 11-13-2016, 05:51 AM   #16
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Becky-
You might want to get another A1C because that might show whether or not your high fasting number is a cause for concern.

From what I've read, when you're eating low carb, the fasting number is the least reliable indicator of how your body handles blood sugar. But if your A1C has also gone up, then that would indicate some issue. A similar A1C to your August test would suggest no problem to worry about.
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Old 11-13-2016, 05:57 PM   #17
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Becky-
You might want to get another A1C because that might show whether or not your high fasting number is a cause for concern.

From what I've read, when you're eating low carb, the fasting number is the least reliable indicator of how your body handles blood sugar. But if your A1C has also gone up, then that would indicate some issue. A similar A1C to your August test would suggest no problem to worry about.

Thanks so much...I need to read up on A1C...it's hard for me to understand how all that works...

I'm 49...not sure if perimenopause starts affecting blood sugar...I just need to start googling, I guess. I want to wait a while before getting more blood work done...my LDL is super high and I want to let my weight loss level out ... my dr would be wanting to put me on statins for sure... My HDL & my trigs are great though.
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Old 11-19-2016, 04:50 PM   #18
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My FBG was high continuously elevated for years while LC'ing. I read all the articles saying that is was okay but I disagree and believe that elevated BG is never okay.
Elevated BG is damaging. Glucose is glucose regardless of where it originates.

Be aware, read, then decide how to proceed.
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Old 11-19-2016, 07:46 PM   #19
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My FBG was high continuously elevated for years while LC'ing. I read all the articles saying that is was okay but I disagree and believe that elevated BG is never okay.
Elevated BG is damaging. Glucose is glucose regardless of where it originates.

Be aware, read, then decide how to proceed.
So how is your BG now? If it's better, what did you do to make that happen? Thanks for your input.
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Old 11-20-2016, 09:35 AM   #20
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It depends on what you mean by 'elevated' BG. My own A1C is a steady 5.2, and although my fasting number is in the 90s, the lab range is to 120, so I'm well below that. Given my A1C, my fasting number should probably be in the 80s, but it's 'elevated' due to my low-carb eating.

There is no 'damage' from my elevated fasting BG. Experts agree that we're talking 'damage' at 140 and above.
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Old 11-20-2016, 08:57 PM   #21
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Oh, interesting that normal is up to120. I thought that changed quite some time ago.

Mine was getting to be consistently over 105 and my doc told me to start monitoring.
Now it's always below 95 but I eat plant based. I didn't change my eating because of BG but that's a nice side effect.
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Old 11-21-2016, 03:46 AM   #22
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Jem-
Labs have different ranges. My endo has an in-house lab, and the fasting blood glucose level of 'normal' goes to 120. It might be different at other labs.

Eating very low carb (my norm), my fasting was 96 on my last labs, but my A1C was 5.1--so no problem with blood glucose.

I've read that the high fasting number is due to a 'sugar dump' by the liver during the night because of LOW BG (similar to a diabetic's Dawn Phenomenon).
Recently I read that a teaspoon of raw honey at bedtime might help--and provide more restful sleep as well. I've been reluctant to try that because I normally avoid sugar in all forms, but I've bought some and might try it as an 'experiment.' I'm not concerned with my fasting number, but I could use more restful sleep.
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Old 11-21-2016, 06:00 AM   #23
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Be careful with your teeth. Long ago, I developed the habit of brushing after my last meal instead of right before bed.

My DH tried a spoon of local honey for allergies and sleep right before bed and I joined him. My next dental visit showed several tiny cavities on my front teeth where I "drug" the honey off the spoon. I had a glass of water after, but the sticky honey must have clung to my teeth.

I don't test my BS and didn't notice better sleep so I had already given it up, but others do. DH has an improvement in his seasonal allergies if he takes it regularly.
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Old 11-21-2016, 07:44 AM   #24
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Thanks for the tip about teeth!
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Old 11-21-2016, 02:21 PM   #25
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Very interesting thread... thanks everyone!
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Old 11-21-2016, 02:26 PM   #26
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I think it was Dr Bernstein who suggested eating a half of a small apple before bed to avoid DP.
Not sure since it's been a while.
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