"Huh, what?" you ask! What are you talking about? Well it's a bit complicated and you can read about it for yourself at Jenny Ruhl's "Blood Sugar 101" web page here: "How Blood Sugar Control Works- And How It Stops Working"
I was reading Jenny's hard copy "Blood Sugar 101" book for the second time through and I just wanted to wrap my head around this and try to understand it. I also became very interested in what my own responses were.
Most of us type 2's don't follow our blood sugar too closely. We may test in the morning or perhaps after a meal so we have a general idea of what our average blood sugar may be. The quarterly or twice yearly A1C gives us another indication. But what is really going on with our insulin response. What happens in those few hours after a meal when we aren't testing? How good or bad is out insulin response?
These were the questions I wanted to answer about my own body. Do I have impaired phase one insulin response? Failed phase 2 insulin response? Both?
I was surprised after doing both experiments. A bit disappointed too!
The first picture is one testing my 1st phase insulin response by taking 1-1/2 tsp of sugar right after testing my fasting blood sugar. This is equal to about 7-8 grams of carbs which was certainly not carb loading. It mimicked an average carb meal for me. I started out with a nice 76 mg/dl (4.2 mmol). In the picture you can see the rise at 15 minutes. At 30 minutes it is already on it's way down. At 90 minutes my blood sugar it is back nearly to where it started at 80 mg/dl (4.3 mmol).
Go to the larger Google Drive chart here.
This was shocking to me! Looking at this you would question if I even was diabetic! This is exactly the way a non-diabetics blood sugar would respond in 90 minutes or so. The increase to 96 a half hour later may have been due to a glucose dump by the liver after blood sugar went below 80.
Exciting news, right! But here is the not so exciting news. My other experiment didn't fare so well.
Here is a chart of two meals eaten yesterday. These were both usual meals for me. I weighed the protein portions to be exactly 3 ounces since that is what I have determined is the right amount for my diet. Both meals were LCHF ketogenic meals with added fats. I stopped taking all of my supplements for this experiment as well so that I could get a true picture of how my body handled the meals without help from anything else.
Lunch was a salad with sour cream chipotle dressing , vinegar, macadamia oil and 3 ounces of Kielbasa sausage. Supper was 3 ounces of baked haddock with butter and lemon olive oil with 7 spears of roasted asparagus. I also had 3 ounces of V-8 juice (3.5 grams carbs) at the beginning of the supper meal thinking that it might get the insulin going faster.
See full chart in Google Drive here
Normally, I test before and after a meal. Sometimes only after the meal. I was making an assumption that my blood sugar would rise mostly the first hour to 45 minutes and then start coming down. When I usually do my post meal test at 2-1/2 hours it is around 105-115 or so. Sometimes it is lower, which is nice!
What I didn't realize is that my blood sugar is only first peaking at the 2 hour mark! This was shocking to me! When I test at 2-1/2 hours I am only just beginning to come down from my "high". Granted my peak is still below 130 which is certainly not anything to be concerned about but this whole experiment now leaves me with more questions to be answered! After both meals my blood sugar didn't come down to a "normal" range below 100 mg/dl (5.5 mmol) for over four hours!
What does this tell me? Well, I guess I am diabetic for one! I knew that already! (smirk) I show a very slow and impaired secondary insulin response. I also wonder why it seemed like there was no 1st phase insulin response to the meals. Is it because it took that long for my pancreas to recognize that I ate carbs? I don't have the answers to these questions so on to more research!
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Sunday, February 16, 2014
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I belong to quite a few low carb, meat eating Facebook groups. Some of the members are diabetic and have adopted a Ketogenic eating plan to normalize blood sugar. Others are eating a low carb high fat (LCHF) diet for reasons like weight loss or because they feel more energetic or it solved gastrointestinal problems, etc.
I eat the diet mainly for controlling my diabetes and it really has pretty much normalized my blood sugar. I also feel great eating this way.
I have this one consistent problem with the diet that has become my nemesis! It is the thing that keeps tripping me up over and over again! It is protein! Yup, protein!
I am not like any other diabetic and another diabetic isn't going to be exactly like me so I want to say that first! Everyone has to find out what works or doesn't work for them by the use of their blood glucose meter and a bit of experimentation.
Just as some are more carbohydrate intolerant than others I have found that we all seem to handle different levels of protein too. Some of you reading this are already scratching your head and wondering why in the world protein would even be at issue. It is a long story that I will not go into in this post but to explain simply, a certain amount of protein converts to glucose and can raise blood sugar as do carbohydrates.
When I began my Ketogenic, LCHF diet about 15 months ago, I had to experiment to get my protein low enough so that my blood glucose would normalize. The amount of protein also seemed to affect my next morning’s fasting blood sugar as well.
I still find myself in a battle to keep protein at a level that I long ago determined was the right level for me. When they bring a big steak to my table at Texas Roadhouse I long to devour the whole thing and often I do! Leftover steak eaten the next day just isn't the same! I am also used to big 1/4 or even 1/3 pound hamburger patties. We've been taught to eat large portions of everything because of the size of portions in restaurants, in commercials and food magazines.
I have found that keeping to my personal protein portion sizes of about 2.5 oz. (70 g) in a meal I will have a much smaller after meal blood sugar rise than if I allow myself a larger portion. My blood sugar may be at 97- 3-3 1/2 hours post meal if I eat the smaller protein portion. When I increase this even by 1 oz I see a very different blood sugar of perhaps 115. An even larger portion of protein means an even larger rise of up to 125 or 130. This is just from protein itself with no added carbs in the meal. I have to add additional fat for calories and to make sure that I am full. Hunger doesn't ever seem to be a problem for me and I am much happier with a post meal blood sugar of less than 100 than one of 125!
Although blood sugar control is mainly about eating a diet low in carbs and sugar, don’t forget to adjust the protein to a level that works for you. If you are one of the lucky ones who do not have to restrict protein then eat up! I envy you!
( I didn't really address carbs in the above blog post. I don't want anyone to think that protein is what they need to focus on for initial blood sugar control. Protein is kind of the final nutrient to be adjusted after blood sugar has been normalized by reducing carbohydrates but is still on the higher end of normal. I eat less than 20 grams of carbs a day most days.)