Monday, February 22, 2016

Out of Ketosis- A Blood Sugar Dilemma

For more than three years I have been on a LCHF Ketogenic diet to manage my type 2 diabetes and metabolic syndrome.   I began the Ketogenic diet in Dec. 2012 after reading Dr. Stephen Phinney and Dr. Jeff Volek's book "The Art and Science of Ketogenic Living".   That was a light bulb moment for me.   I went LCHF and never turned back.  I had been eating a low carb diet but not LCHF prior to this.

I saw fantastic results of normal blood sugar in the first 48-60 hours.   I went from post meal blood sugars of 135-140 to post meal blood sugar readings of under 115.  At the same time my fasting blood sugar went from 110 to 85-90!   It was a very exciting experience to achieve this control!

Something happened this past week that took me back to my past life.   It was another reminder of how small and very short term changes in diet can quickly show unintended consequences.   I have never been in the dark about this and have told others many times how such seemingly small things have an impact for days or even weeks.   My five day vacation trip this past week gave me a reason to write this blog post.

I knew that this trip was going to be my biggest travel challenge.  Las Vegas resort casino's do everything possible to keep you eating in their restaurants. They do what they can to keep you from making or keeping any perishable food in your room.  They purposely do not provide microwaves or mini refrigerators or any conveniences that may help you avoid eating in the restaurants.

I went armed to beat them at their game!   I packed nuts, cheese, hard boiled eggs and tuna for breakfasts and snacks.  I brought coconut oil and olive oil too.   I was ready, so I thought!    My meter told me something else over the 4-5 days.

I still had to eat out in restaurants.  I was after all, on vacation!   Part of vacation is enjoying some excellent food and shows, etc.  I chose the restaurants carefully.  Most had their menus posted outside so I could see what would work for me.  What I was not prepared for was the portion sizes of all of the meals and how to deal with the emotional side of the thought of throwing away food that we paid good money for.  This, in the end, was the issue that led to my highest blood sugar readings in three years.

Steaks and burgers all were at least 8 ounce portions everywhere we went.   I am used to limiting protein portions to less than 3 ounces a meal.   Often, I asked them to sub a vegetable in place of the potato but then a salad was also served on the side.  Night one my husband and I ate in a restaurant in our hotel for convenience. We both ate an 8 oz rib-eye steak dinner with a vegetable side.  I requested an additional side of butter for my steak.  I knew this 8 oz steak was too large a portion but the fact that we were spending nearly $30.00 a person really got into my head.   This is the emotional part of it that I was referring to!   The thought that I could not use a take out box and it would be thrown out bothered me.

On day two I woke up to my first over 90 fasting blood sugar reading in a long time.  It wasn't too serious but I am normally pretty close to a 74 fasting number every day.

Each day of eating the large portion sizes of meat and vegetables were taking their toll.  I could also taste the addition of sugar in vegetables and sauces used on the sides and in the dressings.   We also ate two buffet meals along the way.  It is difficult to take a plate with only one small piece of meat.   I wanted to take a meatball, a peice of chicken thigh, and a small peice of ham too!   The price of the meals again got to my head.   My husband thought that I was not eating much considering the prices of the buffets.

For the sake of keeping this blog post as short as possible I'm not going to go into a complete breakdown of all of my meals and choices.   I did the best I could to choose wisely but It wasn't a controlled environment like my diet is at home.   Stressing out over restaurant foods while on vacation wouldn't have been helpful to me or my partner either.

So the bad and the ugly of this is that my blood sugar readings in just 2-3 days time were back up to the blood sugar control that I had experienced prior to changing to the ketogenic diet in Dec. 2012.   My fasting number on the final morning there was up to 103 and my post meal numbers were up to 130.  I was checking my readings before bed and they were in the 115-125 range when they should have been below 95 at that time.  Within 3 days I was out of ketosis and back to diabetic blood sugar readings averaging 25-30 points higher than my usual averages over the past 3 years.  I was surprised at how quickly my body went back to these higher numbers.

My experience this past week just goes to show how quickly daily mistakes in food and portion choices can lead to the loss of blood sugar control.  It also helped me to understand once again that this dietary approach isn't an easy path. Small mistakes can make the difference between tight blood sugar control or roller coaster control.

 I am glad to see my blood sugar control coming back to normal now after eating my usual meals here at home in the past two days.   My fasting reading this morning was 83 so I expect to be back to my usual blood sugar control by tomorrow.

I hope that this helps others who may be questioning why the Ketogenic diet doesn't seem to be working for them.   When I ask people to show me their daily menus or meals it is portion sizes of protein or vegetables and sometimes it is both.  The other issue is that the meals need to provide enough fat in order to be ketogenic.  It can't just be low carb, it must also be high fat.

See my daily menu samples here.   Sample pictures of portion sizes are here.  

For diabetics managing blood sugar and insulin levels we need to meet the targets of 75-80% fat, 15-20% protein and 5% non-starchy carbs.

I am a type 2 diabetic who blogs about my personal journey and observations while choosing a ketogenic dietary approach.    I am not a scientist or a physician. What you read here is not to be taken as medical advice.