Besides lowering blood sugar what does the LCHF ketogenic diet do for you and why is the side benefit often weight loss? There is a really good explanation of this as I have experienced in my own life while eating this way since December of 2012. When I first started eating this way I did start out eating 3 meals a day and even a snack at night. Sometimes I did just skip breakfast though or just had breakfast for lunch. Still, I ate kind of as we were taught to eat trying not to skip too many meals. As months went by things changed. I didn't need to eat for many hours after waking up and in some cases literally just "forgot" to eat. I had my Bulletproof Coffee in the morning and it kept me going until 1 or 2 PM. When I finally was hungry I ate my 75-80% fatty meal keeping my carbs low and my protein moderate like the size of my inside palm. As a diabetic large amounts of protein can be problematic as they can convert to glucose or glycogen that may increase blood glucose later. As time went on I was even less hungry and went even longer between meals. Sometimes as long as 22 hours naturally. So even though I was eating high fat meals I was burning body fat. You can easily understand the reason. I stopped eating! I was fasting! I didn't think of it as fasting though. Not at all. I just followed my body's natural desire to eat or not eat. It really is a simple concept! The biochemistry isn't so simple though. I am not a biochemist and I'm not going to pretend to be one but here are the basics.Eating less often naturally lowers your insulin levels. Eating moderate protein also keeps insulin levels lower than eating a 12 ounce steak. Of course if I only ate one meal in 24 hours I could certainly take in a larger protein portion because for the next 23 or more hours of not eating my insulin will be low during that time. Don't get me wrong here! I am not telling you that you have to fast. I am telling you that eventually you just will end up doing it and you won't even think about it in that way! That is part of the magic!
The magic of the lowered insulin levels is that fat burning begins! Fat stores that have been unable to be utilized now can be released. There is no additional fat being stored from your diet because you are not overeating carbs, proteins or even fat. You are eating just enough! Your body perceives you in a fasted state (low insulin) and begins to use the body fat. This is a natural thing. It is just like the tribes who hunted but didn't get their kill for a few days. Did they lose their energy? Were they unable to continue to hunt because they needed food! No, not at all! They burned their body fat as naturally designed to do. We have done it for thousands of years. Only in the last 35 years have we been taught to eat our 3 meals and 2 snacks. What has that accomplished?
The LCHF ketogenic diet is best for blood sugar, it's best for health and it seems to be the best for weight loss because you keep your insulin low and the reality is that it seems to lead to naturally just plain eating less food!
So is a LCHF diet a super high fat diet? No it is not at all! Not when you become fat adapted and are not eating your 3 meals and 2 snacks! You are now burning body fat instead because you don't need to eat 24/7. You will be reversing high blood sugar and reducing meds. This is the best gift of all!
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 arehere.
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.
Most of us are aware of the ADA guidelines for carbohydrate consumption for diabetics. We come across these all over the place; online, at the diabetes education classes, at the docs office and on facebook groups too.
The daily carb intake for male diabetics recommended by the American Diabetes Association varies between 135 and 180 grams for your three basic meals along with up to 60 to 90 grams of extra carbohydrates at snack time. Your daily recommended carb intake could therefore vary between 135 grams a day if you don't snack up to 270 grams a day. In many cases I've seen dietitians allow up to 60 grams of carbs a meal.
Let’s just use the 45 grams a meal and 25 grams of carbs at 2 snacks and the recommended 3 meals and 2 snacks scenario that most diabetics are told to stick to. Get a picture in your head to start off with.
4 grams of carbs in any form, sugar, rice, bread etc. is equal to 1 teaspoon of sugar. Our bodies can handle at most 1-2 tsp of sugar at ANY time! Keep this picture in mind.
4 gr carbs= 1 tsp sugar.
If we take Dr. Bernstein's math from his book "The Diabetes Solution" 1 gram of carbs raises blood sugar by about 5 points.
Barney, our patient in this scenario was given the standard ADA advice that he needs 45 grams of carbs for breakfast. Barney's blood sugar before breakfast is 120. This is a common number for many diabetics in the morning.
For breakfast he eats 45 grams of carbs; a bowl of Special K with some sugar, toast with margarine and a glass of skim milk. Within 30-45 minutes his blood sugar will rise and continue to rise over several hours.
45 X 5 = 225
That isn't all! Barney started with a blood sugar of 120 and he is still making insulin to try to get the original high blood sugar down. Now he has added 11 teaspoons of sugar to his bloodstream and his blood sugar rises to 350 (19.5 mmol/l). Remember our blood stream can only handle 1-2 teaspoons of sugar. This is an emergency! The pancreas pushes out massive loads of insulin! The insulin gets the glucose out of the blood and tells Barney's fat cells to store all of the extra sugar in the fat cells.
Barney took his pill so that he can make more insulin to help get his blood sugar down. 2 ½ hours later his blood sugar is 200. (11.1 mmol/l) He is already starving and it is time for his work break and his snack. He eats a large apple and 2 pieces of string cheese at 25 grams of carbs. His blood sugar rises by an additional 100 points and once again the pancreas must work hard to make insulin and try to get rid of an additional 6 teaspoons of sugar in his blood.
After break, Barney feels sluggish and thirsty. He remains hungry and is thinking about lunch already. Lunch comes two hours later! Since Barney is following his dietitian's guidelines to the letter he has his low fat turkey and cheese sandwich on whole wheat bread. That is pretty much his 45 grams of carbs allowed for a meal. He has a diet Coke and a piece of string cheese on the side.
He doesn’t take another blood sugar reading at this time but we can figure that it is still high from his earlier snack. Now the math again is 45 X 5 = 225. Barney takes his pancreas stimulating medication again at lunch to help get his blood sugar down. With his earlier snack and a high blood sugar that was never able to come down due to the snack earlier Barney’s blood sugar never goes below 200 on this day.
At 3:00 Barney can’t wait for his snack! He is starving! He checked his blood sugar and it was down to 180 since lunch. That is in the range that his doctor says is okay so he heats up one bag of microwave low fat popcorn. He eats the whole bag at 23 grams of carbs. 23 grams of carbs X 5 = 115 added to the 180 reading he just had is going to drive blood sugar up to about 300 (16.7 mmol/l) He doesn’t take any medications at snack times.
After work Barney makes a quick trip through Wendy’s for a regular sized grilled chicken sandwich with a side salad and a packet of the low fat ranch salad dressing. He also ordered an extra large Diet Coke because he is so thirsty. This is his 45 gram carb meal. At home he checks his blood sugar and takes his diabetes pill that will help his pancreas to flood his blood with insulin. His blood sugar reading is 195 at the start of his meal tonight. He shrugs because this is just the reality of his life with diabetes.
Again the 45 grams of carbs is equal to a blood sugar rise of 225 and he has put more than 11 teaspoons of additional sugar in his blood stream by eating this meal. His pre-meal reading was
195 so adding another 225 points will get him up to a reading of over 400. It's a good thing he has his diabetes pill because that will once again help make a lot more insulin to try to reduce the blood sugar.
Barney is hungry again but he is afraid to snack. His post meal number was just too high and his doctor has told him not to eat after supper unless his blood sugar goes low. At the end of the day, Barney takes his 1500 mg metformin pill and goes to bed with a blood sugar reading of 260 (14.4 mmol).
This is a day in Barney’s life that repeats over and over again because no one has taught Barney the diabetes math. Barney is a compliant diabetic. He follows all of the rules given to him by his diabetes educator. He doesn’t cheat although he would love to have chips with his lunch or fries with his burger sometimes because he is always so hungry eating the low fat diet.
Not too many people eating a diet like this would be able to avoid the carby sides that Barney has worked very hard to try to avoid. This poor man just has no idea to help his diabetes. He is becoming more and more upset and thinks about his grandchildren and wonders how much time he will have left with them.
It is my hope that Barney, like so many of you, will find the LCHF Ketogenic diet like I and many others have. Learn the diabetic math and have the beginning of a new life. I hope this helps many of you understand the blood sugar roller coaster as Dr Bernstein calls it.
It's that time of year once again for "the New Years resolution". Have you come up with one? Are you mulling it over? Do you even remember last years resolution at all? Perhaps you are only reminded by the monthly gym membership that you are still paying? Do you remember what the gym looked like 9 months ago?
If you have a resolution do you have a plan? Remember that a resolution does not equal success or results. A resolution is a decision based on determination. If you lack determination then you will not be able to follow through with your New Year's resolution. You are just going through the motions.
To make a true change you have to recognize that you have to change a habit or habits. In something like quitting smoking most past smokers will tell you that the hardest part of quitting smoking was not the withdrawal. Yes that is definitely very difficult. Most who successfully have quit will remember that it was the habits that went along with the cigarette that was the hardest to overcome. The first cigarette in the bathroom after the alarm goes off, the one in the car on the way to work, the one on your 10 minute break, the after dinner cigarette. What do you do now on that 10 minute break? How do you change your habits during these times so you don't break down and ask a co-worker for a cigarette which is the beginning of the failure once again?
Habits are so hard to change! That is why it seems to be harder to change something in your life that consists of multiple habits. Changing one small habit is fairly easy. An example of this might be a resolution to go to bed 45 minutes earlier each night or wake up 45 minutes earlier. This is one habit that done over about a full week will most likely be very successful. Also, deciding to walk one extra mile when you already walk four miles will be easily achieved.
So, lets take this idea and apply it to a difficult resolution that involves a lot of habits. Apply it to a resolution to change to a LCHF Ketogenic diet. This year you resolve that you want to be really committed and make it your lifestyle and you are going to stop eating the wrong snacks. What habits will need to be changed? Each eating habit you have can be a stumbling block so they each need to be addressed seriously and separately. Here are some examples you may want to consider:
Eating on the run or in the car
Eating too late because you have to get the kids ready first
Munching on the kids or spouses foods while you prepare their meals
Taking bars or shakes to work for breaks
Eating fast food lunches
Eating while watching TV
Eating based on your emotions
Keeping high carb foods in the house for the family that you seem unable to avoid yourself.
There are many more food "habits" that could be listed but you get the idea. Do you see from this list why changing eating habits may be just as difficult as quitting smoking?
Once you identify your habits you have to find a solution. Will you be successful if all of these habits are changed at once? That certainly looks like a fail when you look at the entire list! You have to create a solution for each one of these habits. The first two on the above list may be solved first by changing a small habit first; that habit would be to change the time that you wake up. Change that habit and perhaps you can find time to prepare a healthy food rather than grab an unhealthy food. Let's face it, you are not eating scrambled eggs in the car.
Another habit that can be changed that is a more simple habit would be to set aside a day and a time once or twice a week to prepare take along foods for breaks and lunches. Changing this habit helps to solve the problem of eating at fast food joints and instead of shakes or protein bars you will enjoy turkey cheese roll-ups, hard boiled or deviled eggs, chicken or tuna salads and the like. Resolve that Sunday afternoon for one hour is going to be a food prep time and make that a habit.
Emotional eating or eating while watching TV are difficult habits to break. Recognizing it is a key to working on the reasons. In the mean time make sure that you make a habit to make better snack choices while at the grocery store and use some of your prep time to give yourself these extra snacks for these emotional eating times.
Instead of grabbing your kids bag of chips, have some turkey and cream cheese roll-ups waiting in the refrigerator or have some of your home made "cheese nachos" and sour cream ready to munch on. Have some "salami jalapeno roll-ups" during your usual TV watching snack time. All of these things can be made and placed into containers or zip lock bags.
So, here are two basic changes that can potentually solve the 8 eating habit issues that are going to be quite hard to change all at once. It is much easier to make the two new habits work than to try to change the others.
Don't make the mistake of making a resolution that creates even more chaos in your habit filled life! If you resolve to both diet and exercise to change your couch potato lifestyle you have doubled the number of habits that will need to be addressed! Think about that! Is it any wonder that the gym membership card has been gathering dust on your dresser?
Again, we want results not just resolutions. Of course make your resolution but also resolve to get results; not in the way you tried to get results in the past but by trying a new way! Think it through. What can you do to create NEW habits that will bring the results you want to achieve?
When I was a kid growing up in the 1950's-1970's I remember being told not to eat snacks because it would "spoil" my next meal. This was a pretty universal thought from what I remember.
In the late 70's and early 80's this all changed right along side the newly released dietary guidelines that had not existed before that era.
Now anybody here who grew up in the 80's or later "knows" that we are supposed to eat three meals and 2-3 snacks a day to keep our blood sugar "stable" and keep our brain and body from experiencing low energy. That is what just about every dietitian, physician or dietary aide will tell you. They will also tell you that skipping a meal or not eating breakfast will "slow your metabolism and make you gain more weight". Well how has this all worked out for the last 35 years? It seems that is has worked out poorly indeed! Because these guidelines to eat all the time came along at about the same time as the published dietary guidelines and the war on saturated fat it is difficult to know which dietary change is the worst culprit here. I'm going to focus here on the 5 meals a day idea only at this time.
Why would eating five or six "small" meals a day be a problem? The first thing seems obvious and that is that most people aren't following the "small" meal part of the advice. That in itself is a fail!
Next, Let’s look at the process of what happens when you eat a meal. I'm not going to go into great detail as I am not a biochemist. At the start of the meal, in the mouth, digestion begins. Enzymes are release to begin the breakdown of starches and sugars. At the same time a signal is sent to the brain. The brain signals that you are eating and the hormones and enzymes are released to process the meal.
Let’s just focus here on insulin and let’s assume that the person eating is not a diabetic. Insulin levels rise and fall in with food consumption. In the standard diet the meal is normally a high carb meal. The hormone insulin is known as the energy storing hormone. This means that the meal causes your body to release insulin. If it is a really high carb meal and blood sugar is still rising after a half hour or so, a second round of insulin is needed and your body will continue to release insulin until the blood sugar is back to normal levels.
In a non-diabetic person this should happen in less than an 1 1/2 hours or so. Insulin then comes back down to baseline and some new insulin is stored for the next meal. In two hours you are now eating again at your morning coffee break. This process begins again. So this is normal right? Why is this a problem and why does it contribute to obesity?
Insulin has several jobs. Number one is to store excess carbs and sugar as fat and secondly to tell the cells not to release any fat. Blood sugar management is not it's primary job. Insulin has several jobs. Number one is to store excess carbs and sugar as fat and secondly to tell the cells not to release any fat. Blood sugar management is not it's primary job. Your body will NOT release fatty acids from your fat cells, and will instead encourage your body to store fat.
This will happen at each meal and snack you eat. It means that you are storing fat all day long. Even eating a low calorie, low fat diet isn't going to do much good for weight loss as long as meals are going to be eaten every few hours. The only time insulin is going to stabilize is when you are sleeping. Most people have noticed that dieting this way just doesn't seem to work out very well.
Now if we go back to the old idea that snacking between meals is not a good idea we should be better off as far as insulin goes. We may have some fat loss between meals once insulin levels are low. This works even better if we eat a low carb diet because insulin levels come down even faster and we don't need as much to deal with the meal.
What if we go to eating only twice a day with 6-7 hours between eating low carb meals; something no mainstream dietician is ever going to recommend? Would this be a fat burning scenario? It should be! It may not be the same once a person has metabolic syndrome or insulin resistance. Things get more complicated and weight loss may still be difficult for a person in this situation.
Here is the problem we face with the dietary guidelines that we have learned to follow. Most adults do become insulin resistant because of the standard American diet and the pounds begin to add up. This is even more reason to leave longer periods between meals. Insulin will have to stay high longer to deal with the insulin resistance and blood sugar problem. It will take much longer to go back to base line. All of this time you are storing fat and not losing it.
So the next time that your dietician, diabetes educator, or doctor tells you to eat several high carb meals throughout the day to keep your blood sugar stable remember that you don't have to be part of the failed 35 year dietary experiment any longer!
We are coming to the time of year that causes the greatest food temptations and the potential for overeating for everyone! For diabetics though giving in to those temptations doesn't only mean some weight gain to shake off after the holidays but it can lead to high blood sugars, guilt, shame, self pity and even depression. Not only that but "well meaning" relatives and friends tell you to relax and enjoy the holidays by eating the stuffing and pumpkin pie. This can also cause you to feel anger because they seem to be unconcerned about your health or are not listening to you.
Most of us have experienced this. I know that I certainly have. Here are some tips to help you survive the holiday parties.
Bring a favorite dish and make it low carb. Don't ask if you can bring a dish. Just bring it! An example would be a low carb version of Green Been Casserole, Cheesy Loaded Cauliflower, a Seven Layer Salad or a Cobb Salad. Fill your plate with the meat and your sides and whatever else you can find that fit's in your eating plan. If you are the one cooking the main meal you will have much more control over the meal and snacks and can choose to make things like a Low Carb Stuffing and serve both a cauliflower mash and mashed potatoes.
For parties where snacks will be served bring a platter of assorted cheeses and bite sized beef sticks, Deviled Eggs or a veggies platter with a Cream Cheese Dip or a Spinach Dip are other ideas. While everyone is filling their snack plates with crackers and nachos you will fit right in by adding the cheese, beef bites and veggies and dip to your plate. You will not feel at all left out this way and you won't feel hungry either.
As for dealing with the pressure of dessert time someone gave me a really great tip and she swears it works perfectly! Take a small piece of pie and chop a small piece from it with your fork and move it to the side of the plate. During conversation stab at the pie a few times and put your fork down in between. If you have a partner then finally just push the plate over to him/her and say that you are just "stuffed" and can't eat another bite. If there is no one to pass it to then just get up from the table and stab at the dessert while walking into the kitchen. Set the dessert down and leave it there. This only will work if you really can "walk away" from the pie! Remind yourself that your low carb dessert is at home!
Alcoholic beverages are also part of this time of year so if you do choose to indulge choose wisely! A vodka or gin with club soda or seltzer and a lime slice would be a good choice or a dry red wine if you like the taste. A glass of dry white sparkling Champagne is also a low carb choice. Alcohol can lower blood sugar so do keep that in mind. See more about alcohol choices here.
So you see that you can survive the holiday parties with just a few low carb tricks up your sleeves and friends and family will barely notice. You will be full and happy and you will be able to enjoy family and friends without feeling shame, guilt or anger. You will instead feel very very proud of yourself!
I want to thank my friend Ellen Davis for addressing the ketogenic diet for use in insulin dependant diabetics. This is not an area of expertise for me so I am thankful that she has agreed to post here!
I use her wonderful websites often. She does fantastic work and is extremely knowledgeable. She has written a book for type 2 diabetics and just finished another one for the type 1 diabetic.
On to Ellen's post!
The Ketogenic Diet: Low Blood Sugar Protection for Insulin Dependent Diabetics
Diabetes, as the readers of this blog probably know, is
a group of diseases in which high levels of glucose or sugar build up in a
person’s bloodstream because insulin, a pancreatic hormone which manages blood
sugar, is either not available (type 1 diabetes), or is not working correctly (type
2 diabetes).
Some people tend to underestimate the implications of a
diabetes diagnosis, but make no mistake, diabetes is a deadly disease. When high blood sugar (hyperglycemia) goes uncontrolled,
diabetics can suffer from a range of serious complications including loss of
eyesight, limb amputations, kidney failure, heart disease and death. And while high blood sugar is damaging,
there’s an even more immediate health risk associated with low blood sugar
(hypoglycemia).
For those with type 1 diabetes and insulin reliant type
2 diabetes, the lack of sufficient internal insulin requires injecting insulin
from outside. Since this external
process is much less efficient than normal pancreatic function, diabetics on
insulin must engage in a moment-to-moment guessing game of judging how much
insulin to inject to offset food intake, while taking into account the sugar
burning effect of normal activity and exercise.
The scary part is that a wrong guess can have serious
consequences. Injecting too little insulin to compensate for food
intake allows blood sugar to climb high enough to cause body damage. But
injecting too much insulin can cause
blood sugar to plummet to levels low enough to be lethal. In fact, the issue of dangerously low blood
sugar is the greater danger for diabetics who inject insulin. About 10 % of type 1 diabetics die each year
from hypoglycemia, and many of those are children who perish when their blood
sugar crashes while they are asleep.[1]
While imprecise insulin dosing
is the major factor, food choices also play a large role in the frequency of diabetic
hypoglycemic episodes. This is because each of the three food macronutrients (carbohydrates,
proteins and fats) have very different effects on blood sugar and compensating insulin
needs.
In particular, carbohydrates,
which are found in all sweet and starchy foods, have the greatest effect on
blood sugar. Ingested carbohydrates in any
form or amount will raise blood sugar swiftly and require insulin to counteract
the rapid blood sugar elevations.
More importantly,the
relationship between carbohydrate intake and compensatory insulin is not a
linear one, but is instead an exponential one[1]. In other words, if 15 grams of carbohydrate
is consumed in one meal, it will require a certain amount of insulin, say one
unit, to counteract the blood sugar rise. But if 5 times that amount (75 grams
of carbohydrates) is consumed at one sitting, more than 5 times the amount of insulin will be needed to
lower blood sugar back to a baseline level.
These larger doses of insulin increase the likelihood of driving blood
sugar down below baseline and causing a dangerous low blood sugar episode.
In addition, protein, which
is found in foods such as meats, eggs, poultry, and fish has a moderate effect
on blood sugar. Whereas carbohydrate raises blood sugar immediately, protein tends
to raise blood sugar several hours after a meal, and extra insulin may be
needed then. This “protein effect” is
not usually discussed by the American Diabetes Association because their
guidelines direct people with diabetes to eat large amounts of carbohydrate at
each meal. The amount of insulin needed to counteract this
high carbohydrate intake tends to mask the associated blood sugar rise from
protein. This is an important point to remember for any diabetic who decides
to lower carbohydrate intake.
In contrast, dietary fats
have little to NO stimulatory effect on blood sugar, so the need for compensatory
insulin is low, and blood sugar stays steady. As you can now understand, meals
which are low in carbohydrate and higher in fat are less likely to result in
hypoglycemia.
Furthermore, macronutrient
choices also determine what type of fuel will be predominantly used by the
body. If one eats a diet high in
carbohydrates, then the body cells will utilize the large amounts of sugar or
glucose created as the primary fuel. If
one eats a diet low in carbohydrates and higher in fat and protein, the body will
generate and utilize fuels created from stored and dietary fat. (Protein is mainly used a construction and
repair material, rather than a fuel source.)
[1]Marran KJ, Davey B, Lang A,
Segal DG. Exponential increase in postprandial blood-glucose exposure with
increasing carbohydrate loads using a linear carbohydrate-to-insulin ratio. S
Afr Med J. 2013 Apr 10;103(7):461-3.
This is why a low carb, high fat ketogenic diet can
help people with diabetes take control of their disease. Over time, when carbohydrate intake is
restricted and fat intake is increased, the liver adapts to the dietary change by
breaking down stored and dietary fat into substances called ketone bodies and
releasing them into the bloodstream. This is called being “in ketosis” and when
blood ketone levels get into a certain range, the brain, heart and other body
systems can use them as an alternate fuel source when blood glucose levels are
low.
However, while our brains can run on both glucose and
ketone fuels, there’s a balancing act involved. This issue of balanced fuel
sources for brain function is crucial to understanding the positive effect of a
ketogenic diet on diabetic hypoglycemia and overall health. The difference is whether
carbohydrates or ketones are being used as a primary fuel. In other words, is one’s brain “carb-adapted”
or “keto-adapted?”[1]
Carb-Adapted or Keto-Adapted Brain?
Our brain cells MUST have a constant fuel source to
stay alive. Any interruption in fuel availability is a critical emergency for
the brain, and it doesn’t take long for our brains to shut down permanently
when brain cells don’t get enough fuel.
Having a carbohydrate-adapted brain versus a keto-adapted brain
highlights this weakness because there are differences in fuel availability
while in these various states. Let’s explore these differences.
We’ll discuss the carb-adapted brain first, because
that’s the typical state for someone consuming a standard American diet.
When a person consumes a high-carbohydrate diet, ketone
production in the liver is essentially shut off due to the presence of large
amounts of stored and circulating glucose and insulin. Since ketones are
unavailable, the brain becomes dependent on glucose as its primary fuel source.
We call this a carb-adapted brain since it relies greatly on glucose from
carbohydrate intake to function and thrive. The problem will bring carb-adapted is that
the human body can’t store a lot of glucose for future use, so unless food is
ingested every 3-4 hours, it quickly runs out of fuel, and blood sugar begins
to drop.
[1](Keto-adaptation is a term coined by Drs. Jeff Volek and Steve Phinney,
authors of the Art and Science of Low Carbohydrate Living.)
When a carb-adapted brain senses that blood glucose is
becoming scarce (such as when food is
scarce, or too much insulin is injected) it takes counter measures and frantically
signals the liver to break down stored energy to glucose and dump it into the
bloodstream. An adrenalin rush ensues, and is experienced by the brain’s owner
as the symptoms of hypoglycemia or low blood sugar.
The signal is frantic because at this point, glucose
MUST be made available to the brain. Otherwise, very bad things happen. For
example, the liver may not be able to break down enough stored carbohydrate to
counteract an excessive insulin dose. As blood glucose levels continue to drop,
the carb-adapted brain starts losing consciousness. Without an intervention of sugar
(juice, glucose tablets or candy) from outside, blood sugar can drop to a level
which results in a coma or death. As you now understand, going on high alert
when blood sugar drops is definitely warranted for a carb-adapted brain.
Now consider a person consuming a ketogenic diet.
Carbohydrates are restricted and ketone production in the liver increases over
time as this person enters a state of “nutritional ketosis.” Blood ketone levels are in a range of 0.5 – 3
mmol/L (mM), and at this level, the ketones act as an alternate fuel source for
the brain. This brain is keto-adapted and low blood sugar becomes less of an
emergency since the brain cells now have an alternate fuel source. For the diabetic in a state of nutritional
ketosis, this is not to say that lower blood sugars shouldn’t be corrected if
discovered, but it is logical and there is experiential and researched based
evidence[1]
that the brain is afforded an extra measure of protection from symptomatic
hypoglycemia when blood ketones are available.
In
the overall evolutionary design of the human body, the ability of the liver to
produce ketones is an elegant solution for providing an alternate body fuel
when food is unavailable. Fasting and starvation cause the same elevation in
ketone production, and in fact, most people wake up each morning in mild
ketosis because they haven’t eaten for the past 8-12 hours. If dietary
carbohydrate is restricted to 20 – 50 grams per day over several weeks and dietary
protein is not excessive, the liver will produce ketones, and blood ketone
levels will rise moderately. However, it’s important to note that blood ketone
levels don’t typically rise as high during nutritional ketosis (0.5 – 3 mM) as they do during prolonged fasting (5 – 8 mM) so this
protective effect may be more pronounced during times of total food fasts.
[1]Cahill GF Jr. Fuel metabolism in starvation. Annu Rev Nutr. 2006;26:1-22. Review.
This alternate fuel effect is a great reason for people
with diabetes to eat less carbohydrate and more fat, but being in ketosis also
brings other significant benefits. Not
only does ketosis provide an alternative fuel for the brain and heart, blood
sugar normalizes, and the spikes and crashes associated with a high
carbohydrate diet and compensatory insulin are minimized. This translates into a much lower risk for
diabetic complications down the road, a reduction in dangerous hypoglycemic
episodes and better overall health.
The ketogenic diet is arguably the best diet for
diabetics, and if you have diabetes and are not on a ketogenic diet, I hope
this post has given you some compelling reasons to change your diet in that
direction.
BIO-
Ellen Davis is the creator and owner of www.ketogenic-diet-resource.com, a website devoted to sharing information on the health benefits of ketogenic
diets for diabetes and other health conditions. She also has a wealth of free information at her other website www.healthy-eating-politics.com
Ellen has a Master’s degree in
Applied Clinical Nutrition from New York Chiropractic College. She recently wrote and released two books
detailing how to treat diabetics with a ketogenic diet. Both books were
co-authored with Dr. Keith Runyan, a physician who successfully treats his own type
1 diabetes with a ketogenic diet, and both books are
available on her website. Ellen lives in Cheyenne, Wyoming and can be
contacted at ask.ellen.davis@gmail.com.
Type 2 Diabetes is almost always thought of as a disease of simple blood sugar management. In reality there is nothing simple about diabetes. There are multiple factors involved on many levels.
In my experience with many Diabetics in my group settings there are always reports of crazy blood sugar swings when the person claims that they have not had any carbs or sugar, Many report high blood sugar either at wake up or after wake up before eating. It is not uncommon to see raised blood sugar after exercising, gardening, or fasting. An argument or bad news can raise blood sugar. What's going on here?
It isn't the most recognized hormone insulin that is the culprit behind these issues. Insulin is the hormone that is supposed to lower blood sugar. People often say "Your blood sugar went up due to an adrenaline response or a cortisol response". But why and how?
I am no scientist but I spend a lot of time teaching others about managing blood sugar so I manage to learn from a lot of sciency people around me. I pick up on a few things along the way.
There is the forgotten hormone Glucagon. It seems that nobody talks about it. Your doctor or diabetes educator won't. They may know of it's use in patients who are passed out in a diabetic coma but that is the only time that they are going to think about it.
Glucagon is a major player in diabetes and blood sugar control. One of the problems is that no one is able to figure out how to manage it. Certainly drug companies would love to find a way to add an additional medication to control the over production of glucagon. Many so-called Brittle Diabetics are thought to have a dis-regulation of glucagon. Glucagon is secreted into the bloodstream by the alpha cells, insulin is secreted by the Beta cells. When insulin is produced, glucagon is suppressed. (after a meal). When glucagon is released it suppresses insulin.
In diabetics many of the beta cells are gone or are overworked so insulin is not working so well. On the other hand the alpha cells are just fine and releasing lots of glucagon when signaled to do so. Your insulin is not responding normally so your blood sugar does not come back down quickly like it would in a normal person.
Glucagon tells the liver to start churning out glucose and the next thing you know, for seemingly no reason that you can think of, you have an unexpected blood sugar high even while fasting! What the heck.
What are some reasons why glucagon is released? Here are some:
Low Blood Glucose, even in a normal range when insulin levels are also low: Good normal blood sugar is great and that is what you want. For many who are new to eating a low carb diet you may see some rises in blood sugar as glucagon is released to compensate. Just keep going and things will level off.
Fasting: Again while fasting insulin levels are low so the brain signals the pancreas to release glucagon. This is a normal response so don't panic. This is why many see higher blood sugar in the morning. Protein-rich meals: stimulate both insulin and glucagon. Too much protein will have to be stored as glycogen (sugar) in the liver and the hormone glucagon stimulates this process. This is the reason that I always advise against large protein portions. Your blood sugar goes up from both the carbohydrates and the protein you just ate. Your body only needs an adequate amount of protein for the use of essential amino acids. Glucagon, Dietary Protein, and Low-Carbohydrate Diets
Stress, Exercise, Bad News, an Argument or Injury: Your body perceives all stress the same way. physical or mental stress cause the same release of various "fight or flight" hormones. Beyond that, a person with chronic and long lasting fear or anxiety is in a constant state of stress. Glucagon is stimulated by these various stress hormones. As long as you are under the stressful condition the liver will receive it's instructions to provide more glucose to give you the energy you need to fight off the dangers around you, perceived or real doesn't matter. This is all a good
reason to try to discover what may be causing your stress and anxiety on a
daily basis and try to find ways to combat it for your blood sugar health.
There isn't much you can do about illness and
injuries but at least you will be aware of why it is affecting your blood sugar
and you won't make matters worse by panicking and then adding to the stress!
In some cases there may be some natural remedies that will reduce pain and
inflammation or you may have to rely on some medical help.
From: Minireview: Glucagon in Stress and Energy Homeostasis
"Evidence for glucagon release in a wide variety of stressful situations began to accumulate after improvements in glucagon assays made accurate measurement possible in the early 1970s. In animal models, large elevations in plasma glucagon are observed immediately after acutely stressful stimuli. Hyperglucagonemia is also well recognized in patients under a range of physiological stress states, including trauma , burns , surgery, sepsis ), hemorrhage, acute myocardial infarction, cardiac arrest, and hypoxia including in neonates Very high plasma glucagon concentrations are seen in diabetic ketoacidosis and contribute to hyperglycemia in this setting." While I have barely scratched the surface of this issue it is important to understand that glucagon may be affecting your blood sugar negatively and some changes may be in order in your life. Try to reduce stress, arguments, negative work environments, etc.
My final word on this is that I hope you will remember not to beat yourself up over things that you can't control. Don't
assume that every blood sugar rise must be due to something you ate or drank. Don't blame yourself and assume you must have "cheated" or
eaten some forbidden food. Give yourself a break!
I will end by saying what I said when I started.
Diabetes is not a simple disease. It is complicated and involves
many hormones and various other factors. Some you can control and others you may not
be able to. I am not an expert on diabetes. I am growing and learning as I continue to discover how to manage diabetes with a ketogenic lifestyle.
What role does protein play in Dawn Phenomenon? DP is that higher blood sugar number that many wake up to. It is frustrating and one of the most questionable topics that diabetics discuss. In just a few days I was able to create a condition where I went from a state of completely controlled morning blood sugar to DP. I did not to this on purpose and please don't try this at home! (wink wink!) ;)
My usual morning fasting blood sugar averages around 74 (4.1 mmol/l). In a few days time I have experienced a nasty return to Dawn Phenomenon and I quickly saw my fasting blood sugars skyrocket! I actually created a situation where DP would return to my life after three years without having it. This was an unwitting vacation experiment on my part and a teachable moment that I feel I can pass on to others.
I just spent the past eight days across the country with family members in a food environment that was difficult to control. Many of you may have experienced this for yourselves. It is a tough situation to be in. Our relatives took us out to eat a lot. They love carbs and sugars. I worked very hard to control my own food choices and often left a lot of included carbs on my plate. I did pretty well in that regard.
What I found more difficult to control was my protein and fat portions. Although I was able to request "no bun" it was hard to find fat choices to add to my proteins and the protein portions were all quite large no matter what I ordered. One of my meals was a burger with a fried egg on top. The burger was 1/2 pound. A fajita meal contained enough protein for 3 of my usual meals. Several meals were from local food trucks and so it was not an option to ask for side items like additional butter, sour cream, mayo, etc. I was also not able to find my usual heavy cream at any establishment or in any of the hotels we stayed in. I am always trying to point out to others that fat grams should be about twice the amount of protein grams. I was not able to follow my own advice. I took a lot of leftover boxed food back to the hotel fridge but at some point I was eating it. In general I was eating way too much food, too much protein and not nearly enough fat. I was very successful at keeping to my daily carb limit though.
Each day I saw an increase in after meal and pre-meal blood sugar despite my attempts at control. For the first few days my morning blood sugar was in the 80's, (4.5) then crept up to the 90's (5's), then 105 (5.8).
The family members that we were visiting proudly refer to themselves as "foodies" who eat three meals a day and numerous snacks in between. On our final night, after figuring out that I was a "meat and vegetables" eater the family treated us to a Brazilian Churrascaria (meat BBQ) restaurant. This is a type of buffet where you can go and get your salad items and then the Gauchos (servers) slice the meats table side. Eleven types of meat were served! Just imagine the protein overload! The restaurant was an expensive treat and I certainly did not want to offend our hosts who were paying the pricey check. I knew what I was in for and it wasn't going to be pretty.
Sure enough, my last morning reading there was a 128 (7.1) It was higher than my bedtime reading. After nearly 3 years on a diabetic ketogenic diet I managed to put myself in the position of reverting back to a state of higher blood sugars in general and brought DP back into my life! It took so little time to do this! Think about the significance of this!
I wanted to make this a teaching moment for those in my groups and for those who follow my blog. My vacation mistakes were not mistakes of eating extra carbs, potatoes, french fries etc. The mistake was a mistake of extra protein over and above what my body needs. This reprogrammed my liver in a way that made it store more glycogen (glucose) for use between meals and overnight. There is a more scientific explanation of this that there is not time for in this post.
The take away from this is that I hope that some of you will have a better understanding of how too much protein can keep you from experiencing the blood sugar levels that you aim to achieve. The DP that doesn't seem to ever go away could be tied to protein portions. This is assuming that you really have been limiting your carbs to the suggested 25 grams a day or less. Eating LCHF has normalized my blood sugars and brought me to an A1c of 5.1.
Look how quickly I was able to mess with that! The Ketogenic LCHF diet for diabetes truly is an art and a science as Volek and Phinney point out in my favorite book "The Art And Science Of Low Carbohydrate Living".
My fasting blood sugar this morning was 105 (5.8). I still have a long way to go to get back to my usual average of 74 (4.1) and this is going to take several days as my liver and pancreas have to readjust to my lowered protein servings again. It is sad to see blood sugars in this range again after 3 years of great control. I will get my normal numbers back in a few days. I hope that my experience has inspired you. Sometimes my mistakes can keep you from making one or can point you in the right direction.
Here is a link to an earlier post where I discussed the over eating of protein as well. http://ketodiabetes.blogspot.com/2014/02/protein-is-my-nemesis.html
Over the past several years I have found that I have taken several different approaches to the low carb high fat (LCHF) diet and kind of put them all together to create what ended up being a complete and perfect plan for me and one that also seems to work best for many.
In my "Revering Diabetes" facebook group we direct most new members to Dr. Eric Westman's "No Starch, No Sugar" plan because he has a great video and a food list that goes along with it. It is an easy place to start and is very understandable to most. He does not recommend limiting protein for diabetics which is something that I think is hindering the fine tuning of blood sugar control for some. I think that protein does need to be limited.
I also point people to Dr. Richard Bernstein's plan which is a bit higher carb and focuses more on blood sugar control with "the law of small numbers" for glucose control. His books and lectures are more directed to the type 1 diabetic.
Rosedale, Volek & Phinney fine tune the ketogenic diet at a more scientific level where fat, protein and carb ratios are more regulated and fine tuned for better blood sugar control and lower insulin levels. Lower insulin levels have been shown to reduce inflammation in the body, lessen free radical damage, slow the aging process and reduce the risk of heart disease, cancer and Alzheimers disease's
I have spent over 4 years of N=1 experimentation on myself. In the process I have shared this in my three facebook groups of over 10,000 other diabetics. I believe wholeheartedly in the plan of attack against diabetes that I have chosen to use and to teach. A scientifically formulated ketogenic diet works if you DO the work. It is not exactly the same for everyone. We all have different levels of insulin resistance and so the diet should be tailored to each person. It is still very basically the same for most. 5% carbs, 15-20% protein and the remaining 70-75% fat is what works for most. It is proven over and over again to do so. I do agree that there are exceptions. In some cases gut health, enzymes, hormones and nutritional deficiencies may be hindering the process or a diagnosis of type 2 diabetes may have been an incorrect diagnosis. You then need to get more testing for LADA (type 1.5). All of these things have to be addressed for those who are not successful after doing LCHF correctly.
Fasting seems to have come in to vogue now with the popularity of Dr. Jason Fung and his protocol as well a the lesser known Roy Taylor's very low calorie diet that mimics gastric bypass surgery. Both of these can be useful for the diabetic for blood sugar and insulin control. Some seem to prefer these methods instead of working out the ratios of the ketogenic diet for themselves. Others find that it is the final step to getting optimal control of diabetes where they are looking to be in a completely non-diabetic A1c range of under 5.0
I wanted to address this mainly so that those following in my facebook groups could understand that my approach is not simply that of Westman or of Volek and Phinney or Rosedale. I lean towards Volek and Phinney's "The Art & Science Of Low Carbohydrate Living" because it brought me to a new place in my level of blood sugar control and it did so in a matter of days. It is a book that I recommend for any who want to understand the science of how and why the ketogenic diet works and what mistakes keep it from working.
I suggest the following websites for more information on the science of the LCHF Ketogenic diet.
A famous quote by Hippocrates (460 – c. 370 BC" is “All disease begins in the gut.” Ongoing medical research is now showing how true that statement really may be. Is it possible that many of our medical issues can be at least partially solved by focusing on ways to heal our gut health rather than trusting in allopathic medicine and drugs? New studies and research are re-exploring how our gut flora is linked to diseases ranging from autism and depression to autoimmune conditions like Hashimoto’s, inflammatory bowel disease and type 1 diabetes. Dr. David Perlmutter has written a new book on this calledBrain Maker. Dr.Nicholaus Gonzalez of New York says that "The gut has it's own active nervous system and also has an active immune system. Scientists never used to think of the gut as an immune organ, but now we know that it is." If this is the case then we had better think about what we are feeding our gut on a daily basis!
This article from Feb. 2015 suggests that the lack of a gut microbe,Lactobacillus gasseri is tied to type 1 diabetes and possibly type 2 as well. Dr Mercola addressed gut microbiota in his article: "Gut Bacteria Differs Between Diabetics and Non-Diabetics" We are living in a time where drugs are now our medicine instead of food. For thousands and thousands of years people relied on foods, herbs, Chinese medicine and other natural therapies for healing. Now, since about the 1940's we have been taught to rely on drugs and eat junk food. We have been duped into believing that food is not medicine for our bodies but only a emotional comforting and social thing. The quality of our food and our gut health is no longer considered. I am currently reading a new book by Suzanne Somers called TOX-SICK: From Toxic to Not Sick. It is a great book that discusses how our modern environment full of toxins in our air, our foods, and in our water are causing a whole host of modern epidemics. Even our children's DNA is being altered by these toxins while they are forming in the womb. This generation of children is expected to have the diseases of the elderly in their 30's and 40's. Toxins and GMO's are affecting our gut heath, our immune systems and our brains.
I have experienced a change in myself in the past year since I started to make my own fermented vegetables and Ginger Kombucha. Although I had been on the LCHF ketogenic diet for a year or more I still found my fasting blood sugar to be in the 90's (5-5.5 mmol/l) and after meal daily blood sugars always hovering around the 100 (5.5) mark even 4-5 hours after eating a meal. I really had no idea why this was continuing to occur but I wanted better results. I started the fermented foods more for the purpose of general overall health rather than to help correct a blood sugar issue. I never really thought about the potential effects that it would have on blood sugar. I still can't "prove" that a change in my gut bacteria had anything to do with it but if not then it is a coincidence that I can't explain. When I started eating my homemade Kimchi I had a rumbling taking place in my tummy. It was a feeling like little mice were doing somersaults in there. It was a bit weird but I knew that it meant something good was happening. I added the kombucha to my diet a few months later to introduce a different type of bacteria to my gut. I had some new and even more aggressive tummy rumbling going on and had to go very slowly with it. I began to get morning blood sugar readings from 69-79 (3.8-4.4) at that time. I also began to lose some weight again which was an added benefit. See this article from Chris Kresser: A healthy gut is the hidden key to weight loss. My daily between meal blood sugars began to drop. I was seeing blood sugar readings in the 80's four hours after a meal. Mostly 90's but some nice surprises. It seemed to be a new level of normal and I liked it! In 6 months my A1c went from 5.6 to 5.1 which is closer to my goal of being in the 4.8 range.
I am only skimming the surface of this vast topic. There is so much more and I wish I had the time to learn it all. I am very intrigued by it and will continue to study it. I hope to post more on gut health and it's numerous benefits in the future. It may well be the key to both our physical and mental heath!
Every year my husband's insurance does a wellness program. This year they offered some additional tests that I decided to take advantage of. There were some good results and some surprises too.
My HDL is 10 points higher than it was in Jan. of this year. My total cholesterol remains the same as in Jan at 221 even though my LDL is about the same as Jan and my triglycerides are lower at 110 now vs. 120 in January. So the great news is that my LCHF diet continues to affect my lipids in a positive manner.
My A1c (3 month indicator of average blood sugar) went from 5.3 in Jan to 5.1 at the end of April. That indicates an average blood sugar of 97 (5.4 mmol/l) per the ADA's ADAG formula of measuring and 101 (5.6 mmol/l) according to Dr. Bernsteins preferred DCCT formula.
Due to one of the "surprises" in my blood tests I discovered that my A1C runs high which I have always suspected. I will explain more a bit further down on the page.
Another test result was for that of kidney function. For as long as I can remember, going back to at least my pre-diabetic days, my e-GFR (estimate of kidney function) has always been at the lowest level of normal. I never knew why but my score was always right at 59 or 60. e-GFR levels below 59 are indicative of a low kidney filtration rate and early stage renal malfunction. I was never told that I had any kidney issue by my doctor but I was always concerned about my lower test numbers.
My new e-GFR test came in at 88! That's great! It means that I am no longer borderline and my kidneys are working better than they have in years!
Now for the not so happy surprises! I had vitamin and mineral testing done. I have been taking a B vitamin formulation with all of the B vitamins and folate for about 7 months. Even so, the tests showed that I am still borderline deficient in both B-12 and Folate, more so in the B-12. This probably explains my morning fatigue. I have been taking the active forms of the vitamins so I was surprised at this result. My B-12 formula contains 1667% of the active methylcobalamin B-12. I actually was concerned that I was getting too much! I guess I need more than I thought!
My magnesium level is borderline even though I take it daily so I need to up that too. I didn't expect to see that after a few years of supplementation.
The final surprise was that I have more red blood cells than most people and they are larger than normal in size. This wasn't a big surprise to me as I have suspected this for a few years. This could be due to the B-12 levels being low (anemia) or my ancestry as I have some Indian in my DNA. These larger RBC's affect the A1c test because more total hemoglobin is in my body. I have always known that my A1c test was higher than it should be based on my meter averages and my fasting numbers in the 70's (4 mmol/l) I was correct in my suspicions. I am going to try to learn more about this.
The last important test was an RA Factor test for Rheumatoid Arthritis or other autoimmune conditions. It did show a fairly high level of RA or autoimmune issues. I guess that would account for my degenerative disk disease and my "bad" knees although it doesn't seem to slow me down at all. I guess I will need to address this with some additional anti-inflammatory nutrition and supplements and also look into what else I can do for this.
Overall I am pleased. Besides good lipid results and a reduced A1c, I learned more about my body and can address the deficiencies. I never feel depressed by any negative test results. Instead I always feel empowered! You can't fix something if you don't know it's broken!
If it were not for the Wellness exam I would have never had these tests. It was nice that they were done at no cost to me. Now I think that it may be worth the cost in the future to be able to address any deficiencies.
I hope this blog post is helpful to you. Feel free to comment!
