Is this normal?

[Nancy LC]

I'm playing with my glucose meter again. I've pretty much weaned myself off of caffeine and I'm doing VIF (very intermittent fasting, just skipping breakfast every other day or so). Both these things seem to lower my blood glucose.

Anyway, my fasting glucose seems to be around 60-70 most of the time (down from 90 awhile back). But today I decided to test 1 hour after eating to see what it rises to. 70. Yes, that's right one hour after eating it was 70. I had corned beef with cooked turnips and onions. Earlier today I did it and it was about the same range after eating.

It just seems a bit odd it is so low at what should be my peak. I can't decide if this is a good thing or not. I feel very tired today so perhaps there is a link between this and my fatigue.

Any ideas?

[LarryAJ]

Nancy,

It sounds like you are doing GREAT! While we have become so used to the blood glucose rising after a meal, we expect it just like the sun rising in the morning. BUT that is because we have always lived in a high carbohydrate consumption condition. We have relatively little experince with a low one.

So if I may make a guess at what is going on.

Dr. Eades in this blog (http://www.proteinpower.com/drmike/ketones-and-ketosis/metabolism-and-ketosis/)says, The protein you eat is converted to glucose instead of the protein in your muscles. If you keep the carbs low enough so that the liver still has to make some sugar, then you will be in fat-burning mode while maintaining your muscle mass, the best of all worlds. How low is low enough? Well, when the ketosis process is humming along nicely and the brain and other tissues have converted to ketones for fuel, the requirement for glucose drops to about 120-130 gm per day. If you keep your carbs below that at, say, 60 grams per day, you’re liver will have to produce at least 60-70 grams of glucose to make up the deficit, so you will generate ketones that entire time. So, I think that what you are eating has so little carbohydrate in it that the glucose coming in from your gut still is not enough to supply ALL the needed blood glucose. Your liver (and other regulation systems) tries to keep the blood glucose in a very narrow range. Seeing the incoming glucose, because all the blood from the intestinal tract goes FIRST through the liver, to filter out toxins, it slows down the glucogensis from proteins. But since you have not eaten enough carbohydrate the liver still has a glucose deficit to make up. And since the blood glucose level is so well regulated, the liver only makes up just enough to keep the level from dropping. And it is not going up because the conversion of complex carbohydrate and the adsorption of rate in the intestinal tract is not adding glucose fast enough to elevate the glucose level above the regulated limit.

As for your being tired, note that ketones are the fuel that you are going to have to use - the glucose amount is just not enough. If there was not enough FAT in your meal, then you will be energy deficient. Something like 60% of calories need to be fat and I know of some that eat higher amounts than that. Of course, some of that can (should??) come from you body stores.

If you want to "experiment" some more, you might see what your BG is at every 15 minutes after eating to see if there is an early peak that is gone by an hour.

[Nancy LC]

I think I'll do that. I'm concerned that my fatigue is due to my blood sugar being slightly low all the time.

I eat mostly paleo so I don't have tons of fat in my diet, dairy products really don't agree with me. But I try to add some fat to whatever I eat.

[Nancy LC]

I remember reading someone in the diabetes forum getting elevated glucose readings after exercising so I did a bit of exercising this morning and I think that brought my blood sugar up a bit.

After 30 minutes after lunch (which seemed to be my peak) I had a BS reading of 116. That was for a lunch of cabbage, tomatoes, ground beef, onions and garlic.

I also feel a bit peppier today so perhaps my BS readings are the cause of my lethargy.

[LarryAJ]

I remember reading someone in the diabetes forum getting elevated glucose readings after exercising so I did a bit of exercising this morning and I think that brought my blood sugar up a bit. That may be true, but that is not what I am familiar with - wife is T1 diabetic. Seems counter to what happened with my wife when she would exercise. She had to be careful of too low BG. After 30 minutes after lunch (which seemed to be my peak) I had a BS reading of 116. That was for a lunch of cabbage, tomatoes, ground beef, onions and garlic. Since 116 is over the upper limit for the desired range, that will stimulate insulin release. Just the thing you want to avoid. Strange too, since your lunch would not be considered high in carbs. I also feel a bit peppier today so perhaps my BS readings are the cause of my lethargy. Have you tried coconut oil? OR even drinking cream if you do not have issues with cassen. It is hard to get a lot of fat in when most of what we can buy is de-fatted meat, etc. You need something to “sopp up” the CO in order to get much in. I use chopped up sardines, but salmon would work also. Or maybe even hamburger cooked loose, like sloppy joes, would give more surface area for the CO to cling to. Got to admit though, that it can be a little sloppy, what with the oil dripping of the fork as you stuff it in your mouth.

[Daryl]

I remember reading someone in the diabetes forum getting elevated glucose readings after exercising so I did a bit of exercising this morning and I think that brought my blood sugar up a bit.

After 30 minutes after lunch (which seemed to be my peak) I had a BS reading of 116. That was for a lunch of cabbage, tomatoes, ground beef, onions and garlic.

I also feel a bit peppier today so perhaps my BS readings are the cause of my lethargy.
Doc Bernstein has said that for some people, exercising in the morning will cause a BG rise, initially, but later, it'll have a positive effect on the BG. As Larry said, for many, exercise can knock our BG down considerably.

[black57]

Nancy, your experience makes sense to me. If it is what I theorize then your BG after exercise is very good. I have been reading about about human growth hormone and how to regulate it. Even if you are past 21 years old, we all have growth hormone that becomes stagnant at that age. To regulate it after 21 you have to have stable insulin levels and have a low carb lifestyle. By exercising on an empty stomach you will activate the growth hormone. In turn, the growth hormone, not glucose, will cause your insulin to rise. It is important not to eat for an hour after exercise or it will cause the growth hormone to become inactive. I will go to wikopedia for more information.

Here it is:

http://en.wikipedia.org/wiki/Growth_hormone#Regulation

The Drs. Eades discuss this in Protein Power.

[gonwtwindo]

Nancy,

I am Type II Diabetic, controlling my BG with diet and exercise alone. I can assure you that BG that is too low will produce fatigue. The actual number value is individual; for me, anything under 90, I feel a little weak. Certainly 60-70 would have me feeling ill.

I suggest you add vegetable/nuts to you diet until you feel well. Check your BG several times daily as you have been, until you learn what foods, in what quantities, keep your BG in a range that keeps you feeling well. There is no "one size fits all" for that range...for me it is 90-110 or so; for you it may be less...but I doubt 60-70 is ideal.

[Nancy LC]

I have to say from everything I've read 90 is not low blood sugar. It might be lower than what you're used to but it definitely isn't low. Fasting blood glucose is ideally 80 at the top end. And I don't think they even bother calling anything low until it falls below 60.

[gonwtwindo]

No, 80 is the low end for fasting. 120 is high.

[gonwtwindo]

No, 80 is the low end for fasting. 120 is high.

I said 'low' is individual, depending on how you feel. If you feel fatigued, your blood sugar may be too low for you. All I'm saying is try to up it a little and see if your fatigue is relieved. Don't be stuck on what numbers "should" be.

[Nancy LC]

No, I'll state again that 80 is a very desirable FBG level and should be one's target if you're above that. Higher FBG levels are associated with increased risk of death. 140 is where damage starts happening to the body so 120 FBG would give you very little room for any raise before you start incurring damage.

Maybe the medical establishment is telling you those numbers are fine but according to what I've read, those are way too high and would indicate pre-diabetes to me. Unfortunately as Jenny points out in these articles, the current diabetes treatments are not sufficient to prevent progressing of the disease.

But, the most interesting aspect of this study is what the researchers found in the normal group first at 10 years then at 33 years down the road. Everyone knows that a markedly elevated blood sugar level or a diabetic glucose tolerance test bodes poorly for long term mortality, but what about the lower end of the curve? Is there a difference there? Is there a difference in long term mortality between a blood glucose level of, say, 95 mg/dl and one of 85 mg/dl, both of which are considered normal.

At the 10 year followup of the 18, 403 men the researchers found that heart disease mortality started to increase at blood sugar levels above 95 mg/dl, but that those subjects with blood sugar levels below 95 mg/dl showed no increased risk for death from heart disease.

After 33 years, however, the picture changes. The cutoff level drops to 83 mg/dl. In other words, in terms of cardiovascular mortality, the risk starts to rise as 2-hr post load blood sugars reach 83 mg/dl and that there is a linear increase in risk between 83 mg/dl and 95 mg/dl. I’m sure that after 40 years, the minimum level will drop a few points further.
http://www.proteinpower.com/drmike/uncategorized/the-sugar-hypothesis/

http://www.phlaunt.com/diabetes/14045621.php

And this:
Truly Normal Blood Sugars

Fasting Blood Sugar
A normal fasting blood sugar (also the blood sugar you'd see before a meal) is roughly 83 mg/dl (4.6 mmol/L) or less. Many normal people have fasting blood sugars in the mid and high 70 mg/dl (3.9 mmol/L) range.
Post-Meal Blood Sugar (Postprandial)
A truly normal person eating the high carb typical American diet does not go over 120 mg/dl (6.6 mmol/L) one or two hours after a meal and many are under 100 mg/dl (5.5 mmol/L) two hours after eating.

http://www.phlaunt.com/diabetes/16422495.php

Especially read that last link. It explains at how the current definition of "normal" was decided upon.

You also might want to read this which might explain why you feel "off" when your blood sugar is not really low.
False hypoglycemia (http://www.phlaunt.com/diabetes/14045621.php)
Why Do I Feel Shaky and “hypo” When I Achieve Normal Blood Sugars?

If you have had high blood sugars for a while—even only moderately high blood sugars—you may find that you feel shaky and even downright sick when you bring your blood sugars down into the normal range.

This is because over time, your body has become accustomed to those much higher blood sugars and it interprets the normal blood sugar as being dangerously low. When this happens, the body secretes those “fight or flight” counter-regulatory hormones to push the blood sugars back up to what it erroneously thinks is the safe zone. The stress hormones associated with the counter-regulatory response can make you feel like you are having some kind of dreadful attack. They may include a pounding pulse, shakiness, a raised blood pressure, and symptoms similar to a panic attack.

After a counterregulatory response you may feel shaky for another hour or two, because of the changes the stress hormones have made in your body, and you may be a bit more insulin resistant than usual. But after some period of time which varies from person to person, your body will get used to these new, normal blood sugars.

So no matter what you feel when you first reach normal levels, try to wait it out. Your body is getting all the glucose it needs when your blood sugar is above 75 mg/dl (4.2 mmol/L). Doctors do not consider true hypoglycemia (low blood sugar) to begin until under 70 mg/dl (3.9 mmol/L). It does not become dangerous until it reaches levels like 45 mg/dl (2.5 mmol/L).

You can make the adaptation process a bit easier by proceeding in stages, setting your blood sugar targets progressively lower, a step at a time, especially if your post meal blood sugar has been extremely high for a while. But don’t stay at higher than normal levels for any longer than is absolutely necessary. Once your body does adapt, you will probably feel much better and much more energetic than before.

So be patient while your body becomes accustomed to new, healthy, blood sugar levels.

Don’t respond to feeling as if you were having a hypo by eating carbs to push up your blood sugar as long as your blood sugar tests at 80 mg/dl (4.4 mmol/L) or above. This is a normal blood sugar. In fact, many normal people will have a fasting blood sugar as low as 70 mg/dl (3.9 mmol/L).

Give your body a chance to adapt and eventually you will feel completely normal when you have a normal blood sugar and may feel surprisingly toxic when your blood sugar reaches the dangerously high levels that you used to feel normal at.


Lower is Better

The 140 mg/dl (7.7 mmol/L) blood sugar target is a good start, but many of us find we get much lower blood sugars and much more normal health if we shoot for truly normal blood sugars. That means keeping blood sugars under 120 mg/dl (6.6 mmol/L) at all times and getting back into the 80s (4.5 mmol/L and up) by three hours after every meal. If you can do it, go for it. Now that we know that heart attack risk rises significantly at A1cs in the mid 5% range, getting to true normal is that much more important.

[Nancy LC]

I think some of my low readings might be due to how I was taking my blood. I wasn't really drawing enough and had to go back and get a second stick in. Now that I've improved my technique my readings seem a lot better. Generally 80 or above.