Hmmmm

[Squid]

I'm not sure what to make of this. I had my A1C and lipids tested after several months on 40-50 grams or less of carbs a day. Mostly those carbs are vegetables and just a tad of fruit (berries only). Almost all of the time in ketosis. During this time I lost 40 lbs and exercised nearly every day. The results definitely went in the wrong direction.

My blood sugar which I'd gotten really well controlled went from 5.0 to 5.6. Still normal, but why did it creep up with no carbs in my diet? High end of normal now.

My cholesterol that was great before went higher. My LDL went from 70 to 120 and my HDL went from 90 to 70. Wrong direction there. The exercise I've been doing should have raised the HDL not lowered it.

At least my triglycerides which were about 100 dropped to 50.

This is all making me wonder if I should be so strict about my carb intake. I wonder if it is making my blood work worse.

[Lottadata]

Squid,

Are you testing your blood sugar after meals? If so, what kinds of numbers are you seeing? How do they compare to your numbers on your earlier diet?

That's a very unusual result in all directions, and makes me wonder if perhaps you are eating more carbs than you thought.

One thing, though, it is common to see cholesterol go up when you are actively losing weight and that shouldn't be a concern. You are losing a lot of weight right now. It takes about 6 months for cholesterol to drop when you start actively losing weight. My doctor warned me about this years ago, and it turned out to be right.

[triplemom]

One thing, though, it is common to see cholesterol go up when you are actively losing weight and that shouldn't be a concern. You are losing a lot of weight right now. It takes about 6 months for cholesterol to drop when you start actively losing weight. My doctor warned me about this years ago, and it turned out to be right.

Thanks for that info, Jenny. I'm worried about my upcoming labs. My cholesterol has always in "normal" for a non-diabetic, and my doctor tried to push statins on me the last time because my cholesterol is too high for a diabetic, according to the "new guidelines." I asked for a little more time - of course, he's absolutely croak if he knew how much fat I was taking in!

Great website, Jenny!

[Squid]

Squid,

Are you testing your blood sugar after meals? If so, what kinds of numbers are you seeing? How do they compare to your numbers on your earlier diet?

That's a very unusual result in all directions, and makes me wonder if perhaps you are eating more carbs than you thought.

One thing, though, it is common to see cholesterol go up when you are actively losing weight and that shouldn't be a concern. You are losing a lot of weight right now. It takes about 6 months for cholesterol to drop when you start actively losing weight. My doctor warned me about this years ago, and it turned out to be right.

Before, if I ate low carb my blood sugars rarely went above 120 and would quickly drop to 80 after a meal. Of course, if I ate carbs, they'd be in the 200-300 range. Now with low carb I'm seeing 120-130 at most, but I only drop to about 100 and don't seem to go lower like I used to. I wish I knew why they were staying higher now.

That's interesting about the cholesterol going up with weight loss. Maybe that is what is going on. The whole thing just puzzles me.

I think what I should do is get back to a strict 6+12+12 and give it four more months.

Thanks for the info Lottadata. Cute nickname.

[Korban]

I had heard about triglycerides going up when you lost weight from Bernstein... my Dr. is gonna be real happy with higher triglycerides and cholesterol... /sigh

/smile

[RobLL]

When I started tracking BGs (against Dr. advice) I switched from low to very low carbs (say 120 to 40 grams a day). And my BGs deteriorated over the next 7 months. Dietetic educators were just sure that some mysterious good quality of carbs would have prevented this. My Read: I was watching my pancreas deteriorate. I do not believe that there is some magic quality in carbs that despite the 160 readings after a slice of bread and jam, and which stay up for hours, are somehow benefitting my pancreas.

[Lottadata]

Baffling indeed.

Is it possible you have autoimmune diabetes? Have you been tested for GAD and islet antibodies? Autoimmune diabetes progresses without regard to diet. More importantly, it appears that injecting insulin may shut down the autoimmune attack on the beta cell and is highly advisable as it can preserve the beta cells you have left.

[Squid]

Baffling indeed.

Is it possible you have autoimmune diabetes? Have you been tested for GAD and islet antibodies? Autoimmune diabetes progresses without regard to diet. More importantly, it appears that injecting insulin may shut down the autoimmune attack on the beta cell and is highly advisable as it can preserve the beta cells you have left.

No one has ever brought that up. It was always assumed this was a result of PCOS which I also have. I'm also recently in menopause so that might have something to do with it.

I was also thinking that maybe since I used to swing high and low a lot, I was low a lot more than I realized giving me a lower A1C because it pulled down the average blood sugar. And maybe now I'm just stable more of the time.

At any rate, my doctor wasn't concerned because it's still "normal" but it's not the levels that Bernstein likes and not what I used to have.

I think I will give it another 4 months eating very low carb and if things are worse, I'll start to dig deeper and look into your suggestion.

[RobLL]

Squid - NONE of the doctors I have gone to, including the University of Washington Diabetic Clinic have offered or suggested any tests that may have helped understand MY diabetes. And this is despite two sessions of retinopathy. I understand that about $3000 in addition to Dr. Bernstein's fees are for a variety of tests. When the average diabetic costs the US health system $35,000 a year (I am not sure I believe that number, but it was the last one I saw - Jenny - you probably know or can put that number in context) to spend $10,000 to nail down just what a patient is facing doesn't look so bad. Dr. Bernstein's goal is that patients seldom or never have serious lows; eyes, kidney's, toes, and feet stay intact; neuropathy pain disappear; cardiac health greatly improve. And so far as I know he is pretty successful at all of that. And for those of us who don't have the $7000 plus $3000 for tests, he put it ALL in his book.

I do NOT think that eating low carb caused my pancreas to deteriorate, it was already deteriorating. I seem to have enough natural glucose function that on many day my 23 units of Lantus at bedtime keep me between 80 and 100. Other days I need an additional four units of Regular. And if I am going to do intense exercise I always need 4 units of R, taken 3 hours before the middle of my workout. If I am going to do intense exercises for hours (mountain climbing) I skip insulin and eat 20-30 grams of carbs an hour. I am not sure what all of this means regarding the state of my glucose metabolism. Wish they woud do the tests. But at this point I feel lucky just to get the Rx for Lantus. Bummer

[Lottadata]

Squid,

I was surprised to learn that something like 1 in 12 people diagnosed with Type 2 have autoimmune antibodies. There turn out to be slow-developing forms of autoimmune diabetes that take 4-5 years to destroy the beta cells, unlike the swift attack usually diagnosed as Type 1 which can complete within weeks.

The likelihood of autoimmune involvement rises if you have other autoimmune diseases, for example Rheumatoid Arthritis, thyroid disease, lupus, etc.

I hear from quite a lot of people who have this. Usually they find out because they are thin so the doctor suspects something odd is going on. But heavy people also get autoimmune attacks. The problem is that when a doctor sees a heavy person with diabetes they don't investigate further.

And even if the person ends up with zero beta cells later on, they will still tell them they are Type 2 and that they exhausted their beta cells thanks to IR and obesity, when that may not be true.

[Squid]

Thanks for the info Lottadata. I'll keep an eye on that. I'm hoping this was just a fluke and the numbers will go back too the low level they were at.

Hey I see you've almost hit your goal too. Good job!

[Lottadata]

Squid,

I'd hit my goal in 2003 and stayed there until this past December when I developed antibodies to R insulin and started having to use analogs, and then I had to stop taking metformin because it was irritating my stomach lining and it got worse and worse no matter what I tried. It's been a struggle since then.

I just saw my endo today and have list of different meds to try, and hopefully I can get things going in the right direction again.