Following on from thread
http://forum.lowcarber.org/showthre...797#post7957797

I would like to focus on one Point in it that thread:

"...................
Ketosis may cause fasting hyperglycemia (high blood sugar) in some people.
..................."

The reference in Hyperlipid's post is

"OK, fasting hyperglycaemia. I have this mildly on a low carbohydrate, high saturated fat diet. My FBG is about 5.5mmol/l, ie 100mg/dl. I've discussed it here. http://high-fat-nutrition.blogspot....resistance.html

But I do know at least one person who can achieve a FBG of 8.0mmol/l on a deeply ketogenic diet. This is 144mg/dl and not a number that I would personally wish to sustain for any period of time. This is not a standard response to marked ketosis, but unless you are checking you blood sugar levels, how would you know that it wasn't your response? A few carbs should reverse this.
"

The latest post brings you here. (I've just posted the first section. Well worth a full read)

"Physiological insulin resistance
Back in mid summer 2007 there was this thread on the Bernstein forum. Mark, posting as iwilsmar, asked about his gradual yet progressively rising fasting blood glucose (FBG) level over a 10 year period of paleolithic LC eating. Always eating less than 30g carbohydrate per day. Initially on LC his blood glucose was 83mg/dl but it has crept up, year by year, until now his FBG is up to 115mg/dl. Post prandial values are normal.

He wanted to know if he was developing diabetes.

I've been thinking about this for some time as my own FBG is usually five point something mmol/l whole blood. Converting my whole blood values to Mark's USA plasma values, this works out at about 100-120mg/dl. Normal to prediabetic in modern parlance. However my HbA1c is only 4.4%, well toward the lower end of normality and healthy. That's always assuming that I don't have some horrible problem resulting in very rapid red blood cell turnover. I don't think so..."

And ..

"However, while muscles are in "refusal mode" for glucose the least input, from food or gluconeogenesis, will rapidly spike blood glucose out of all proportion. This is fine if you stick to LC in your eating. It also means that if you take an oral glucose tolerance test you will fail and be labelled diabetic. In fact, even a single high fat meal can do this, extending insulin resistance in to the next day. Here's a reference for this.
http://www.ncbi.nlm.nih.gov/sites/e...Pubmed_RVDocSum
"


This article has links to related articles in the right hand tab that references:
Impairment of glucose tolerance in normal adults following a lowered carbohydrate intake.
http://www.ncbi.nlm.nih.gov/pubmed/10622209?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_SingleItem Supl.Pubmed_Discovery_RA&linkpos=3&log$=relatedarticles&logdbfrom=pubmed
(I can't get this link to work)

This starts to get very interesting.
The last ref'd article shows insulin resistance in 3 out of twelve and 2 out of 8 test subjects on a low-carb diet for one and three days respectively.

The questions this raises for me are what causes some and not others to experience this.
Also whether elevated blood glucose in a subject showing this effect is as harmful as elevated blood glucose in other situations.
Lastly, whether this varying response may be related to the varying experiences related on these boards to VLC (Very Low Carb) and moderate carb diets like South Beach etc.


There's many other related links I found interesting, but I'll leave it at that for now.

Peter also remarks that a high FBG in a low carber is just a temporary IR state. As soon as you eat something you lose the IR and deal with the incoming glucose/protein and your post-meal BG will be shiny.

http://high-fat-nutrition.blogspot....resistance.html

He states the difference is that a diabetic is permanently IR because they have high insulin levels and low carber is just IR when they're fasting and only because they have such low insulin levels.

So how do you know which sort you are? I suppose get a fasting insulin test next time they check your fasting BG.

Blood glucose is regulated up or down depending on the needs of the body. Consequently, normal isn't fixed nor is it the same for everybody. However, it's a measure, rather naive measure you'd say, of whether a person has diabetes type 2. Now that we know about normal physiological insulin resistance induced by a high fat diet, which is otherwise completely healthful, then the resulting blood glucose measurement should be viewed as normal, whatever that measure is. A GTT is a rather archaic method of determining if a person's glycolysis pathways are disrupted, i.e. we overload the pathways and see if it returns to normal in a pre-determined "normal" time. Let's see if we could do this with the pain pathways of our various organs like, I dunno, hit somebody on the head with a hammer and check how much pain he feels.

The point is that blood glucose varies for several reasons, only some of which are due to disease.

About one to two hours after I eat after fasting my glucose drops to about 60. My FBS is normally 87 - 88.

Amergin, this is truly interesting stuff. I was embarrassed by a FBS of 105 a few months ago and was afraid to repeat it. Now I want to repeat it along with an insulin level and maybe a HBA1c. If I have "physiological" insulin resistance I wonder if there are any implications and like you I wonder why others don't have the same results.