Can anyone help? Sorry, long post!
Have a pretty good diet but carrying a stone and a half in extra weight I can't shift and only getting heavier...brisk 1 hour walk daily, power yoga 3 x per week, bit limited in aerobic choices due to severe arthritis one hip, replacement the other side and lots of pain.
Eaten "paleo" - grain free, lowish carb, lots of veg and probably a bit too much fruit for 10 years and still gained this weight in last 2-3 years. Fasting 2 days a week for 4-5 months not impacting on the weight at all so decided to try going ultra low carb... got a glucose/ketone monitor to monitor ketones really. As went into new eating regime of around 20g carbs, 60g protein, rest from fat.
Fasting glucose has been consistently high every morning from 6-6.5, and even after a full 24 hour fast 6.8.....rarely coming below this throughout the day, so not "dawn phenomena", lowest reading ever 5.3 about 4 hours post-eating, a one off. Of course, I don't know if this is new or been going on for years...no significant ketone levels at all, so not in ketosis despite not eating carbs. If anything there is an upward trend in Fasting glucose over the 10 days of ultra low carb.
What is confusing me is the highest reading I have had is 7.1, taking it around 45, 80 and 100 minutes post-prandial. I quickly return to my "normal" I am maintaining BG in a narrow range well, it is just all high. Surely if pre-diabetic or T2DM it would soar up more? Or is this a result of low carb eating?
Also, I am very hungry and struggled to fast even though I normally do that easily. Still tired, perhaps more than before.
Read about physiological insulin resistance raising fasting glucose, but think that should go away with eating not stay all day? Had a total panic I was approaching diabetes, but blood lipid profile excellent, bp normal, other than extreme tiredness, no symptoms. Can anyone explain this???

I'm not diabetic, so not an expert. But I do know that BG monitors sold for home use are notoriously inaccurate.

Have you checked the range of accuracy for yours? What is your "normal" fast? As in, how long between the last time you eat at night, and the first time you eat in the morning?

Next question: are you eating enough fat? You are not that much overweight, so I assume you are not carrying that much extra fat. If your nutritional fat isn't high enough to lower insulin levels, your fat will stay in the fat cells, and your liver will use protein to make glycogen (gluconeogenesis).

Final question: (actually, two questions) are you taking any meds? And now much sleep are you getting at night? Many meds mess with the biochemistry in the body. And, of course, too little sleep, even a little too little, over time, can lead to extreme tiredness.

Thanks for the reply. I am eating as much fat as I can tolerate, coming out about 60-65%. I am carrying at least 20lb extra so plenty to burn!
The metre I got was recommended as a good one, but it is "to ISO standard" which seems to be 10%+-. If it is consistent then that could mean all is well, or much worse! If it is not consistent I could be wasting my time.
To check it - do I get a lab test done and sample at the same time? Or is there some other way to calibrate - it is an Abbott Freestyle neo.
I eat a meal about 8.30pm due to work, but then eat again about 11am next day after exercise (1 hour dog walk daily, plus yoga 3 x week). Usually don't eat snacks, but occ have a can of fish in oil or similar....since keto I am starving by 2pm! Having a bigger (more calories, more fat) breakfast than before so I don't really understand this. Also pretty intolerant!
Sleep can be disturbed by hip pain. Maybe less than once a week I take codeine to get a good night to catch up if its been bad.Otherwise, no.

It sounds to me like your blood glucose is acting pretty normal--just somewhat higher than usual. That plus/minus ten percent means that a glucose monitor is a pretty rough tool to measure diabetes. My experience with glucose strips has been that when a box of strips reads higher, the whole box reads higher--the strips aren't less accurate compared to other strips in the same box, only compared to other boxes.

Also, are you sure about that plus or minus ten percent? All I can find is plus or minus twenty percent, although the guidelines for clinical application do seem to be plus or minus ten.

http://scothealthcare.com/new-iso-d...glucose-meters/

And of course an Hba1c at your doctor's office, or a glucose tolerance test would be the way to go if you're really concerned.

Were you diagnosed as pre-diabetic previously by your doctor, or do you write that because of this new meter you have not tested yet against a lab value? nor even taken your glucose ever before to compare? Do test it against a lab, or maybe for now with someone you know who has home glocose meter they trust? Also be sure you follow all proper steps to take blood, wash/dry hands everytime, etc.

Assuming that is OK, you have only been low carb 10 days. If your BG was high before, it may take a while to come down. A blood ketone meter only measures beta-hydroxybutyrate and it takes some time to see a rise in that. The urine strips measure acetoacetate and you may have those ketones for now, but not yet Keto-adapted to see the BHB.
If you are hungry eat...I don't think you should limit your protein to start.

EDIT: I recently heard Dom D'Agostino recommend this meter for ketone testing, however, customer reviews on Amazon are not positive for its accuracy.

How long have you been at 20g of carb/day? It can take a while to reduce your insulin resistance. People who have really high blood glucose can see a rapid decline in their numbers, but in my experience, the change is slower as your numbers get lower. I am diabetic and went from readings of 238 (13.2) down to 150 (8.2)fairly rapidly. It took quite a while longer to get down to 100 (5.6) and below. Even now 20 months later, my fasting BG can be just over 100 or in the 90's (5.3), while dropping into 80's (4.7) by lunchtime.

Others have had more success in being consistently in the 80's -90's by fasting. Ken's journal is a great success story in losing weight and achieving normal blood glucose readings:

http://forum.lowcarber.org/showthre...616#post9163616

Rather than doing 23 hour fasts, you could try to expand your current fasting window by pushing lunch back another hour or so. I too have a hard time fasting now that I am at goal. I get very hungry and cold, so I try to do an approximately 16:8 eating schedule. I eat lunch at 12:30pm and dinner about 7:30pm. Breakfast is coffee with heavy whipping cream and about 100c of fish oil (you could do coconut oil in your coffee). I do get hungry by 11am, but I make myself wait until 12:30 to eat.

What are your 20g of carbs consisting of? I would try to stick to lower carb veggies, no fruit. So spinach, lettuces, cauliflower, broccoli, cabbage, zucchini, celery etc. Avoid carrots, fruits, tomatoes, etc even if they are in the carb range. Also check your calorie totals for the day. If you are too low, you definitely need to eat more fat as suggested above.

And you could try taking apple cider vinegar, either make it as a salad dressing, drink it in a glass of water or take capsules.

As for fatigue, you might need to up your salt. I have a distinct lack of energy when I don't get enough salt. A cup of salty broth can take care of this or just add extra salt to your food if you like the taste.

Whatever the truth right now, this way of eating (WOE) will likely help as it has for many who post here.

I had fasting readings of about 110 the past two years and now they are in the 80s. The change was pretty quick for me, but you are starting at a higher level if your monitor and strips are accurate.

As teaser says, you could go see your doctor, but he or she will probably push medications. I personally had lab results from annual health testing affecting medical benefits at work. I purposely stayed away from my doctor's office, hoping to get it under control without nasty drugs. Thanks to this WOE I have!

Also, you might find more helpful information in the diabetes section of this forum.

http://forum.lowcarber.org/forumdisplay.php?f=45

I read somewhere for sure on 10%+- - it may've been a piece of research for the specific monitor...been on line so much I can't recall where!
I'd rather keep the doctor out of it if I can, although if the trend continues I will have to get them involved. I can't remember ever having a fasting glucose test done medically, so never been diagnosed prediabetic, just panicking over my numbers on this test kit. I am on a 2nd box of strips, as it came with just 10 included. There has been an upward trend, will try and work out if that came on the new box, but all are high.
I think salt is ok, as I have been drinking electrolytes, my carbs are coming from veggies, not fruit. The fatigue predates the change in eating from pretty low carb for years (not had bread, potatoes etc for about 10 years), to really low 10 days ago.
I think as an active person with a bit of stubborn weight gain I was just shocked!
I still can't see why the level never drops down to normal, that is what seems unusual for anyone, but more so considering I don't go on massive highs - in fact I have a normal range post-feed, just not in between -wondered if that could be the result of this way of eating?

Not the result of this way of eating, especially in 10 days! Until you have a lab value, and know this meter actually works, just focus on eating well.

Unlikely to be a result of how you're eating. A ketogenic diet mimics a fast, this can cause physiological insulin resistance--but that just means that your response to an oral glucose tolerance test should temporarily be worse than usual. Glucose tolerance isn't normally an issue unless you're actually eating significant amounts of carbohydrate.

I have never been diagnosed as diabetic but I expect I could have been about 10 years ago if I had gone to a doctor. Instead I started eating lchf and got my bg's down to normal, that is under 100 (5.6) almost all the time. I quit testing for a number of years figuring I had it under control. Fairly recently I started testing again and found that my bg's were running usually between 100-120 (5.6 - 6.7). At this time I was also testing my blood ketone levels and I was always in ketosis. When I ran out of strips I decided to just stop testing. I don't know why my bg readings are higher than they used to be but since I figure I am eating in a healthy way and I have achieved all other goals including a weight loss of over 100 pounds that I maintain without problem, I have decided to not worry about it or at least to only worry occasionally. I did do a home HbA1C test and that came out at 5.0. Sometimes our bodies do not follow the rules.

Jean

Regarding the exercise, is this a new regimen or have you been following it for a while? If it's new, it could be causing your body to hold onto some extra water, which should be temporary.

Most people note that their BG goes DOWN when they exercise, but a percentage of us experience a RISE in BG instead. I thought I was crazy for a long time but I read an article recently about why it happens. If I can find it again I'll post it. My BG goes up during and for a few hours after exercise; however, I find my BG reads a bit lower overall. It could be when you're testing that's throwing your numbers.

The exercise has decreased in intensity a lot since hip replacement 3 years ago as I was a runner before. Not any recent changes. My BG seems to go up, if I do a really demanding power yoga especially with a lot of resistance it is higher than before. The article would be great

An increase in blood glucose with high intensity exercise is normal, it's just your body's response to the stress hormones released. I've found that on many days, the highest blood glucose I'll measure isn't after eating (as long as all of my food is low carb), it's after I do some heavy exercise, like deadlifts. I do find that if I'm eating a more strictly ketogenic diet, this increase will be lessened (carbs very low, but protein intake also controlled), but the increase itself doesn't really worry me. This is something that can get out of hand in an actual diabetic, but a moderate increase in blood glucose during exercise is normal. This sort of acute stress may be a blood glucose control challenge in the very short term, but is likely to improve control in the long term.

http://eatingacademy.com/nutrition/...-ketosis-part-i

Peter Attia gives examples of what can happen to blood glucose post exercise in a non-diabetic (himself). It goes up from 77 mg/dl to 132 mg/dl after a high intensity strength training session-- that's about 4.3 mmol to 7.3 mmol.