Lisa, I am not trying to prove anything, there is a prove that even on a low carb diet IR and diabetics can't attain the same weight loss as otherwise healthy LCers. But this does not meant that we are doomed, just still have higher than normal levels of insulin, which does not work as efficient for us. Also, until you get your fasting insulin checked and dare to post your number, you can't convince me. Normal should be <5, everything over 10 - IR, and diabetec.

How IR is improved? Does you body "grew" new receptors sites once insulin level was reduced somewhat? Can you double your carb intake (still very low - 60g a day) without compromizing your BGs? Can you eat more than 12 g of carbs per meal and not see Bgs spike? Can you eat any fruit or grain and stay under 120 in 2 hours? Whas has improved, you simply by-passed one mechanism, that is PERMANENTLY BROKEN and using a back-up system. it does not mean that you fixed the broken one.
This is JMO, once you have IR, it never can be cured, you can by-pass it, and use fat as primary fuel, but this is it.


Come one, don't male me dig posts from your journal, , you even tried fat fast, so let's be honest. I am in the same shoes, as many many members of this forum, despite staying on very low level of carbs, and still can't lose weight.

I never doubted it, this diet works better for Bgs control than standard ADA diet, but weight loss is different story. I also ibelieve that weight loss was also on your list, since in many cases weight loss alone improves blood sugar control.

Well, I am sorry, again, not exactly true, but it is OK. For me BGs control is also very important. But I can hardly believe that weight loss is just a matter of "motivation" for you, consider that you previously stated being around 1300-1400 calories and 30 g carbs a day, you should be losing weigh with no problem if indeed your IR has improved after so many years of LC diet.

Apparently it does, in just 2 weeks...



http://docnews.diabetesjournals.org...ent/full/2/6/15

They used to think that but it has been long proven that you grow more new fat cells.

Allparticipants were encouraged to maintain their usual level of physical activity. Although the study had a small number of participants and lasted only a fewweeks, it was strictly controlled and provides evidence concerning the valueof low-carb diets that may merit further exploration in larger controlled studies. [/quote]
I wonder how they determine 75% improvement in insulin sensitivity? The only one way to measure insulin sensitivity, is to conduct GTT with INSULIN, when both fasting glucose and insulin are measured before injesting 75 g of standard glucose solution, and then again both Bgs and insulin checked every 30 minutes, for at least, 3 hours, and yet, better 5 hours.
Do you really think any T2 that will pass GTT with insulin after 2 weeks on Induction? FWIW, after being on 20g carbs for prolonged period of time, any significant glucose load, will spike Bgs even higher than before.
I recall a T2 from Dr.Bernstein Diabetes forum tried GTT, and still, the results were in diabetic range, despite years of LC, major weight loss, and good H1C.
it is no doubt that Bgs drop, appetite is suppressed, and there is initial weight loss. But it does not mean that body became insulin sensitive.
JMO

I wonder what would happen if a T2 returned to normal weight level via very low calorie LC dieting and exercise. Would there be any further improvements to IS due to the weight loss? Just low carbing certainly didn't cut it for me for the weight loss, and I am not even T2...just have an ageing metabolism.

Not to hijack the thread, but since you brought it up, I should point out that was 5 years ago when I was a lot heavier, but thanks for paying a visit (or several) to my journal.



You measure how much circulating insulin a person has and you don't need a GTT to do that; circulating serum insulin levels can be drawn at any time. The researchers checked the patient's circulating insulin levels at end of the high carb portion (day 7) and then again after 14 days on low carb and noted the drop. They also correlated those with serum glucose concentrations.



That speaks more to their beta cell status than their IR status; by 'abnormal range' I take it that their blood glucose still went high and took a while to come back down. FWIW, I had a 3 hour GTT when I was pregnant both times when I had been diagnosed T2 for a few years already (have no idea why doc ordered it, but they did) and was in normal range both times. Strange because being pregnant is supposed to make a person more IR.



Dina, if you won't believe the results in a documented study, I can't honestly believe you'll suddenly change your mind based on my lab results alone and, as I said before, my doc doesn't do fasting insulin levels just because I ask him to (that whole insurance/HMO thing).

Lisa,
I only read your journal because I was new to Dr.B's diet and diabetes (this is when I found this forum), I recall sending your PM asking for tips on how to get my FBG under control (but did not get any response). Since you were raving about your perfect results, it sounded logical to see what is your diet, exercise, etc. regimen was, so I read through your journal- after all you made it public. I just happen to have a good memory, long term at least, LOL. I am not a "stalker", and was not not trying to "dig out" some information. But I recall that it was when your weight was lower, and probably lower than now, somewhere around 190, is when you tried fat fast, and you indeed were very frustrated about scale not moving. I may be wrong, but I just really think we should be consistent and honest, I am at least.

The article did not specify how they measured it, and what you sugested is MEANINGLESS. It is not mesuring of insulin sensitivity, but just random glucose/insulin test, which tells nothing. My understanding of 75% improvement in insulin sensitivity as follows:
1) one is able to pass GTT (i.e. body can handle 75g of glucose without significant Bgs spike)
2) glucose/insulin ratio after glucose is injested, is >7, and 3-5 post insulin measured <5.
I want to see their method and results, and especially when they were given more than 20g of carbs per day. it was only 2 week study, and the data has just demonstrated that ketogenic diet will help to keep Bgs at lower raange, especially at the beginning of the study.
I have read a lot about insulin resistance, and all the sources point to only one meaningfull test to measure degree of IR and insulin sensitivity.


Then you were not diabetic back then, no T2 can pass GTT unless they take meds. But again, you are not typical diabetic, you have no DP, no beta cells loss, but I am puzzled again, since I recall your highest H1C was 11%? This alone for me indicates a good deal of b-cells loss or a very poor dietary choices full of very high GI food and beverages (aka like regular soda).


Lisa, I won't, you are right, but then again, the study was 2 weeks long, and they did not describe method of how IS was measured.
Forget about your fasting insulin, try to eat an apple, a cup of oatmeal, or an orange, and any meal that has 75 g of slow acting carbs (not even liquid glucose) and then check your Bgs in 30-minutes, 1 h, and 2 hours. Then you will see if your body became insulin sensitive again.
I prefer real ppl experience over 2 weeks study without any details given, and just ball park numbers.

Before I respond to this, I have to ask, Dina, why you are making this so personal? This is about the data, not me.
Now, I also have to ask if you are psychic to know my current weight since it is not posted in my stats?
I stated that I am content with where I am for the moment, having met my initial goal which was to control my blood sugars. A lot changes in the course of 5 years, not the least of which is priorities.



Then you are working with a different definition of IR than the rest of the medical world, including the researchers who published the study. As you can see below, the GTT doesn't have a lot to do with IR diagnosis. It also makes sense, if you stop to think about it, that if your circulating insulin levels drop along with your blood sugars, it is taking less insulin to get the glucose from your bloodstream into your cell than it did before therefore, the 'resistance' to the insulin is less because it can be demonstrated that the body is requiring less insulin to lower blood glucose readings than it did before.


http://www.wdxcyber.com/ngen10.htm



I can assure you that I was diabetic prior to those tests with a couple of fasting readings over 200. My highest A1C was actually 11.8 and I was following the standard ADA diet at the time; 1500 calories and I agree that was a poor dietary choice. Dina, I never said I no longer have DP; even normal people have DP to the extent that their fasting blood sugars tend to the highest readings of the day but when your fasting readings are usually 90 and lower, it ceases to be an issue, nor is it DP as most diabetics think of it. I think you are confusing or equating beta cell loss with IR; they are not one in the same, nor does one correlate exactly with the other. In fact, IR precedes beta cell loss by quite a long time. I have no doubt that I have lost beta cells; most diabetics have lost at least 40% of their beta cells by the time they are diagnosed. But that does not preclude or exclude an improvement in IR nor does an improvment in IR give me license to further tax my remaining beta cells by eating foolishly.

I am not taking it personally, it seem that you got upset that I visit your journal, then why make it public. If you recall how the aergument started, then you would remember that I pointed out that even on very low carb diet weight loss is hard for T2 and IR, even if only protein and fat is eaten.

Just a simple logic: ppl normally like to and indeed show their progress, I bet you are not any different, as much as you are gang-ho with your plan, you won't miss an opportunity to show your success with scale. So if your weight loss continued, you would update your profile, rather than make this number blank. Correct me if i am wrong. I know how hard is to lose weight being t2 and female 40+, so don't take it personally. I am not saying that you gained it all back, but my guess is - your no longer losing weight. Last time I remember you were very happy to get be under 190, 187 or so. Still, I understand from where you started, it is still a great success. But from a very low carb diet point of view, not so much, and again, this proves that your body still has higher than normal insulin, even oafter long term of 30g plan.

You still not getting it, it is not a matter of priorities. I too put Bgs control over weight loss, but I believe that we still have more insulin than those who will eat the same number of carbs and double the calories, and continues to lose weight. I recall one women on Dr.B's forum was afraid she will dissappear on 6-12-12 plan, this is how much and how fast she lost weight, and she is T2. So what gives then, you see many T2 stuck on Induction level (20g) and despite having good Bgs, still obese? How do you explain it, if not having more than normal insulin level while glucose is normal range?


I understand pretty well what is IR: the ratio of glucose to insulin, but this study did not explain how they measured it, no details whatsoever. Under another circumstances, you won't even consider data from a study like this.
Now, IR should be mesured while eating normal amount of carbs ( at least 150g a day), not after one was put on 20g a day for 2 weeks, AFAIK. This is why to Dx IR corrently, ppl are adivced to eat at least 150 g carbs for few days priopr to the test, so the results are valid.
Since 20g carbs hardly produces any glucose, mostly via gluconegenesis, there is nothing to lower so to speak, so insulin may stay constant, but not exactly as low as in ppl with pancreatic functions intact. But as soon as they add more cabrs to the regimen, their Bgs will be back in no time. Now, how is this a sign of improved IS? it is not just a matter of diet, once the receptors are gone, they are gone forever, just like betta cells


Then again, after low carbing for 5+ years, I don't have much of a problem with DP anymore.[/quote]

FBG ,/= 90 is not a problem at all, it is absolutely normal, and, NO, healthy ppl habe no DP, only diabetics.

No, I am not, one can have IR for life, and never become a T2, even being obese and have lots of circulating insulin. Could be that one's pancrease simply expands number of B-cells to accomodate the demand, while pancreatic failure in other folks does not correlate with years of poor diet choices? Could it be poor quality insulin, that is not easily recognized by receptors too?
overall, the point was- years of LC diet can't make one IS again. If indeed insulin is much lower after 5 + years on lc diet, then your body should have become IS to the smallest amounts of insulin, so you would be able to eat a little bit more than 30 g carbs a day.

Why not, if you are in fact no longer IR, you won't need much insulin for the same number of carbs, as before, and this won't impact your b-cells. if you mean that eating more than 30 g carbs daily is 'eating foolishly' than I think 30g carbs is 'starvation mode'. This only works when you eat very little carbs, because your body does not care about insulin at all, it is no longer uses glucose as a primary fuel, and it must relay on glucagon to survive now. But something else prevent us from losing all the weight still, and this is what makes me think it is extra insulin. So, yes, even if it not no longer your goal, something else is preventing you (and me) from losing extra pounds, so I keep wondering what?
Ok, peace out. Sorry, did not mean to make it sound like something personal. Feel free to ignore, actually, I am still trying to understand why some have great success while others - barely any.
ETA: Oh, and one more thing: my fasting insulin was 13 (range 4-29) but my FBG was 140, does it mean I am not IR since glucose/insulin ratio is >10?
http://www.ncbi.nlm.nih.gov/entrez/...3&dopt=Abstract

What did your doctor say? Nearly all T2s are insulin resistant (which means that some are not), but as you've stated before, even your doctor can't quite figure you out and says you are not at all typical. Your lab reference values put you squarely in the middle range.



They did, but you had to follow a few rabbit trails to find them. They measured both serum glucose and circulating insulin levels, along with leptin, ghrelin and others.
See this link for more details.



Then you'd lose the bet, I'm afraid. I have my reasons for it and that's about all I'll say on the matter. I'm sure neither of us would want to further hijack this informative thread with irrelevent discussion in any respect.



There are many reasons other than IR why people fail to lose weight; too many calories, too many carbs, too many cheats, too many 'frankenfoods', not enough exercise, medications, allergies, undiagnosed food sensitivities, a metabolism that is messed up from years of dieting, just to name a few, and diabetics aren't the only people here who sometimes have trouble losing.



Yes, everyone, Dina. Non-diabetics just don't have it to the degree that diabetics do.
http://www.diabetic-talk.org/dp.htm

My doctor told me that according to my labs I am not a typical T2, since my H1C and 2h PP are always in non-diabetic range but could be because I never been on a high carb/processed sugar diet. he also said that I am not IR (I can't believe it), and could be something esle going on in my body. he said that trully IR would have really high fasting insulin (50-60), that he observed in his practice many time. But I have read on Mercola that trully insulin senstivie ppl have fasting insulin <5.
OK, so on a very low carb diet there is insulin drop until the low carb level is maintained, but adding carbs will change the picture, I believe. So, the insulin sensitivity is not improved generally speaking, but maintain under certain conditions.


Could be, personally I don't eat any frankenfoods and neither do you AFAIK, aging metabolism, not enough physical activities and too many calories are most obvious causes. But somehow diabetes makes weight loss very hard.

Well, of someone has FBG of 90, does it mean they have DP? I know that Bgs rise between 4-8 am compare to before bedtime Bgs is what called DP, normal ppl have enough insulin to cover for glucose rise.

There is a saying that goes, "If you always do what you've always done, you'll always get what you always got" which is right up there with "One definition of insanity is to continue doing the same thing and expecting a different result." I have no doubt that going back to eating in a way that made me IR in the first place won't have that same effect again if I were foolish enough to return to it. Just because it's been reversed doesn't mean it won't ever come back if you do the same thing again that caused it in the first place. That's kind of like thinking that if you lose all your weight, you can go back to eating like you did before when you got overweight and not gain any weight back. As many here can attest, it doesn't work that way.




When that's the highest reading of the day, yes. As I said before, it's a matter of degrees.

yes, Enstein said "Insanity: doing the same thing over and over again and expecting different results", but this has nothing to do with our discussion. No one suggested to get back to eating sweets and drinking soda, BTW, I never even mentioned that it was ever part of my diet, but this is what is called to pull a strawmen.
Now, what you are saying is eating more than 30g of carbs is made you and me IR and diabetic? I think my food choices were far from being "foolish": no processed food, no sweets, sugars, soft drinks, no junk either. I ate healthy and fresh food, so I don't blame my diet in becoming T2. You probably know better what made you diabetic.
If the condition is reversed, it means you your body needs much less insulin and you can increase carbs and get more variety of food. But it does not work like this, and this is why I disagree that LC diet can actually "heal and reverse IR and diabetes". It never can be healed or cure. If I get a cold, I will start couching and sneezing, and may get slight fever. It means that I would stay in bed for few days, drink lots of tea with lemon and eat chicken soup. Once the cold is over, I can resume my daily routine, and stop sneezing and couching, and don't have to stay in bed for the rest of my life. This is when I say, ok, my cold was cured.
But if I have to keep my BGs in normal range by eating 20-30g carbs daily, for the rest of my life, it does not mean that this plan reversed anything. But again,it is a usefull tool for BGs control, no doubt about it.

I seriously doubt you will find many healthy folkds with BG of 90 as highest reading of the day.
JMO
OK, let's just agree to disagree, as we usually do.

Just to put my own $.02 in to this:

To avoid semantic arguments and details not necessarily germain to many of us:

1) Diabetes is said to be a disease that could take 20-50 years to develop. [Assuming T2]

2) One factoid definition for the disease is that you cannot process food [presumably mostly carbs, but protein effectively breaks down to BG anyway if necessary, so a somewhat moot point] the way the statistically "normal" people eat lots of carbs and do not get BG levels the way diabetics do. Thus, diabetes can be thought of as a cause-and-effect-induced "statistical abnormality" etc.

So, the argument is this: Are you "cured" if by severe enough dietary modification [clearly quite familiar to most of us with regard to weight reduction] you can more statistically "correctly" maintain BG levels adequately? Or, alternatively, are you merely dealing with the problem that cannot go away by avoiding that which initiates the symptoms?

Most of us agree that taking insulin by injection isn't a "cure" so much as a sane regimen to contain the symptoms and hopefully largely halt the progression of the disease.

Thus, if the severe dietary modification also gets you to approximately the same place, this also isn't a "cure" but it certainly could be equated as an equivalent regimen to hopefully accomplish the same thing vis-a-vis the symptoms.

The main point seems to be to evade the episodes of the consequences of the disease caused by being out-of-control regarding the time periods where BG levels could be too much. For many, the LC diet regimen can stabilize BG levels perhaps better than insulin [or perhaps the two together, or perhaps the dietary regimen and oral stimulants such as Orinase, Diabinase, etc.]

I know of two people, mother and daughter. Mother was diagnosed at age 40 as diabetic requiring insulin by injection, then spent 14 years faithfully self-administering insulin shots. Eventually, hearing about the Atkins methods, uses same to cause significent weight drop as well as all of the usual other improvements.

Unexpectedly, doctors find insulin system partially working more normally than ever seen; Diabinase instead of injections is prescribed and patient lives rest of life without another injection with markedly improved overall health.

Clearly mother is unable to ever return to "normal" dietary regimen unless prepared to abandon Diabinase in favor of insulin injections and finds that a heavily motivating factor to stay the Atkins course, etc.

Mother would consider this a "cure" while we may instead call it something to the effect of halting the symptoms, etc.

Daughter is diagnosed at age 36 as T2; doctor prescribes Diabinase. Daughter stubbornly refuses to change eating habits, actually gaining weight which is no surprise considering how much total intake, lack of exercise, high carb content, etc. Cause and effect quite readily satisfied, etc.

Daughter's condition degrades; in several years has ballooned up to the former weight range of mother and now can only get by with insulin injection, generally doing poorly, still stubbornly refusing to change eating habits despite pleas by family members, doctors, etc. As of this writing, overall health still degrading severely. [Note: Mother never was, daughter entire life is heavy smoker; mother does not have much heart disease involvement; daughter has major heart-related problems, etc.]

Simplistically speaking, mother and daughter "reversed roles" in that duaghter was younger and initially healthier, but due to gross irresponsibility self-induced predictable path to ever-increaseing diabetic symptoms and ever-increasing overweight. Mother fared better and when weight loss occured, diabetic symptoms were much easier to control. They simply went in opposite directions.

Anyway, I don't think too many of use need to bother with words like "cure" when we can at least do something to [re]-gain control of our metabolic lives, and that's really far more important than semantics, etc.

cjl

IMO, once a diabetic, always a diabetic unless and until they find a way to regenerate beta cells, and there is some promising research going on in that respect. But until they find a cure, good control is the next best thing.
Reversing insulin resistance is definitely possible, even for a diabetic, but that is not a diabetes cure; it does not restore phase 1 insulin response or regenerate destroyed beta cells, those are gone for good. What reversing IR does do, in the diabetic's favor, is to put less stress on the remaining beta cells that produce insulin since they are not having to crank out huge amounts of insulin to keep up; once the phase 2 insulin response kicks in about 70 minutes after eating, the pancreas can do it's job just fine if IR is reversed.
Insulin is secreted by the body in at least 2 (sometimes more) phases. The first is called the phase 1 response where the body releases a small amount of stored insulin as soon as we begin eating (this is missing in all Type 1 and most Type 2) in non-diabetic people, this keeps blood sugar from rising much after a meal. The second (and any subsequent) insulin relase phase is about 70 minutes after you begin to eat if the body senses that blood glucose is still high or still rising and continues in spurts until blood glucose returns to normal.
Even if IR is reversed, a type 2 diabetic is going to see a spike (quick rise to higher than normal levels) in blood glucose in the first hour after eating even a 'normal' amount of carbs because of the missing phase 1 response.