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MrsMia

I didn't know this about low carbing

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MrsMia

Recently I read at a paleo blog that low carbing will cause your fasting blood sugar to rise because you will be more insulin resistant. That people who low carb should deduct 10 md/dl from their FBS that their meter posts. Have any of you who low carb read that? I had heard that eating higher fat makes you insulin resistant until you reach a certain level and then there is no longer the insulin resistance but I've never heard that about low carbing. If that is true then my morning numbers aren't too bad. :)

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Lloyd
Recently I read at a paleo blog that low carbing will cause your fasting blood sugar to rise because you will be more insulin resistant. That people who low carb should deduct 10 md/dl from their FBS that their meter posts. Have any of you who low carb read that? I had heard that eating higher fat makes you insulin resistant until you reach a certain level and then there is no longer the insulin resistance but I've never heard that about low carbing. If that is true then my morning numbers aren't too bad. :)

 

That does not match my experience.

 

-Lloyd

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Peggy_TX

That doesn't sound right, and I'm not sure it even makes sense... Why would LC make you insulin resistent?

And why should "LC people" deduct anything from their reading? Their reading is the level of glucose in their blood. What sense would there be to adjusting it based on what they ate? Do I get to "deduct 100 points" from my meter if I eat pasta??? What is the purpose of deducting this #??? The # is what the # is -- whatever caused it. Food, resistence, medication, stress.... they all change the #, but not what the # MEANS

This is really confusing.....

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MrsMia

Ok. From Hyperlipid this is what I read about how low carbing makes you insulin resistant:

 

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...

 

I spend rather a lot of my life in mild ketosis, despite the 50g of carbs I eat per day. So I can run a moderate ketonuric urine sample with a random post-chocolate blood glucose value of 6.5mmol/l.

 

What is happening? Well, the first thing is that LC eating rapidly induces insulin resistance. This is a completely and utterly normal physiological response to carbohydrate restriction. Carbohydrate restriction drops insulin levels. Low insulin levels activate hormone sensitive lipase. Fatty tissue breaks down and releases non esterified fatty acids. These are mostly taken up by muscle cells as fuel and automatically induce insulin resistance in those muscles. There are a couple of nice summaries by Brand Miller (from back in the days when she used her brain for thinking) here and here and Wolever has some grasp of the problem too.

 

This is patently logical as muscle runs well on lipids and so glucose can be left for tissues such as brain, which really need it. Neuronal tissue varies in its use of insulin to uptake glucose but doesn't accumulate lipid in the way muscle does, so physiological insulin resistance is not an issue for brain cells.

 

I think you can ignore the deduction of the 10mg/dl as it appears that I mixed that up with another test and low carbing.

 

Here is the link to Hyperlipid:

 

Hyperlipid: Physiological insulin resistance

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Daytona

As the hyperlipid article explains, your body conserves the limited glucose by having your muscles refrain from gobbling it all up when they can use fat and your brain still needs a certain amount of glucose. So yes it's insulin resistance and this is why if you have been low carbing, you will most likely fail a glucose tolerance test.

 

However it is not a "bad" insulin resistance. When glucose is low and insulin is low, it's appropriate to save glucose for your brain. The kind to worry about is when glucose is abundant and your body inappropriately ignores insulin, driving your glucose and insulin even higher.

 

Anecdotally, some people have reported higher fasting BG when low carbing though I do not know the details of what they were eating (maybe they were experiencing liver dumps due to excessive protein or fructose, etc). I have not experienced this. When I keep my carbs super low (<30g total not net) and my protein medium low (e.g. 75g/day) my fasting BG is in the 70's. When I screw up and eat 1.5lbs of steak, treat chocolate protein (or fiber) bars like candy or indulge in fruit, I may not spike immediately but the next day my fasting BG is over 100.

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jwags

I also think that diabetes is progressive. Low carbing will definitely help the progression but it does not necessarily mean it stops it. Even with low carbing I have had to increase my metformin. One thing Dr B recomends is taking the appropriate medication to deal with with the increased bgs. I doubt Low carbing increases insulin resistance but as you become insulin insufficient your bgs may rise.

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NickP
Recently I read at a paleo blog that low carbing will cause your fasting blood sugar to rise because you will be more insulin resistant. That people who low carb should deduct 10 md/dl from their FBS that their meter posts. Have any of you who low carb read that? I had heard that eating higher fat makes you insulin resistant until you reach a certain level and then there is no longer the insulin resistance but I've never heard that about low carbing. If that is true then my morning numbers aren't too bad. :)

 

I would disagree. I have read many of the Paleo Books, and I would say that, for the most part, Paleo Diets are a Low Carb Diet (but not all Low Carb Diets are Paleo). Some Paleo diets do believe in "safe" carbs (another discussion).

 

I would agree that eating a Low Carb diet does make us more carb sensitive at times, meaning, if you eat a low carb diet, and then eat a high carb meal, your body will react with a higher BG, then if you had been eating high carb all the time.

 

Since eating low carb over the past two years, my fasting BG has been very consistent. Some days great, some days not as great.

 

Unfortunately, we all have been taught that average fasting BG should be in the mid 80's. For my experience, and talking to other Low Carbers, it is not unusual to see "normal" fasting numbers in the 90-100 range. Again, this may bother some people, and some might say it is caused by insulin resistance.

 

IMHO, your body finds a "good spot" for your fasting BG. When you Low Carb, your BG is very stable, so your fasting number might not be as low. If you eat a lot of carbs, then your BG will swing up and swing down a lot more, which may give a lower fasting number. So, if you only compare fasting numbers, the high carb diet could look better.....but it is not.

 

So, overall, I would say that the Blog is making an incorrect conclusion looking at a small amount of data.

 

Hope this helps......

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ShottleBop

Chris Kresse, "The Healthy Skeptic," has also said that a low-carb diet may result in higher FBGs, but it's nothing to worry about. "Why your “normal” blood sugar isn’t normal (Part 2)":

One caveat here is that very low-carb diets will produce elevated fasting blood glucose levels. Why? Because low-carb diets induce insulin resistance. Restricting carbohydrates produces a natural drop in insulin levels, which in turn activates hormone sensitive lipase. Fat tissue is then broken down, and non-esterified fatty acids (a.k.a. “free fatty acids” or NEFA) are released into the bloodstream. These NEFA are taken up by the muscles, which use them as fuel. And since the muscle’s needs for fuel has been met, it decreases sensitivity to insulin. You can read more about this at Hyperlipid.

 

So, if you eat a low-carb diet and have borderline high FBG (i.e. 90-105), it may not be cause for concern. Your post-meal blood sugars and A1c levels are more important.

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jwags

I try to keep my HbA1c in the low 5's but I am rarely below 100 for fasting most days. But then again I am rarely above 110-115 after meals either. I am one of those people who is very carb senstive and I do think low carbing for a very long time may make the sensitivity worse. But that happens on any type of diet. If you diet for a long while and stop you always gain back the weight faster than you lost it.

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MrsMia
Chris Kresse, "The Healthy Skeptic," has also said that a low-carb diet may result in higher FBGs, but it's nothing to worry about. "Why your “normal” blood sugar isn’t normal (Part 2)":

 

You know, come to think about it, I think Chris Kresse's site was where I read about deducting the 10mg/dl from your fasting numbers but it was in regard to a different test. So I got that part mixed up. But the explanation from Hyperlipid and Chris Kresse makes sense to me. The key seems to be that it is okay to have the slightly above normal elevated fasting blood sugars if your post prandial numbers and A1c levels are within normal boundaries. Fortunately I do have the post prandial numbers in check. The A1c is a different matter as I have a few things that has influenced a different A1c outcome at various times. My A1c rarely matches up with the meter and it is because of the different variables I've had to contend with it throws my A1c reading off into a basic guessing game. That is why my endo told me he will take my meter readings and bg records as being more indicative of where my management is over solely my A1c. Thanks, ShottleBop.

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MrsMia
I try to keep my HbA1c in the low 5's but I am rarely below 100 for fasting most days. But then again I am rarely above 110-115 after meals either. I am one of those people who is very carb senstive and I do think low carbing for a very long time may make the sensitivity worse. But that happens on any type of diet. If you diet for a long while and stop you always gain back the weight faster than you lost it.

 

I have always strived to keep my A1c in the 5's and low 5's would be great but the closest I have gotten my A1c was 5.4 in September of 09 and I just took the last test I had of a Bayer A1c now test a few days ago and that said 5.4. But because of different health factors I really don't know for sure what my A1c actually is. I usually have fastings between the 90's and low 100's. And you are right. Everything I've read is that you do become carb sensitive or insulin resistant with fewer carbs. I also think you are right about dieting and gaining weight back.

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MrsMia
I would disagree. I have read many of the Paleo Books, and I would say that, for the most part, Paleo Diets are a Low Carb Diet (but not all Low Carb Diets are Paleo). Some Paleo diets do believe in "safe" carbs (another discussion).

 

I'm not really sure what you are disagreeing with? Is it that you become more insulin resistant the lower your carbs or that you deduct the 10md/dl from your fastings? If it is the latter then I totally agree since I completely messed that one up! I must have been in some kind of an alternate universe when I got that mixed up with my thread.

 

I would agree that eating a Low Carb diet does make us more carb sensitive at times, meaning, if you eat a low carb diet, and then eat a high carb meal, your body will react with a higher BG, then if you had been eating high carb all the time.

 

When you say carb sensitive do you mean insulin resistant? Or are you meaning something else? Just want to be clear since it seems I have the ability to really mix things up.

 

Since eating low carb over the past two years, my fasting BG has been very consistent. Some days great, some days not as great.

 

Oh me too! And even though I get various ones from day to day, some higher and some lower it seems that they stay in a pretty flat consistent range. That has been pretty comforting. No huge surprises.

 

Unfortunately, we all have been taught that average fasting BG should be in the mid 80's. For my experience, and talking to other Low Carbers, it is not unusual to see "normal" fasting numbers in the 90-100 range. Again, this may bother some people, and some might say it is caused by insulin resistance.

 

I've got to be honest. It does bother me a bit as that is the only reading of the whole day that doesn't fall into line with the rest of the readings. It's almost like that constant reminder that I can never let up. That diabetes is relentless. My endo told me that if I were to start losing control it would start showing up in the post meal numbers. Mine are still good there but I still see that fasting number like all my lab reports have it...."flagged".

 

IMHO, your body finds a "good spot" for your fasting BG. When you Low Carb, your BG is very stable, so your fasting number might not be as low. If you eat a lot of carbs, then your BG will swing up and swing down a lot more, which may give a lower fasting number. So, if you only compare fasting numbers, the high carb diet could look better.....but it is not.

 

So, overall, I would say that the Blog is making an incorrect conclusion looking at a small amount of data.

 

Hope this helps......

 

I read something similar about the high fat insulin resistance in a low carb diet in the Art and Science of Low Carbohydrate Living except they say that the insulin resistance is overcome when you reach a certain level of fat in the diet while keeping the carbs low. So now I'm wondering if the insulin resistance is caused by the low carbs and not necessarily the high fat? Getting into the science of low carb/high fat diets is quite interesting and long overdue.

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NickP

Hey Mia,

 

Thanks for the response. You certainly have gotten some interesting input on this thread!

 

I'm not really sure what you are disagreeing with? Is it that you become more insulin resistant the lower your carbs or that you deduct the 10md/dl from your fastings? If it is the latter then I totally agree since I completely messed that one up! I must have been in some kind of an alternate universe when I got that mixed up with my thread.

 

I disagree that a LCHF diet will cause insulin resistance. I do understand and don't disagree with Shottlebop's quote above. Maybe it just semantics. If your body is using Ketones for fuel, then your body will not be used to using BG as fuel. So, temporarily, you could call that increased insulin resistance. I hadn't thought of it that way...but that could be argued.

 

Personally, when I hear someone say that I have elevated insulin resistance, it is more like being diagnosed with a medical or physical condition, and is a BAD thing.

 

With the HFLC diet, this "state" of insulin insensitivity, is a temporary condition that would be gone with an increase in carbs. So, overall, this cpndition is a GOOD thing. It means you have conditioned your body away from using carbage for fuel, and now you are burning Ketones.

 

So, OK, I can agree with that, but would still prefer to say that I have a "Carb Sensitivity"

 

 

When you say carb sensitive do you mean insulin resistant? Or are you meaning something else? Just want to be clear since it seems I have the ability to really mix things up.

 

Again, I would say that I am not insulin resistant, but I am Carb Sensitive. I think we are saying the same thing......

 

 

Oh me too! And even though I get various ones from day to day, some higher and some lower it seems that they stay in a pretty flat consistent range. That has been pretty comforting. No huge surprises.

 

My BG is very flat throughout the day. My BG program tracks my high, my low, and my average. Most days, these are all just 10 points from each other. I think if you can keep your BG that consistent, then you are doing everything you can to control your BG.

 

 

I've got to be honest. It does bother me a bit as that is the only reading of the whole day that doesn't fall into line with the rest of the readings. It's almost like that constant reminder that I can never let up. That diabetes is relentless. My endo told me that if I were to start losing control it would start showing up in the post meal numbers. Mine are still good there but I still see that fasting number like all my lab reports have it...."flagged".

 

I agree...I would love to see a low fasting numbers. However, I also have DP. So, by the time I awake, shower, get dressed, and then go to the Lab, my BG is about 115. However, I awoke around 95. Not much I can do about that.

 

I also agree that controlling your post meal numbers are the single most important thing we can do to control our BG. We don't have much direct control over our BG except to when it comes to food.

 

 

I read something similar about the high fat insulin resistance in a low carb diet in the Art and Science of Low Carbohydrate Living except they say that the insulin resistance is overcome when you reach a certain level of fat in the diet while keeping the carbs low. So now I'm wondering if the insulin resistance is caused by the low carbs and not necessarily the high fat? Getting into the science of low carb/high fat diets is quite interesting and long overdue.

 

Do you remember what chapter they referred to this? (I would love to read that again to understand your question better).

 

I don't know. Again, when your body converts to Ketones as a fuel source, it would make sense that it would no longer prefer to use BG (and the insulin that comes with it) for it fuel source. So, when you are on this diet, your body will indeed be more carb sensitive.

 

 

 

 

BTW....The Art and Science of Low Carbohydrate Living is an AWESOME book and a GREAT READ! I highly recommend it.

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MrsMia
I read something similar about the high fat insulin resistance in a low carb diet in the Art and Science of Low Carbohydrate Living except they say that the insulin resistance is overcome when you reach a certain level of fat in the diet while keeping the carbs low. So now I'm wondering if the insulin resistance is caused by the low carbs and not necessarily the high fat? Getting into the science of low carb/high fat diets is quite interesting and long overdue.

 

Do you remember what chapter they referred to this? (I would love to read that again to understand your question better).

 

Hi Nick,

 

In chapter 7 about insulin resistance, on page 86 in bold it says 'Why do many experts believe that high fat diets cause insulin resistance?. There are reasons why the authors give that some believe it to be so and then goes on to explain things in a bit more detail. In the third paragraph they state: "What we do know is that, pretty consistently, as dietary fat percent is increased from 30% to 60% in animals and humans, insulin sensitivity does get worse. But once above 60% of energy as fat, which typically translates to less than 20% of energy as carbohydrates (assuming 15-20% from protein), insulin resistance turns around and starts to improve."

 

I really like the book too. It gives more details as to why things work for low carbing rather than just saying it does. Plus it gives good reasoning as to why one diet doesn't fit all.

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xMenace
Recently I read at a paleo blog that low carbing will cause your fasting blood sugar to rise because you will be more insulin resistant. That people who low carb should deduct 10 md/dl from their FBS that their meter posts. Have any of you who low carb read that? I had heard that eating higher fat makes you insulin resistant until you reach a certain level and then there is no longer the insulin resistance but I've never heard that about low carbing. If that is true then my morning numbers aren't too bad. :)

 

Almost complete hooey.

 

IR may increase slightly, but it will be muddied very much by lowered glycogen and increased activity. With less insulin in your body, you will store less glycogen. Our basal sugars come from our body burning glycogen. If you have less, your basal pressures (sugar releases) will be less. You will likely become more active from low carbing because more energy is directed to muscle instead of fat, and this will tend to lower IR.

 

Your basal pattern will not change; though it will shift, and it will likely shift down. If your basal need drops for most of the day but goes up at dawn, I'd suggest you either didn't really know your basals or something else is causing the rise. IR is not associated with times of day as afar as I know. This is absed on my experience only.

 

My basals dropped 20% within about six weeks. My second weight loss phases caused another 20% drop.

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MrsMia

Well, actually it is "complete" hooey because the proper context of deducting the 10md/dl is found in this article at Chris Kresser's blog:

 

http://chriskresser.com/how-to-prevent-diabetes-and-heart-disease-for-16

 

I completely messed up and mixed up on the context. :o So the deduction is not accurate. But it does appear that the insulin sensitivity with HF or LC might be to some degree. In HF it seems it is a non issue once someone hits the 60% mark of fat as an energy source in their diet. With low carbing I'm still not absolutely sure about that.

 

 

From Kresser's article:

 

"Second, if you normally eat low-carb (less than 75g/d), your post-meal readings on the third day following the simple carbohydrate (rice or potato) challenge will be abnormally high. I explained why this occurs in the last article, but in short when you are adapted to burning fat your tolerance for carbohydrates declines. That’s why your doctor would tell you to eat at least 150g/d of carbs for three days before an OGTT if you were having that test done in a lab.

 

If you’ve been eating low-carb for at least a couple of months before doing the carbohydrate challenge on day three of the test, you can subtract 10 mg/dL from your 1- and 2-hour readings. This will give you a rough estimate of what your results would be like had you eaten more carbohydrates in the days and weeks leading up to the test. It’s not precise, but it is probably accurate enough for this kind of testing."

 

I think there are two separate issues we are talking about. One is low carb diets causing insulin resistance or sensitivity. And the other was the one about deducting the 10md/dl from fasting numbers. This latter I unfortunately mixed up into the mix so I hope this link and article adds some clarity to what the reference was.

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Hoping4Cure

I've been trying low-carb / high fat for a short while (I just bought Bernstein's new edition of his book the day it came out), and though I'm a complete noob, I have already seen a drop in weight and feeling better. My insulin requirements have gone down, and I've lowered my Lantus and Victoza by 20% and 33%, respectively. I think it's a good match. Though I have had to be VERY careful about taking too much insulin, when I don't eat carbs with supper I have a better sleep and feel much more rested. I prefer to take a bit more carbs throughout the day, in the form of cappuccino. It barely spikes my sugar and I find lowering evening carbs to be more important than other meals. What I mean is, I think it's better to not eat any in the evening and keep it during daylight hours. (and even those, at a moderate level).

 

It's certainly tricky to get used to the idea of not eating any fruit. Goes completely against everything I've been taught my whole life. Strawberries, in moderate quantity, are good to keep me normal after a workout so I don't bottom out. // my $0.02

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DeusXM

What's really interesting from Kresser is that he claims complications occur above 140/7.7.

 

That means if you're keeping your BG below this, you're essentially at no risk of complications.

 

That also means (theoretically)if your A1c is 6.1 or below, there is no point in actually lowering your A1c any further. Obviously with that assessment, that depends on a constant BG of 7.7 so let's assume a more real-world solution requires a lower result. It still looks like there's actually very little point in reducing your A1c below the high 5s. Furthermore, if we assume that complication severity/occurrence is greater and younger the higher your A1c, this also means that in the early 6s, your complications are minimal and won't happen until after many years - possibly by which time you might have already died of something else.

 

Food for thought for anyone busting a gut to get an A1c in the 4s...

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Lloyd
What's really interesting from Kresser is that he claims complications occur above 140/7.7.

 

That means if you're keeping your BG below this, you're essentially at no risk of complications.

 

That also means (theoretically)if your A1c is 6.1 or below, there is no point in actually lowering your A1c any further. Obviously with that assessment, that depends on a constant BG of 7.7 so let's assume a more real-world solution requires a lower result. It still looks like there's actually very little point in reducing your A1c below the high 5s. Furthermore, if we assume that complication severity/occurrence is greater and younger the higher your A1c, this also means that in the early 6s, your complications are minimal and won't happen until after many years - possibly by which time you might have already died of something else.

 

Food for thought for anyone busting a gut to get an A1c in the 4s...

 

Low carb (80 a day in my case) is the only method of sustained weight loss that has ever worked for me. I'm down more than 40 pounds almost 5 years later. For me, it's working, so I won't be messing with it. 5.0 5.2 5.0 5.0 this year.

 

-Lloyd

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DeusXM

And that's great Lloyd. When you find a way that works for you, stick with it. What I'm saying is that people shouldn't stress out over the odd high reading or if they can't get an already great A1C even lower.

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Hoping4Cure

Complications arise not just from the average of your blood sugars, or even the AIC readings which are VERY suspect (it's easy to keep it within that range, but not to have a low average AND a low variance)

 

Keeping your graph a solid, straight line is what you should be after. The AIC levels are a red herring because you can have a good monthly average but terrible control. It's the variance in sugars that matters. For instance, I've set my graph thresholds in my One Touch software to 4-7 as the all-day target I'm after. In the last three months, I went from being in that range 15% of the day, to 30% of the day, and that's made a HUGE difference in the way I feel, even though I know there is still a HUGE way to go. It's not just avoiding complications long-term, but loss of short-term memory, irritability, all the other nuisances we have to put up with. The closer yours sugars are dialed in ALL the time, the better you will feel. The only way that even is theoretically possible given the chaotic nature of our day-to-day differences in handling of insulin, is by trying to go after the Phase II response. I.e. only eat stuff that spikes your sugar slowly, such as fats and proteins and avoid carbs as much as possible. I'm pretty angry my doctors never hammered that into my mind since I got the disease.

 

I've had a lot of USELESS doctors over the years...honestly this website and the food / reading tips in here have helped me way more, in a very real way, than all my endos have put together. thanks

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Moonpie

My experience has been the opposite, When I first reduced my carbs, I was averaging 50-100 per day. My FBGs were normally anywhere form 110-120. Then I went on Atkins induction, & after a few days of only about 20 carbs a day, my numbers were under 100 every morning. Now I am not on induction anymore, but still lowish carb (20-50) & I hover anywhere from 90 to 110 in the mornings, I am Ok with that, as it goes down over the course of the day.

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