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TomMarkz

Does Low Carb Diet create Insulin Resistance???

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TomMarkz

Hello All,

Last Thursday I received the terrible news that I am pre-diabetic. I was told to eat less carbs, stay away from sugar and sugary drinks. My tryglicerides are at 212 so I have to watch my fats and to exercise. Fine. I got it. But what perplexes me (from what I have read) is that a low carb diet can induce insulin resistance. So this is where I need help. If Im insulin resistant hence the diagnosis. I was told eat less carbs isn't that counter-productive? According to what's out there on the net, being on low carbs would add to the problem, wouldn't it? This is all new to me.

Because since Thursday when i got the news I have stopped carbs completly for the exception of the oatmeal i eat in the morning. Its day three and my head feels heavy and I feel pressure against my eyeballs from the inside of my head. I bought a blood glucose reader today (Sunday) and have been monitoring my blood levels after I eat. So approx 2 hours after lunch I was 88mg and diner I was 89mg. So I gather I have my sugar levels normal after a meal.

 

Any type of explaination or suggestion would be great. Im really worried. Im 42 with a little girl and boy in his way into our world. I want to enjoy life with them. I already suffer from Gerd and Barretts esophagus (which is precanerous) I dont need Diabetes in the mix.

 

Thanks,

TomMarkz

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Forester

Hi Tom, and welcome to the Forums.  

 

First of all, a low carb diet will tend to decrease your insulin resistance over time, since you will need need less insulin to cover what carbs you eat.  What did you read that suggested low carb could increase your insulin resistance?  I've never seen that in all of my research into this.

 

Secondly, your trigliceride levels are not primarily a result of eating bad fats, but rather too much carbs in the diet, believe it or not.  Sounds counter-intuitive, I know.  And by "carbs", I mean not just sugar, but many starchy foods like rice, pasta, potatoes, breads, and may other baked goods. 

 

And even "healthy" foods like oatmeal can be rapidly converted to high blood glucose levels ("high BG" spikes). You may not detect these rapid high rises in blood glucose from foods like oatmeal, because you are testing too late (2 hours) to catch them.  If you still produce insulin in response to a carby meal, your blood glucose levels initially rise rapidly, then drop just as rapidly. Try testing 1 hour after the first bite, and if it is going over 140, it may be contributing to damage and an overall high "fasting" level.

 

Getting a diagnosis  of pre-diabetes is not terrible news, it is a warning and a wake-up call to do something.  I was not diagnosed until I was full-up diabetic, and still was able to control it with diet and exercise.  You are way ahead of me, and I am doing fine.  So read what people have to say on these forums, and you will also be fine.

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dowling gram

Hi TomMarkz

 

Take a deep breath and relax. Getting a diagnoses of prediabetes is not the end of the world. We have all gotten that diagnoses and have been able to live healthy lives. Some on just diet and exercise  but even if you have to take meds in the future it is not that bad.

 

Samuraiguy also has GERDS and diabetes and does quite well on just diet and exercise. I imagine he will be along to tell you about living with GERDS and diabetes. If he doesn't happen to see this you could always send him a message and talk to him that way.

 

Cutting carbs will give you control over your Blood glucose but it will also lower your triglicerides. It has been seen here time and again. Eating a low carb high fat diet has not only put our blood sugar in the normal range but helped our cholesterol too.

 

Carbs are not just sugar and sweet stuff. grains and pasta rice and potatoes are high in carbs and that includes your oatmeal. Have you tested it? Test 1 hour after eating it and that will tell you how high your blood glucose goes with oatmeal. Then test at 2 hours to see how fast it comes down. It may be that you can eat some oatmeal. You could try halving it and using flax meal for the rest. What you can eat will differ from what I can eat so testing is the only way to find out what a particular food does to you.

 

Once you've been doing low carb high fat a while and testing each food it becomes easier because you'll know what each food does to you. High blood glucose effects every part of your body including your vision. If you can keep your Blood glucose in the normal range you will find that you not only feel better but a lot of those things like tgat heavy head will disappear. I know my vision improved once I got control.

 

Stick around, read and ask questions and learn how we deal with our diabetes. We will help you all we can. You have much to learn but once you know what to do it becomes second nature and you treasure how healthy you feel. I know I will never go back to my high carb ways

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3flourmix

Welcome TomMarkz

 

I am not a fan of high fat, and I can only relate my own experience.

 

Firstly, I think that weight loss will reduce insulin resistance because it appears to have for me (with low carbs.)

 

For my Endro diabetes specialist

No major carbs and extra veg

 

For my Cardiologist not much processed meat or cheese

 

For my gout no prawns, offal or pork. (no purine overload)

 

12 months on, I am off insulin and onto tablets and all my blood test results are in the normal range and I have lost 22kg and my results have been stable for months.

 

I did not have to measure/count carbs or cals I just cut out major carbs everything else was sensible not radical.

 

At this point I am increasing carbs just a little because my GP has said to not lose an more weight.

 

I am not a fan of high fat - I know it has its champions but it was not necessary for me.

 

 

 

 

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Oriana

with instant oatmeal my highest # is at 30 mins. oatmeal puts me much higher than chocolate.

 

the carb/ir thing probably came from vegans. i've had them tell me that a high carb diet will cure my bs problems. they live in their own little world where good info does not get involved.

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samuraiguy

As Gram stated I have GERDS, do not have Barretts just a lazy LES, so I had to adjust my diet even before I was diagnosed diabetic. I think you'll find high blood glucose can lead to inflammation that makes the GERDS worse and both will be "alleviated" when you get your numbers down. I found it's easier to break my day into five smaller/meals snacks which you may already do because of the GERDS, so I eat less carbs, protein and healthy fat at each, but still get sufficient amount for my daily needs.

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jwags

I don't think they know what causes Insulin Resistance. It is often from many years of eating way too many csrbs, even the healthy ones. When you eat carbs your pancreas needs to put out insulin. If you eat more carbs than your pancreas can handle, often your pancreas is forced to work too hard and overproduce insulin. Eventually your cells become resistant to your own insulin, so bgs go up. Usually a Low Carb diet reduces insulin resistance. Also increasing exercise helps build muscle which helps some with IR.

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georgepds

I don't think they know what causes Insulin Resistance. It is often from many years of eating way too many csrbs, even the healthy ones. When you eat carbs your pancreas needs to put out insulin. If you eat more carbs than your pancreas can handle, often your pancreas is forced to work too hard and overproduce insulin. Eventually your cells become resistant to your own insulin, so bgs go up. Usually a Low Carb diet reduces insulin resistance. Also increasing exercise helps build muscle which helps some with IR.

This doc says high fat causes IR

 

http://nutritionfacts.org/video/what-causes-insulin-resistance/

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Kit

Yeah, and my dietician told me a cockamamie story that a steak could ruin your blood glucose for days.  My own testing has proved that a steak dinner will give me some of my best readings, and will usually give me a pretty good morning reading as well.

 

Seriously.  About 16 or so years ago I had my gall bladder removed.  I was basically told that fat was the root of all evil and to avoid fat as much as possible.  So, for the most part, I did  (I splurged once in a while, but not often).  I ate lots of whole grains (I'm one of those people who always preferred whole wheat bread and pasta, brown rice, etc).  I didn't eat a lot of sweets (lost my taste for them a long time ago).  I ate a lot of grains, fruit, and vegetables.

 

The results - I still had gastric issues.  And 16 years later I was diagnosed with an A1C of 10.4 and a horrific lipid profile caused by all those fats I . . . wasn't eating.

 

So many out there are so fat phobic that they can't even call the diet low carb high fat.  They call it high protein, because obviously no one in their right mind would touch a micron of fat if they could avoid it!

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georgepds

I always wondered why T2D was characterized by both high glucose and high triglycerides, and this video helped me understand the link. Let  me summarize the video 

 

For nearly 80 years we’ve known that the PPG rise depends on the amount of fat in the meal  ( a fact not a supposition) . Now we know that insulin acts on a cell wall receptor that in turn activates glucose absorption from the blood into the cell( Insulin attaches to the cell wall receptor, that activates an enzyme cascade, that  in turn sends the GLUT4 vacuole to the cell wall for glucose absorption from the blood into the cell) . The fatty acids in the blood interfere with the glucose absorption ( we know now it’s the fatty acidsin the blood that attach to their own receptor on the cell wall, the sets off its own chemical reaction, that interfere with the set of reactions that send GLUT4 to the wall for glucose absorption). Hence a high fat meal means higher PPG , and observed  and documented by Himsworth

 

 

For those who like to go straight to the source..here are the references presented in the video

 

H P Himsworth. The dietetic factor determining the glucose tolerance and

senility to insulin of healthy men. Clinical Science 1934; 2, 67-94.

 

H P Himsworth, E M Marshall. The diet of diabetics prior to the onset of

the disease. Clinical Science 1935; 2, 95-115.

 

M Roden, T B Price, G Perseghin, K F Petersen, D L Rothman, G W Cline, G

I Shulman. Mechanism of free fatty acid-induced insulin resistance in

humans. J Clin Invest. Jun 15, 1996; 97(12): 2859–2865.

 

S Lee, C Boesch, J L Kuk, S Arsianian. Effects of an overnight

intravenous lipid infusion on intramyocellular lipid content and insulin

sensitivity in African-American versus Caucasian adolescents.

Metabolism. 2013 Mar;62(3):417-23.

 

M Roden, K Krssak, H Stingl, S Gruber, A Hofer, C Furnsinn, E Moser, W

Waldhausl. Rapid impairment of skeletal muscle glucose

transport/phosphorylation by free fatty acids in humans.

 

M Krssak, K Falk Petersen, A Dresner, L Dipetro, S M Vogel, D L Rothman,

M Roden, G I Shulman. Intramyocellular lipid concentrations are

correlated with insulin sensitivity in humans: a 1H NMR spectroscopy

study. Diabetologia. 1999 Jan;42(1):113-6.

 

J Shirley Sweeney. Dietary Factors that Influence the Dextrose Tolerance

Test a Preliminary Study. JAMA Int Med, Dec, 1927, Vol 40, No. 6.

 

E W Kraegen, G J Cooney. Free fatty acids and skeletal muscle insulin

resistance. Curr Opin Lipidol. 2008 Jun;19(3):235-41.

 

A T Santomauro, G Boden, M E Silva, D M Rocha, FR F Santos, M J Ursich,

P G Strassmann, B L Wajchenberg. Overnight lowering of free fatty acids

with Acipimox improves insulin resistance and glucose tolerance in obese

diabetic and nondiabetic subjects. Diabetes. 1999 Sep;48(9):1836-41.

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Kit

If higher PPG is caused by higher dietary fat in a meal, then why are my numbers so much better when I do LCHF?

I see it every day when testing from 1 to 4 hours after eating a meal.

 

My meters, my lipid profiles, my A1Cs all contradict your statements.

 

So, why is that the case?

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georgepds

If higher PPG is caused by higher dietary fat in a meal, then why are my numbers so much better when I do LCHF?

I see it every day when testing from 1 to 4 hours after eating a meal.

 

My meters, my lipid profiles, my A1Cs all contradict your statements.

 

So, why is that the case?

 

Because if there is no glucose (or other carbs that lead to glucose)  ingested, there is no increase in PPG....

 

You can't increase what is not there.. That does not change teh fact that you have altered your IR

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Kit

I eat carbohydrates.  My diet is chock full of veggies.

I don't eat grains.  I don't eat most root vegetables.  I can't tolerate them.  But then I obviously couldn't tolerate them prior to my diagnosis either.  Otherwise I wouldn't have had an A1C of 10.4.

 

So, how do you know my insulin resistance is higher now than it was prior to me going low carb?

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georgepds
.....

 

So, how do you know my insulin resistance is higher now than it was prior to me going low carb?

Hi

 

You might want to dial this back a notch.. I don't know anything about you.  If you want to know about your IR, do an oral glucose tolerance test [OGTT]. I used you in the sense of one, as in  "One can't increase what is not there.. That does not change the fact that one  has altered their  IR" but that is ugly syntax, it's much easier to write you, and trust the reader doesn't take it personaly.

 

The Banting memorial lecture of 2012 (Taylor) gives a good review of long term IR and its relation to T2D progression and regression. (Yes, there is good news.. for some  T2D is reversible, ). Here is the discussion, and it's all about fat accumulation in the liver and pancreas, which causes IR. This fat can be caused by excessive calorie intake . The solution proposed here is a low calorie diet

 

"During chronic positive calorie balance, any excess carbohydrate must undergo de novo lipogenesis, and this particularly promotes fat accumulation in the liver. As insulin stimulates de novo lipogenesis, individuals with a degree of insulin resistance (determined by family or lifestyle factors) will accumulate liver fat more readily than others because of the higher plasma insulin levels. The increased liver fat, signalled by rising serum ALT levels 23 in turn will cause relative resistance to insulin suppression of hepatic glucose production. Over many years the resulting hyperinsulinemia will increase further the conversion of excess calories into liver fat. A vicious cycle of hyperinsulinaemia and increased liver fat will become established. Fatty liver leads to increased export of VLDL triacylglycerol 24, which will increase fat delivery to the islets, with excess fatty acid availability impairing the acute insulin secretion in response to ingested food. Eventually the fatty acid and glucose inhibitory effects on the islets will reach a trigger level, precipitating clinical diabetes. Post-bariatric surgery, the whole mechanism could be thrown into reverse because of profound negative calorie balance. ."

 

Taylor spells it out more clearly

 

"Is long-standing Type 2 diabetes reversible? The Counterpoint study involved only people with short duration of diabetes. But we now know of many people reversing long-duration Type 2 diabetes (one person after 28 years) following either a hypocaloric diet or bariatric surgery 26,27.

 

"Is diabetes with normal BMI reversible? Yes: if you show me a person of normal BMI who has classical Type 2 diabetes, I shall show you a relatively fatty liver. This is most evident in people of South Asian ethnicity.

 

"Will diabetes come back? No, provided weight is kept down below an individual's personal fat threshold to trigger Type 2 diabetes.

 

Lots of people opt for high fat diets, because it helps lower their BG reading. Perhaps they might want to consider that they might be doing themselves harm by excessive calorie intake

 

 

ref  http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3593165/

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Kit

Hi

 

You might want to dial this back a notch.. I don't know anything about you.  If you want to know about your IR, do an oral glucose tolerance test [OGTT]. I used you in the sense of one, as in  "One can't increase what is not there.. That does not change the fact that one  has altered their  IR" but that is ugly syntax, it's much easier to write you, and trust the reader doesn't take it personaly.

 

No, you don't know much about me.  But when you make global statements like "High fat causes insulin resistance" you are applying that to everyone who is eating a higher fat diet, which includes me and everyone else here who is on a LCHF diet.

 

An OGTT test won't tell me anything other than that I am insulin resistant (which I have never said I wasn't).  My point is that I was quite insulin resistant before when I was on a low fat diet.  Since I have changed to a high fat diet, my numbers have drastically improved and I have gained more wiggle room in the carbs I can eat.  For example, I can eat beans now in small quantities as long as its not on a regular basis.  When I was first diagnosed, small amounts just once would cause my numbers to soar.  That does not sound like an increase in insulin resistance to me.

 

 

 

"Is long-standing Type 2 diabetes reversible? The Counterpoint study involved only people with short duration of diabetes. But we now know of many people reversing long-duration Type 2 diabetes (one person after 28 years) following either a hypocaloric diet or bariatric surgery 26,27.

 

"Is diabetes with normal BMI reversible? Yes: if you show me a person of normal BMI who has classical Type 2 diabetes, I shall show you a relatively fatty liver. This is most evident in people of South Asian ethnicity.

 

"Will diabetes come back? No, provided weight is kept down below an individual's personal fat threshold to trigger Type 2 diabetes.

 

 

I have a friend who was diagnosed as pre diabetic a number of years ago.  She had bariatric surgery.  She was told that after the surgery she wouldn't have to worry about her diet because she wouldn't be able to eat enough carbs in one sitting to cause any problems.  That turned out to be wrong.  She still can't eat rice or potatoes (even in small quantities), her numbers haven't really improved much, and she can only have 1/2 a slice of a low carb bread a day.  Even though she lost a significant amount of weight.

 

 

 

Lots of people opt for high fat diets, because it helps lower their BG reading. Perhaps they might want to consider that they might be doing themselves harm by excessive calorie intake

 

 

I eat a high fat diet.  I average around 70-75% of my calories a day come from fat.  I also average around 1500 calories a day and have a moderate/high activity level.  This is not a high calorie diet.

 

Lots of assumptions here.  Like the assumption that low carb diets are high in protein that is often made.  Assumptions annoy me.

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3flourmix

People forget that some measurements are taken as gospel but they can be Inferential measurements ie measure one thing and infer another.

 

I think cholesterol could be one of those because the issue is plaque build up - restricting blood flow and bits breaking off that can lodge somewhere causing stroke.

 

What has this got to do with this thread - it is the reason I take my heart specialist advice and do not do hi fat.

 

I am advised to not eat much cheese or processed meat.Should I listen to a poster or my Cardios.  

 

A life threatening problem if I choose the wrong advice. I already have a pacemaker.

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georgepds

No, you don't know much about me.  ....

 

I eat a high fat diet.  I average around 70-75% of my calories a day come from fat.  I also average around 1500 calories a day and have a moderate/high activity level.  ...

OK, so let me find out a bit about you... what's your LDL?

 

If it's under 60 mg/dl, you are assured you wont get CVD.

 

So, does your high fat lo cal diet lead to an LDL level that guarantees you won't get CVD?

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Kit

On 1/29/2014 (just diagnosed, still on a low fat diet) my numbers were

 

Trigs:  479

HDL:   31

LDL:    Not calculated

Ratio:  7.6

 

on 8/7/2014 (a little over 4 months on a LCHF diet) my numbers were

 

Trigs:   148

HDL:    42

LDL:    111

Ratio:   4.4

 

On 3/23/2015 (almost 1 year on LCHF diet) my numbers were

 

Trigs:   138

HDL:    44

LDL:     91

Ratio:   3.7

 

As you can see, my numbers have drastically improved, and I expect to see further improvement by my next checkup this fall.

I'd like to get my ratio down to around 2.

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georgepds

Hi

 

Thanks for the info.. LDL below 100 is considered good for the general population. Those with heart disease target <70 mg/dl. Myself I'm struggling to get it under 60. Two authorities  I follow ( Roberts, and O'keffe) state that LDL in the 50-70 range eliminate allmost all CVD (except in rare cases) . One reason to worry is CVD is the principal cause of mortality in T2 diabetics

 

The very low calorie diet you are following looks like it's working

 

 

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Kit

Well its not a very low calorie diet.  I'm a 40 something barely 5'1" woman.

1500 calories a day is just under maintenance for me.  I can easily gain weight on 2000 a day.  :)

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georgepds

....Fine. I got it. But what perplexes me (from what I have read) is that a low carb diet can induce insulin resistance. So this is where I need help. If Im insulin resistant hence the diagnosis.

 

Any type of explaination or suggestion would be great.

 

Here is an explanation that makes sense to me

 

"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"

 

http://high-fat-nutrition.blogspot.com/2007/10/physiological-insulin-resistance.html

 

Or to spell it out

 

low carbs => low insulin => activated lipase=>fatty acids release=> muscle IR

 

If there is no glucose to digest, then you need something to run on, and that something is fatty acids. Alas fatty acids mean high IR.Fatty acids disrupt the glucose uptake in muscle cells, hence high IR

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Kit

Its not just you.

 

You can quote as much research as you like, but it just doesn't match up to my experience or the experience of many of us here.

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Orlando

I have heart disease ....had heart attack and later quadruple bypass surgery etc.

 

I chose to follow the VLCHF diet ,starting a couple of years ago.

 

Here are my latest results.

 

Fasting blood glucose 81 mg/dl

 

Total cholesterol 131 mg/dl

 

Triglycerides 69mg/dl

 

HDL 62 mg/dl

 

non HDL 69 mg/dl

 

LDL 55.5 mg/dl

 

My cardiologist doesnt ask me what I eat, just goes by the results of scans and treadmill tests etc. ie theory to one side and factual test results to the other.

 

Low carb high fat seems to work rather well for me, at least in practice, and thats what counts in the final analysis.

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georgepds

Its not just you.

 

You can quote as much research as you like, but it just doesn't match up to my experience or the experience of many of us here.

You can have high IR and low BG,  just don’t eat any starches or sugars. 

Where does that fact contradict experience?

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