George, you grasp of biochemistry is superb yet again.GeorgeN wrote:Could be physiologic insulin resistance (which is a good thing and to be expected). It is quite common with those on a VLC diet. In chronic low glucose situations, the muscles don't use the glycogen - it is saved for the brain. Standard advice for those on a VLC before they take an oral glucose tolerance test is to eat at least 150 g/carbs/day for 3 days before testing. These carbs cause to body to reduce or abandon the physiologic IR.LAC1965 wrote:My glucose/insulin situation is just strange. My fasting insulin is really low, often non-detectable, and my fasting glucose, provided I’m in ketosis, is in the high 60s. But I can’t tolerate any rapid acting carbs at all without huge elevations in glucose (similar to the effect that one would see in a type 1 diabetic).
Correct - LAC - if you are in ketosis for ages you WILL have a huge spike the first big carb load you ingest as your insulin will be "dormant" and needs to "wake up" again. This is called "physiological insulin resistance". Its not an issue and your response to a carbohydrate load after being in ketosis for ages is not predictive of your true insulin resistance whatsoever.
As George says, you need to re-feed 3 days before you can interpret carbohydrate response.