Stubborn Fasting Glucose

[kayakmac08]

Hello,

Has anyone else had a hard time getting their fasting glucose to drop into optimal ranges? For the last two months, I've been doing "everything right" (or so I assume; I could be missing something), but cannot get it to drop below 96, which is exactly what it was a year ago, when I was still eating like a college freshman (before my APOE4 wakeup call).

Ok, some context:

Since discovering my 4/4 status about two months ago, I began a regime of 12-16 hour daily fasting, low-carb/high-MUFA/PUFA dieting and 150+ min of cardio/week. I've held that pretty consistently for 6 weeks now, with the occasional allowance of high-glycemic food (1-3 snacks/week). Now, I'm in the process of getting all my baseline numbers in the domains recommended by the likes of Bredesen, Gundry, etc. And lo and behold, my fasting glucose (I know, by no means the most important of the forthcoming numbers, but still...) hasn't BUDGED.

What makes this all the more confusing is that 1) I fasted for 12 hours before the blood test and 2) My BMI is 21.75 (and has never been above 23, anyway). So, I'm just a little stunned that my glucose just hasn't been fazed.

Any wisdom or advice? Maybe I'm making too big a deal about this or barking up the wrong tree, or maybe it just takes longer than 6-8 weeks for a body to regain its insulin sensitivity (there's no doubt that from ages 0-30 I was pummeling the heck out of my pancreas with the amount of high-glycemic food that I used to eat on a daily--no, hourly--basis. Or maybe I'm missing a step in the insulin sensitivity protocols?

Anyway, appreciate any feedback! Thanks!

[floramaria]

Hello,

Has anyone else had a hard time getting their fasting glucose to drop into optimal ranges? For the last two months, I've been doing "everything right" (or so I assume; I could be missing something), but cannot get it to drop below 96, which is exactly what it was a year ago, when I was still eating like a college freshman (before my APOE4 wakeup call).

Ok, some context:

Since discovering my 4/4 status about two months ago, I began a regime of 12-16 hour daily fasting, low-carb/high-MUFA/PUFA dieting and 150+ min of cardio/week. I've held that pretty consistently for 6 weeks now, with the occasional allowance of high-glycemic food (1-3 snacks/week). Now, I'm in the process of getting all my baseline numbers in the domains recommended by the likes of Bredesen, Gundry, etc. And lo and behold, my fasting glucose (I know, by no means the most important of the forthcoming numbers, but still...) hasn't BUDGED.

What makes this all the more confusing is that 1) I fasted for 12 hours before the blood test and 2) My BMI is 21.75 (and has never been above 23, anyway). So, I'm just a little stunned that my glucose just hasn't been fazed.

Any wisdom or advice? Maybe I'm making too big a deal about this or barking up the wrong tree, or maybe it just takes longer than 6-8 weeks for a body to regain its insulin sensitivity (there's no doubt that from ages 0-30 I was pummeling the heck out of my pancreas with the amount of high-glycemic food that I used to eat on a daily--no, hourly--basis. Or maybe I'm missing a step in the insulin sensitivity protocols?

Anyway, appreciate any feedback! Thanks!

Hi, kayakmac, what you are describing is not unusual! I highly recommend that you check out the excellent Wiki on blood sugar; in the WiKi look for section 9.2. That will provide some information about why your FBG may be high.
Sometimes there are hidden carbs that are the culprit. I know if one person who was eating about a cup of cashews/day, thinking of them as healthy fats without realizing they are also high in carbs (almost 35 grams net). So having a careful look at your food intake can be helpful for troubleshooting. I like the free Cron-o-Meter website/app. If you track intake carefully for a few days, it might turn up some higher than expected carbs.
Time of day for testing can also make a difference in your reading , as can stress, sleep deprivation, and proximity to exercise.
Personally, though I have been keto-adapted for several years, I sometimes get FBG readings in the mid-upper 90’s for no reason I can identify. Perhaps the Adaptive Glucose Sparing that you’ll read about in the WiKi. When I started the ketogenic diet, it took several months for my markers to reflect the dietary changes. Maybe your body is still adjusting to your new diet, and the markers are just lagging your progress.
Best wishes to you. Keep doing everything right!!

[roxanne]

Hello,

Has anyone else had a hard time getting their fasting glucose to drop into optimal ranges? For the last two months, I've been doing "everything right" (or so I assume; I could be missing something), but cannot get it to drop below 96, which is exactly what it was a year ago, when I was still eating like a college freshman (before my APOE4 wakeup call).

Ok, some context:

Since discovering my 4/4 status about two months ago, I began a regime of 12-16 hour daily fasting, low-carb/high-MUFA/PUFA dieting and 150+ min of cardio/week. I've held that pretty consistently for 6 weeks now, with the occasional allowance of high-glycemic food (1-3 snacks/week). Now, I'm in the process of getting all my baseline numbers in the domains recommended by the likes of Bredesen, Gundry, etc. And lo and behold, my fasting glucose (I know, by no means the most important of the forthcoming numbers, but still...) hasn't BUDGED.

What makes this all the more confusing is that 1) I fasted for 12 hours before the blood test and 2) My BMI is 21.75 (and has never been above 23, anyway). So, I'm just a little stunned that my glucose just hasn't been fazed.

Any wisdom or advice? Maybe I'm making too big a deal about this or barking up the wrong tree, or maybe it just takes longer than 6-8 weeks for a body to regain its insulin sensitivity (there's no doubt that from ages 0-30 I was pummeling the heck out of my pancreas with the amount of high-glycemic food that I used to eat on a daily--no, hourly--basis. Or maybe I'm missing a step in the insulin sensitivity protocols?

Anyway, appreciate any feedback! Thanks!

Hi kayakmac08:

I, too, have high fasting blood glucose, and I've been eating this way for years. In fact, there have been times when I eat higher carb meals and my FBG does not budge. In fact my A1C is always higher than optimal. The less carbs I eat, the higher the A1C . I just decided it's the Adaptive Glucose Sparing that's at work here. I keep doing everything right, nonetheless, and try not to worry too much about the A1C or the FBG, as long as my insulin is low and the tests for Insulin Sensitivity are in the right range.

Perhaps your body needs more time to adapt, as floramaria says. Read the wiki on blood sugar and continue with your strategy. You are very young and will definitely learn a lot about how your body responds to the changes you are implementing. One step at a time is the best way to go, also take time to enjoy your life in the process.

Roxanne.

[Tincup]

Has anyone else had a hard time getting their fasting glucose to drop into optimal ranges?

Thoughts. Have you tracked your glucose before and 30/60/90 minutes after?

Have you tried extended (multi day) fasting and tracked your glucose to see what happens?

Per Peter Attia, in this podcast with Iñigo San Mílan (researcher and coach of this years Tour de France winner), Peter notes that when he does exercise at the Zone 2 level wearing a continuous glucose monitor, his glucose levels drop during exercise. He also notes he has a T1 diabetic patient who does 3 hours of Zone 2 walking daily in the evening and his insulin use is at 9 units a day. By comparison, I know a T1 who controls his blood sugar with a very low carb diet and an A1C of 4.75 who uses 27 units a day (considered very low). Zone two is defined as a serum lactate level of 2 mmol/L. An easier way get to the same place as Zone 2 without lactate testing is to follow Phil Maffetone's MAF approach. Peter interviews Phil here Phil's approach is here See the exercise part of his approach. I have a doc friend who has successfully followed the MAF approach for 20 years. He calls his training "loafing." He's also run 30 marathons under 3 hours.

San Milan notes this approach improves your mitochondria as well as increasing your ability to dispose of lactate when you exercise in a higher zone. Maffetone notes people who follow his approach typically can do much more exertion (faster) at the same heart rate over time. I think this is because of the adaptations San Milan talks about. In this article, the author talks about visiting San Milan's lab and what he learned about himself and what happened after he trained per San Milan's instructions.

I personally implement this using Phil's heart rate approach (I'm 65, so my MAF heart rate is 115 - I have no meds or other issues, so no additional discount). I just wear a monitor and will do anything keeping my rate between 105-115. This can include jumping rope, a fan bike (Schwinn Airdyne), fan rower, Nordic Track, TRX, Pilates Reformer, bodyweight, as in You Are Your Own Gym Never Gymless (currently $1), the list is endless. I have a programmable timer app and may set if to beep every 30 seconds, 1 minute or whatever and just alternate various exercises for 45 minutes to an hour, keeping the heart rate in the zone. I've noticed that a) my glucose does not increase after this exercise (though would for more exertion) and b) I can eat a 60 gram glucose (starch) bolus afterward (large for me) without any increase in glucose after 30/60/90 minutes.

This exercise activates a non insulin pathway to get glucose into the muscles.

Another non-insulin pathway is provided by intermittent hypoxia exercises. A T1 discovered this in himself and then went looking for research, like this paper: Hypoxia stimulates glucose transport in insulin-resistant human skeletal muscle - Azevedo et al. (1995) His website is excellent on breathing in general. I will typically end a workout jumping rope with an exhaled breath hold as long as possible, 5 times.

Nick is a 33 year old PhD scientist and an Oxygen Advantage breathing instructor on the side. He has many pearls in his weekly email.

Nick has found a lot of other breathing modalities that positively impact blood sugar - including slow breathing (4-6 BPM), cadence breathing and so on. Explore his excellent website.

{edit}

Determining your MAF HR
1. Subtract your age from 180.
2. Modify this number by choosing one category below that best applies to you:
a. If you have or are recovering from a major illness (including any operation or hospital stay), are in rehabilitation, have been prescribed any regular medication, or are chronically overtrained, subtract an additional 10.
b. If you are injured, have regressed or not improved in training (such as poor MAF Tests) or competition, get more than two colds, flu or other infections per year, have seasonal allergies or asthma, are overfat, are acutely overtraining, or if you have been inconsistent, just beginning or returning to exercise, subtract an additional 5.
c. If you have been training consistently (at least four times weekly) for up to two years without any of the problems mentioned in a) or b), no modification is necessary (use 180 minus age as your MAF HR).
d. If you have been training for more than two years without any of the problems listed above, have made progress in your MAF Tests, and have improved competitively, add 5.
The resulting HR is the high end of the HR range with the low being 10 beats below. For example, a 40-year old in category b) would have an exercise range of 125-135 bpm. Users can self-select any intensity within this range.
While the 180 Formula is best known for guiding aerobic exercise, initially it was for used for weight- and fat-loss. It soon became popular with athletes in virtually all sports to boost performance (including use with performance horses beginning in the early 1980s), and continues to help virtually all types of people monitor their heart rate. Success is demonstrated by increased fat-burning, improved health, and the ability of athletes to run, bike and otherwise perform at faster paces and increased power at the same MAF HR as determined by the 180 Formula.

.

[Family Tree Guy]

Hello,

Has anyone else had a hard time getting their fasting glucose to drop into optimal ranges? For the last two months, I've been doing "everything right" (or so I assume; I could be missing something), but cannot get it to drop below 96, which is exactly what it was a year ago, when I was still eating like a college freshman (before my APOE4 wakeup call).

Ok, some context:

Since discovering my 4/4 status about two months ago, I began a regime of 12-16 hour daily fasting, low-carb/high-MUFA/PUFA dieting and 150+ min of cardio/week. I've held that pretty consistently for 6 weeks now, with the occasional allowance of high-glycemic food (1-3 snacks/week). Now, I'm in the process of getting all my baseline numbers in the domains recommended by the likes of Bredesen, Gundry, etc. And lo and behold, my fasting glucose (I know, by no means the most important of the forthcoming numbers, but still...) hasn't BUDGED.

What makes this all the more confusing is that 1) I fasted for 12 hours before the blood test and 2) My BMI is 21.75 (and has never been above 23, anyway). So, I'm just a little stunned that my glucose just hasn't been fazed.

Any wisdom or advice? Maybe I'm making too big a deal about this or barking up the wrong tree, or maybe it just takes longer than 6-8 weeks for a body to regain its insulin sensitivity (there's no doubt that from ages 0-30 I was pummeling the heck out of my pancreas with the amount of high-glycemic food that I used to eat on a daily--no, hourly--basis. Or maybe I'm missing a step in the insulin sensitivity protocols?

Anyway, appreciate any feedback! Thanks!

Just my personal experience, but if you are measuring your fasting glucose first thing in the morning, your prior night's sleep will likely impact your numbers. When my kids were little, some nights I would get woken up in the middle of the night by them for some incredibly urgent emergency ("Daddy, I had a bad dream"). 8 continuous hours of sleep vs. 3.5 hours, interrupted, then another 3-4 hours definitely gave me different glucose numbers. At one point I researched this and there were some publications documenting this.

[cdamaden]

Me too. Have you considered the “dawn effect”? Measure your glucose before going to bed, assuming you haven’t eaten/drank in 3 hours. That might give you insights about sleep contributions too.

Hello,

Has anyone else had a hard time getting their fasting glucose to drop into optimal ranges?

Anyway, appreciate any feedback! Thanks!

Sent from my iPhone using Tapatalk

[TLS]

Even if you are fasting, if you are eating close to bedtime that can impact your glucose in the morning. I had that issue and once I switched to an earlier dinner my numbers went down.

I have also heard that eating saturated fat can cause some people to have elevated fasting glucose. We have other genes in addition to APOE 4 that may impact our ability to process saturated fat.

You may want to keep a log for a little while to see if there are any patterns.

Finally, when I get a standard blood draw I make sure I measure my fasting glucose to compare it to the blood draw results as a way to see if my meter is matching their results.

[SusanJ]

I have also heard that eating saturated fat can cause some people to have elevated fasting glucose.

Wondered about that, and found this meta-analysis:

Replacing 5% energy from carbohydrate with SFA had no significant effect on fasting glucose (+0.02 mmol/L, 95% CI = -0.01, +0.04; n trials = 99), but lowered fasting insulin (-1.1 pmol/L; -1.7, -0.5; n = 90). Replacing carbohydrate with MUFA lowered HbA1c (-0.09%; -0.12, -0.05; n = 23), 2 h post-challenge insulin (-20.3 pmol/L; -32.2, -8.4; n = 11), and homeostasis model assessment for insulin resistance (HOMA-IR) (-2.4%; -4.6, -0.3; n = 30). Replacing carbohydrate with PUFA significantly lowered HbA1c (-0.11%; -0.17, -0.05) and fasting insulin (-1.6 pmol/L; -2.8, -0.4). Replacing SFA with PUFA significantly lowered glucose, HbA1c, C-peptide, and HOMA. Based on gold-standard acute insulin response in ten trials, PUFA significantly improved insulin secretion capacity (+0.5 pmol/L/min; 0.2, 0.8) whether replacing carbohydrate, SFA, or even MUFA.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4951141/

Interesting, because like many, I concentrate on MUFAs, although given I'm eating flax, sunflower and pumpkin seeds, perhaps my PUFA levels are okay. Might have to put that on my next test list.