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Are elevated glucose and low insulin problematic ?

Answered on August 19, 2014
Created November 10, 2010 at 2:50 PM

I read somewhere that the combo of high glucose and low insulin may indicate that there isn't enought being insulin produced but (again) I can't seem to find the ref so if anyone has anything to share, please do.

My numbers (after a 12 hour fast) :

Insulin - below 2 (range 0-29,1 mE/L)

Glucose 5,5 mmol/L = 99 mg/dl (range 70 to 99 mg/dL (3.9 to 5.5 mmol/L))*

Fasting Blood Glucose

From 70 to 99 mg/dL (3.9 to 5.5 mmol/L) Normal fasting glucose

From 100 to 125 mg/dL (5.6 to 6.9 mmol/L) Impaired fasting glucose (pre-diabetes)

126 mg/dL (7.0 mmol/L) and above on more than one testing occasion Diabetes

388637efb09568e7c1e2527de2a8bfd5

on December 30, 2010
at 06:58 AM

Thanks for this. You are right. I got my A1C down to 5.2 with Primal and now (just in the last month or so) I can tolerate a higher level of carbs - all veg, some fruit, homemade yogurt, squash, etc, and my BG are still non-diabetic normal. Luckily for my beta cells I won't be testing their tolerance any time soon. I am certain that they will get every opportunity to recover to their fullest potential. :D

149af6e19a06675614dfbb6838a7d7c0

(3202)

on December 30, 2010
at 05:47 AM

Melissa, according to Dr. bernstein, if y will achieve normal BS...83 fasting and never over 120 after meals, your betas will rest and yor ability to maintain normal bS will then be easier. Damage is dne but sme will repair. You can have a normal healthy life with nrmal healthy BS. Cap that with Primal and yr results should be stellar. Welcome to the tribe.

A968087cc1dd66d480749c02e4619ef4

(20436)

on November 11, 2010
at 01:54 PM

Eva is correct. If you are really concerned, check BS before each meal and then at 1 hour and 2 hours post-prandial (after each meal).

4e40d2b9e1a762949a25b958762aa10d

(762)

on November 10, 2010
at 08:09 PM

I agree with Dave. Although decreasing carbs initially increases insulin sensitivity, in the long-term it would be expected to (and as Peter comments can) make one insulin resistant. However, insulin resistance only means Type 2 Diabetes in the context of a high-carb diet. If you are resistant to insulin that you rarely secrete, I don't see that as pathologic.

84666a86108dee8d11cbbc85b6382083

(2399)

on November 10, 2010
at 04:35 PM

99 mg/dl is very close 100 mg/dL which "is" Impaired fasting glucose (pre-diabetes). I'm not worried because of the glucose itself but just wondering if the combo of that and having a very low insuline level is an indicator of something.

84666a86108dee8d11cbbc85b6382083

(2399)

on November 10, 2010
at 02:52 PM

Paleo for 4-6 months, 20ish, Vit D @ 60 ng/mL, sedentary lifestyle.

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5 Answers

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3
A968087cc1dd66d480749c02e4619ef4

(20436)

on November 10, 2010
at 07:36 PM

"Are elevated glucose and low insulin problematic?"

Nope. In fact your numbers are excellent and typical for a low carb eater. For a complete analysis, I defer to Peter at Hyperlipid:

http://high-fat-nutrition.blogspot.com/2008/08/physiological-insulin-resistance.html

A LC eater has a FBG of 5.5mmol/l, technically pre diabetic, but blood insulin is 3.5 IU/ml. This is VERY low. Glucose is in very short supply but blood glucose is maintained by physiological insulin resistance, ie the muscles are full of triglycerides assembled from free fatty acids (NEFA) from lipolysis. The LC eater has breakfast, with enough protein from his eggs or particularly casein from his yoghurt to raise insulin from 3.5 IU/ml to 5.0IU/ml. This inhibits lipolysis enough to reduce NEFA in the bloodstream, intramuscular triglycerides fall and muscle insulin sensitivity returns. There's minimal glucose coming from the gut and so plasma glucose drops to between 4.0 and 5.0mmol/l, probably nearer 4.0mmol/l. It fluctuates between 4.0 and 5.0 after and between each LC meal. In the early hours of the morning there is a growth hormone surge and NEFA from lipolysis peak early morning to give insulin resistant muscles and an elevated FBG.

MEAN glucose over 24h will be in 4 point somethingish, HbA1c will be between 4 and 5%. INSULIN will probably average out around 5-10 IU/ml, averaged out over 24h. ... A high carb eater with FBG of 5.5mmol/l implies chronic hyperinsulinaemia, 24/7 and is looking for something to die from.

A LC, very high fat eater with a FBG of 5.5mmol/l implies they haven't had breakfast yet. They are not going to be hyperinsulinaemic at any stage. Unless they eat a bagel instead of their normal bacon and eggs that is. If they do this their blood glucose will hit 10mmol/l before insulin can shut down lipolysis and get the muscle accepting glucose.

It's NOT the FBG of 5.5mmol/l that matters. It's what that means about insulinaemia if you are eating a rice based diet. It's bad.

4e40d2b9e1a762949a25b958762aa10d

(762)

on November 10, 2010
at 08:09 PM

I agree with Dave. Although decreasing carbs initially increases insulin sensitivity, in the long-term it would be expected to (and as Peter comments can) make one insulin resistant. However, insulin resistance only means Type 2 Diabetes in the context of a high-carb diet. If you are resistant to insulin that you rarely secrete, I don't see that as pathologic.

1
62ed65f3596aa2f62fa1d58a0c09f8c3

(20807)

on November 11, 2010
at 06:10 AM

If you want to know, you could always try ramping up fruit intake slowly for a week until you are moderate carb, give the body some days to adjust, and then see where your fasting blood glucose is at. Might be an interesting expirement. I understand your concern. Blood glucose close to 100 at fasting and low insulin could be a sign of diabetes. Or it could be just as Dave suggests.

However, I think you need a lot more than those numbers at fasting to be in the danger zone for diabetes. Diabetes is not just about fasting blood glucose. Diabetes is also about what your blood sugar does after eating and where it is all day. My advice would be to do a 12 hour blood glucose curve and see how your numbers do all day in the morning, right after eating, between meals, etc. That will give you a much more accurate picture as to what blood sugar issues you may or may not have. Certainly, I have never heard of paleo giving anyone blood sugar probs, but then again, I have no idea if you ever checked your numbers before paleo either so we have little to compare them too.

A968087cc1dd66d480749c02e4619ef4

(20436)

on November 11, 2010
at 01:54 PM

Eva is correct. If you are really concerned, check BS before each meal and then at 1 hour and 2 hours post-prandial (after each meal).

1
0bc6cbb653cdc5e82400f6da920f11eb

(19245)

on November 10, 2010
at 04:01 PM

If you are worried about it go and see a doctor.

I am a little confused though as your glucose seems within the normal range? Having normal glucose after 12 hours without eating is usually a sign that your blood sugar is well regulated.

Normal ranges are there for a reason, not everyone will have a fasting blood sugar of 70 or 80 whatever they do, it is just natural variability. It seems you have similar fasting insulin levels to Stephen from wholehealthsource: What's the Ideal Fasting Insulin Level?.

84666a86108dee8d11cbbc85b6382083

(2399)

on November 10, 2010
at 04:35 PM

99 mg/dl is very close 100 mg/dL which "is" Impaired fasting glucose (pre-diabetes). I'm not worried because of the glucose itself but just wondering if the combo of that and having a very low insuline level is an indicator of something.

0
388637efb09568e7c1e2527de2a8bfd5

on November 10, 2010
at 04:10 PM

I had this issue in December of last year. I've been Type 2 since 2004, so when I asked for my insulin levels we were concerned when they were normal. As my BG was in the 300's at the time, it was indicative of my pancreas crapping out - according to my doctor. I never questioned it, I just used it as incentive to lifestyle my way to better health. I am tempted to have levels retested now that I am Primal, but I have a feeling that the damage is still there because my BG will rise at the least provocation, and I feel that speaks to continued beta cell damage. It is my greatest hope that some recuperating of that will happen, but as I plan to be Primal for life, and keep high-carb indulgence to a minimum, I don't worry overly much about it. I wish I had more information about it, but I just took my doctor at her word. It worked in my favor for getting back to healthier eating. :)

388637efb09568e7c1e2527de2a8bfd5

on December 30, 2010
at 06:58 AM

Thanks for this. You are right. I got my A1C down to 5.2 with Primal and now (just in the last month or so) I can tolerate a higher level of carbs - all veg, some fruit, homemade yogurt, squash, etc, and my BG are still non-diabetic normal. Luckily for my beta cells I won't be testing their tolerance any time soon. I am certain that they will get every opportunity to recover to their fullest potential. :D

149af6e19a06675614dfbb6838a7d7c0

(3202)

on December 30, 2010
at 05:47 AM

Melissa, according to Dr. bernstein, if y will achieve normal BS...83 fasting and never over 120 after meals, your betas will rest and yor ability to maintain normal bS will then be easier. Damage is dne but sme will repair. You can have a normal healthy life with nrmal healthy BS. Cap that with Primal and yr results should be stellar. Welcome to the tribe.

0
A8d95f3744a7a0885894ee0731c9744c

(3761)

on November 10, 2010
at 03:17 PM

What you're describing sounds like a pancreas problem....specifically: Type 1 Diabetes (or Type 2, I suppose. I assume you don't have Type 2 since you're on paleohacks...)

https://health.google.com/health/ref/Type+1+diabetes

http://www.mayoclinic.com/health/type-1-diabetes/DS00329

http://www.nlm.nih.gov/medlineplus/ency/article/000305.htm

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