1

votes

High A1C, FBG after 8-month EXTREME LC diet

Answered on August 19, 2014
Created August 15, 2012 at 12:18 PM

Frustration...

I recently had a very bad reaction to a series of Hep B vaccine - bad polyarthritis, eye, ear problems, dizzy, etc etc. I had no insurance at the time (pre-Medicare) so I went on an elimination diet for it. In Feb of 2012, I ended up cutting out all sugar, ALL grains, most fruits and vegetables. After the third shot, (dumb, I know...) I was so sick that I even had to give up all fruit for awhile. Now I can have berries, pears, and peaches -just for breakfast.

I lost over 50 pounds in just 2 months.

No diabetes anywhere in my family. But I recently had my first Medicare tests, and my A1c is 6%. My FBG is 87 mg/dl. (I even had some ketones in my urine)

My Dr. tells me I'm Pre-diabetic. She knows exactly what I eat; she knows I just lost 60 pounds, yet she simply gave me a handout telling me that I had to lose weight and "cut down" on sugar.

This bit of allopathic "Wisdom" is why I'm here.

These results simply can't be accurate. I've read that LC can cause high FBG. But what about the A1c?

Thanks!

B3173217a49b5b0116078775a17eb21d

(11488)

on August 16, 2012
at 10:04 AM

Root veggies, (non-berry) fruits and sweet-potato chips aren't going to do your (pre) diabetes any favours. Reducing your carb intake is much more important than cutting your protein.

F1e5ff10797e0e35cda081a4221cb614

(346)

on August 15, 2012
at 11:32 PM

One thing that seems to happen with some people who start on an LC diet is an increase in circulating growth hormone (GH), especially if they do weight training. The effect is a little bit like the effect of GH replacement therapy. Insulin resistance sets in, probably in body fat and muscle cells, leading to higher than normal blood glucose levels (and A1C’s). This situation tends to normalize after a while, but can last months, eventually leading to a significant improvement in insulin sensitivity.

5e92edc5a180787a60a252a8232006e9

(345)

on August 15, 2012
at 11:10 PM

Very intriguing, Ned. But given his Medicare status, don't you think it's progressive T2 diabetes at work, which can still catch you unawares as you get older and your remaining beta cells lose functionality, even with a very low carb diet with few breaches above, say, 140?

5e92edc5a180787a60a252a8232006e9

(345)

on August 15, 2012
at 11:08 PM

Ned's comment below seems to be intriguing. If he's right, your trigs should be low and HDL should be rising. They probably are since you lost 60 lbs. Are you doing glycogen-depleting exercises? Fast intermittently? Another possiblity is that given your age (65), you may have burnt out much of your beta cells from past excesses, notwithstanding your recent turnaround. 1/3 of all senior citizens are diabetic. Diabetes is progressive but it could also be that it's due to growth hormones, if you do GD exercises.

5e92edc5a180787a60a252a8232006e9

(345)

on August 15, 2012
at 10:54 PM

That's only for physiological insulin resistance and shouldn't affect A1c. His fasting is fairly good at 87 but his A1c is a bit elevated at 6, interpreted by some to be prediabetic. If carb sensitivity was causing this, his FBG would be somewhat high while his A1c would be normal.

211d4075d68b24cd0aa7ebfa94262bb9

on August 15, 2012
at 06:00 PM

...which has nothing to do with it be insulinogenic.

E8bf28bd28f5be7c34d4a1a97e7c1353

(253)

on August 15, 2012
at 03:58 PM

yes but when carb intake is very low, excess protein is converted into glucose which raises blood sugar accordingly.

510bdda8988ed0d4b0ec0b738b4edb73

(20888)

on August 15, 2012
at 03:10 PM

A1C is sugar related, not insulin related.

1edb06ded9ccf098a4517ca4a7a34ebc

(14952)

on August 15, 2012
at 02:27 PM

that's what I was going to write. There's seriously little/to no need for muscle meat unless you're highly physically active.

F48250756d4fa84784f5d1215343a929

(5)

on August 15, 2012
at 02:01 PM

Thank you for all that. I was wondering about the protein. I do eat too much of it, because there are so few other things that I CAN eat. But it's getting a little better lately. I can now have root veggies, more fruits, and a few sweet potato chips. I was also considering a glucometer. (Ouch.) I'll do it.

  • F48250756d4fa84784f5d1215343a929

    asked by

    (5)
  • Views
    3.1K
  • Last Activity
    1432D AGO
Frontpage book

Get FREE instant access to our Paleo For Beginners Guide & 15 FREE Recipes!

6 Answers

4
510bdda8988ed0d4b0ec0b738b4edb73

(20888)

on August 15, 2012
at 03:17 PM

Chris Kresser has a good piece on this. The basic point is that A1C is just a measure of the fraction of blood cells that are "runined" by sugar. The rate of reaction of ruining the blood cells goes up as blood sugar goes up. However, as blood cells die, they get cleaned up and don't show up any more. So you have two competing rates: the rate at which you create bad blood cells minus the rate at which they die and get cleaned up.

Generally we assume that a blood cell live like 3 months or so. So when we say an A1C of 5 is bad, that means that we don't like having 5% of the current living blood cells to be ruined by the sugar. If the assumption is that blood cell life is constant, then higher blood sugar is directly related to higher A1C. But what happens if the average blood cell life expands? That means the ruined cells live longer to be measured and the A1C can go up from that case too.

So it's totally possible to be LC with low sugar concentrations which results in slow A1C growth, however the blood cells could live longer giving a higher A1C number.

I answered a similar question here, with I think a better answer: http://paleohacks.com/questions/91583/glucose-fructosamine-and-a1c/108831#108831

And here's what Chris Kresser says about it: http://chriskresser.com/why-hemoglobin-a1c-is-not-a-reliable-marker

2
E8bf28bd28f5be7c34d4a1a97e7c1353

(253)

on August 15, 2012
at 01:55 PM

Many people here forget that protein can be just as insulinogenic (sometimes more-so) as carbohydrate. This could be part of the reason for your high a1c and fbg.

1edb06ded9ccf098a4517ca4a7a34ebc

(14952)

on August 15, 2012
at 02:27 PM

that's what I was going to write. There's seriously little/to no need for muscle meat unless you're highly physically active.

510bdda8988ed0d4b0ec0b738b4edb73

(20888)

on August 15, 2012
at 03:10 PM

A1C is sugar related, not insulin related.

211d4075d68b24cd0aa7ebfa94262bb9

on August 15, 2012
at 06:00 PM

...which has nothing to do with it be insulinogenic.

E8bf28bd28f5be7c34d4a1a97e7c1353

(253)

on August 15, 2012
at 03:58 PM

yes but when carb intake is very low, excess protein is converted into glucose which raises blood sugar accordingly.

1
F1e5ff10797e0e35cda081a4221cb614

on August 15, 2012
at 08:14 PM

Strength training plus fasting regularly, and becoming diabetic!? No, it is just compensatory adaptation at work

http://bit.ly/jh9wcm

5e92edc5a180787a60a252a8232006e9

(345)

on August 15, 2012
at 11:10 PM

Very intriguing, Ned. But given his Medicare status, don't you think it's progressive T2 diabetes at work, which can still catch you unawares as you get older and your remaining beta cells lose functionality, even with a very low carb diet with few breaches above, say, 140?

F1e5ff10797e0e35cda081a4221cb614

(346)

on August 15, 2012
at 11:32 PM

One thing that seems to happen with some people who start on an LC diet is an increase in circulating growth hormone (GH), especially if they do weight training. The effect is a little bit like the effect of GH replacement therapy. Insulin resistance sets in, probably in body fat and muscle cells, leading to higher than normal blood glucose levels (and A1C’s). This situation tends to normalize after a while, but can last months, eventually leading to a significant improvement in insulin sensitivity.

1
11838116de44ae449df0563f09bd3d73

(655)

on August 15, 2012
at 01:09 PM

Look at Dr. Rosedale's site. He would probably say you're going to need to reduce the amount of protein per meal. The vaccine reaction makes knowing what's going on tough. But your A1c will probably improve over time. I suggest you get a glucometer.

F48250756d4fa84784f5d1215343a929

(5)

on August 15, 2012
at 02:01 PM

Thank you for all that. I was wondering about the protein. I do eat too much of it, because there are so few other things that I CAN eat. But it's getting a little better lately. I can now have root veggies, more fruits, and a few sweet potato chips. I was also considering a glucometer. (Ouch.) I'll do it.

B3173217a49b5b0116078775a17eb21d

(11488)

on August 16, 2012
at 10:04 AM

Root veggies, (non-berry) fruits and sweet-potato chips aren't going to do your (pre) diabetes any favours. Reducing your carb intake is much more important than cutting your protein.

1
0a0afca93a127c82ec4192a2e99647f4

on August 15, 2012
at 01:02 PM

This is a recurrent issue within paleo-LC circles. At one time, I would've considered this impossible. After all, LC is supposed to be a virtual cure-all for T2D...so it certainly should NOT make blood sugars worse. But a few years ago, on one of the LC forums, a guy announced he'd just been diagnosed as a T2D after 7 years on Atkins. Since then I seem to keep hearing of folks ending up with high blood sugars after a time on VLC. Folks say that's "normal and ok" (Peripheral insulin resistance to ensure brain gets first-dibs on glucose) within the context of LC diet, but I'm not so sure.

0
F9638b939a6f85d67f60065677193cad

(4266)

on August 15, 2012
at 04:35 PM

All you have to do is eat a little more carbs (150-200g a day) a week before a blood test so that your numbers will fall in the normal range on the test. The lab numbers are somewhat arbitrary and don't take into account all the complicated processes the body does in response to carb restriction. They're based on "normal", whatever the heck that means. If you had eaten higher carb for a week before the test you would have gotten a clean bill of health, not a diagnosis of pre-diabetes.

5e92edc5a180787a60a252a8232006e9

(345)

on August 15, 2012
at 10:54 PM

That's only for physiological insulin resistance and shouldn't affect A1c. His fasting is fairly good at 87 but his A1c is a bit elevated at 6, interpreted by some to be prediabetic. If carb sensitivity was causing this, his FBG would be somewhat high while his A1c would be normal.

Answer Question


Get FREE instant access to our
Paleo For Beginners Guide & 15 FREE Recipes!