I am a T2 diabetic who has always managed to maintain a decent blood glucose and A1c by diet alone. I have low-carbed (more or less) for years.

I was widowed 18 months ago and found comfort in "comfort food" which sent my weight and my blood glucose skyrocketing.

Recently (last few months) my carbs have been around 50g net and I have lost some weight on that but I have not been feeling good. The last few weeks I have got more serious and decided to start testing my blood glucose again and got a nasty shock. My fastings have been anywhere from 111 (lowest) to 156 (highest) where previously they were maintained at around 90-ish.

I started LCHF following (I hope) Dr Fung's protocol, eating mostly only once per day, fasting 23/1. I am simply not hungry at all and find that eating "to satiety" means I only tend to eat around 450 to 550 kCal. for that meal. My total carbs have been running from 5 to 26g. I have used Ketone testing sticks to test my urine and they show a high level of ketones - 80mg/dl. I have ordered a blood meter and strips to do blood ketones, but that hasn't arrived yet.

My blood glucose is still running high. This morning was 125 despite eating almost nothing yesterday - about 2 ounces of beef steak and a few veggies (broccoli, about half a green bell pepper, a small scattering of green onion tops) all fried up in butter and with a small amount of grated cheese melted on the top.

I wondered if I did several short fasts - say eating dinner M-W-F - do you think that would help? Any other suggestions for getting my BG under better control?

I apologize for the mini-novel...

Edited to add a question: Anyone here use home made milk kefir on this woe? As I understand it, the bacteria in the kefir grains utilize the milk sugars and so the carb count of the milk is greatly reduced (by up to about 50% according to one site) I have made it using half milk and half whipping cream and it is delicious, so wondering if anyone had any thoughts on that, too?

Mary

So it seems you have only been very low carb for about two weeks? and even more recently added fasting? I can only suggest to give it more time...we read of amazingly quick successes but others do take longer depending on how long you have been diabetic, how LC, etc. There are two threads below this on the same topic.
Please watch Dr. Westman's new Vail talk on Diabetes...he has a range of clinical cases in the last half of it. http://www.dietdoctor.com/member/pr...ns/westman-vail You have to join to see this talk, first month free, easy to un-join but this site has many good presentations and worth the $9.

As long as you are monitoring your BG to be sure you do not go too low, I would think you could try a longer fast IF you can comfortably do it. if you wake-up the second day very hungry, eat and try for longer another time. I eased into fasting, and vary it often. You have to see if it will help your BG, everybody's different. Other ideas...have you added exercise, fiber and vinegar?

I have read the same about kefir and yogurt. In the US it is the carb count of the ingredients put on the label, not the carbs in the ultimate product. And fermenting at home depending on time, etc will result in different carb outcomes. Half was an estimate.

Hi Mary!

I'll let the fasters weigh in, but keep in mind that fasting may not work for you. Anytime I've given it a go my baseline BG has gone up - way up - and I've felt just plain terrible. But loads of people swear by it so by all means give it a chance.

Are you testing the foods you're eating? Even LC foods may impact your BG in ways you don't expect, so make sure you're watching how your meals impact your BG. (For instance, I have trouble with chocolate and tomatoes, in any quantity and variation. Irritating!)

Satiety is a great benefit of LC, but yes, it can be a problem if you stop wanting to eat. The effects you are feeling may be temporary, but they may last - they do for me. I don't eat a lot of calories myself, but I spread three smaller meals across the day and that makes it easier to take in the quantity/quality I need to fuel my body.

Are you exercising? If not, now is a good time to start. You might find you need that more than you did in the past.

I'm so sorry for your loss, and that you are struggling with your BG again. Hopefully with some trial and error you will be back to full health very soon!

Janet: Yes, I have only been doing really low carb for just over 2 weeks. Prior to that I was eating around 50 net grams per day.

Fasting was actually just an incidental side effect of the lowered carbs. I am just not hungry. When I do eat I really don't want very much and feel satisfied with very little.

I don't do much formal exercise, even less since I broke my leg 3 weeks ago. I have a small farm, so I am pretty active, though. I haven't added either extra fiber or vinegar. I will try them. I think I may try the kefir again, as I have also read that it helps keep the "good" gut bacterial populations high, and that can also make a difference in both blood glucose and weight.

JuliaR: No, I haven't tested my foods. Perhaps I need to. This is like learning all over again - I thought I had it all figured out.

I used to do Leslie Sansone's "walk away the pounds" but sort of let it go...

Mary

Hi Mary -

I've been doing IF for almost a month now, and it did take a while to get my BG down. But I'm eating two meals most days & fasting 16-18 hours. And for me, those meals have to be breakfast & lunch - I can't eat much in the evening without my FBG going up. A little lchf snack seems to be OK sometimes, but a full meal messes me up. It seems that any little deviation makes my BG go up & it takes a few days to come back down.

You didn't mention how old you are, and that can make a difference in your BG control.

Mary,
Only eating when hungry has always been Dr Westman's advice, he just didn't call it intermittent fasting. Not being hungry when you lower the Carbs way down is common, then appetite returns but it is not those raging cravings that happen when eating refined carbs. Not being hungry is how he tells you are doing the clinic diet correct for your first return visit. I was following the Atkins book with 3 meals and a snack when I went to my first local support group and heard many others were eating only one meal or a meal + snack. moment for me! Watch all his videos courses on DietDoctor and you will be reassured...the clinic results indicate a range of times for people to see lower FBG. Here's another older TV story about two patients. Janet is a good friend (same name, not me ) and she has a coffee when she gets to work, about 2 pm a small LC snack, and being a good cook, makes herself a nice dinner in the evening or eats out. BG still under control but she stays under 20g.
http://www1.cbn.com/cbnnews/healths...d-Cure-Diabetes

From the article:

That's what "scared me straight," knowing someone with both legs amputated. When I realized that medications I could afford had side affects I couldn't tolerate I got very serious about the diet. But I've had messed up eating for years - this isn't easy. Even sugar-free treats can cause problems for me. Sometimes I feel like a toddler mid-tantrum - I want goodies now! But I can't have them, unless I'm willing to see my BG go up & the struggle with the food get more difficult. Having indulged myself for so many years, self-discipline is not easy.

I'm sort of way of 'net' carbs.

It depends, really, what they're net of. Net of fiber naturally occurring in food (so, you know, the fiber in spinach etc) - probably fine.

Net carbs in manufactured foods? That never works for me. And what I've found, actually, is that it's deceptive in regards to blood sugar. It slows down the initial spike, but raises my overall blood sugar over time.

Beyond that, though, it just takes a while for some people. If I've been off low carb for any more than a meal, it'll take a couple of days of (very) low carb to get my FBS down into the low 100's.

But getting lower than that takes much longer. Weeks.

I'd note that FBS is sort of deceptive for me. My highest BS reading is usually my morning fasted (hello dawn phenomenon) - my through the day fasted (I only eat twice, so I get to a at least semi fasted state) is always lower.

Working out pretty hard will drive it down faster. The caveat there being that any workout hard enough to help me will cause a blood sugar spike an hour or two after, which if you're not aware that will happen can make you think something weird is happening.

Mary, there is another thread in General LC about Dr. Westman's diet. Just today posted the story of another friend from that group. It is a short 5 page article placed in a medical journal from both the perspective of patient and physician. She doesn't mention her BG but I know she monitors is closely. One photo is from her Mom's funeral, with T2DM, she was her primary caregiver for years.

From Lynne Daniel:
Eric C. Westman, MD, MHS and I recently co-authored a paper that has been published in the medical journal, Advances in Therapy. We wanted to let you know that our article is fully accessible online, so it is free for anyone around the world to read and download (no subscription or pay-per-view fees).
Please help us spread the word about this article by sharing with those who may find it helpful (friends, family, colleagues, healthcare providers, etc.). Please share it with anyone who may be questioning LCHF as a viable therapy and a sustainable way of living. Please share it with anyone who is questioning what you are doing, why you are doing it, and how it works.


Download .pdf from here: http://link.springer.com/article/10...2325-016-0334-5

It took a long time (or at least it seemed that way) to get my BG's, at any time, down below 120. I was very strict, no tomatoes, carrots or any veggies slightly higher in carbs. My FBG was always the highest of the day. By the time I started concentrating specifically on that, I had been very strict for a while. So you may just need more time.

I did try many things to get my FBS down under 100. I had some success with r-ALA and evening primrose oil which are recomended by Dr. Berstein, but those caused a skin rash for me so I stopped using them. I did the vinegar before bed for a while, but finally couldn't stomach it.

Finally, I tried IF 16:8 with just fat in my coffee in the morning and broth for lunch and a regular dinner. Doing that a few times a week seems to keep my BG's including FBG under 100 and sometimes in the 80's. If not IF'ing, I eat 3 meals and sometimes an afternoon snack if I can't make it until dinner. Eating lettuce and celery seem to help too.

I do take metformin in addition to diet. When I have tried to stop, I see a 5-10 point rise in my BG's. Since I tolerate it ok, I'm willing to keep taking it for the assist it gives me.

Anyway, that is my experience.

I wonder if that broken leg isn't throwing things off a bit? That seems like a pretty major possible confounder.

With kefir, and other fermented milk products--that sort of depends. If somebody had type 2 and wasn't ready to go low carb, things like kefir or yogurt or the fiber in beans could make a big difference, because they do tend to decrease the glycemic response. A meal of beans and kefir would likely be an improvement over a plate of spaghetti. Once you're low carb, though--kefir added to a meal might be better than some other carbohydrate sources, but it's still adding carbs to the meal. It's possible it would still have a positive effect outweighing its carbohydrate content, but I don't think we know that for sure. Even the "used up" sugars--are still largely present in the form of lactic acid, this is probably what improves the response to carbohydrate in the diet--but in the context of very low carb, lactic acid is potential raw material for synthesis of glucose.

Doreen (forum founder) started a thread here from 2003 looking at lower carb claims for yogurt;

http://forum.lowcarber.org/showthread.php?t=138905

Showing that the decrease in carb content of fermented milk products by as much as 50 percent is probably an overestimate. One thing she mentions is that getting past 30 percent, the stuff would start tasting pretty bad.

Dr Bernstein allows yogurt--but he says to count all the "carbs" that show up on the nutrition label, no discount for lactic acid.

Thanks everyone.

Well my BC this morning was 94, so getting better. It was down to 75 last night before bed.

My net carbs are virtually all from "real" food. I almost never eat anything processed. I raise 100% of my own meat and generally about 85% of my veggies which are raised more or less organically. Almost all my "canned goods" were canned by me and came from my own garden. Pretty much everything else I buy from people whose practices I know (small community). However, I will now just count total carbs as recommended by Dr Fung.

The broken leg may have something to do with it - the body uses up a lot of energy when doing major repairs.

I did have about 4oz of plain kefir (home made with half milk, half heavy cream) and checked my BC after half an hour and an hour and it went from 80 to 84, so it would seem that it made little difference in that small amount. Also that had been in the fridge for 3 days so may have gone through a secondary fermentation. I have no real way of knowing that. I will follow that link to Doreen's thread. Thank you.

Janet: that link is broken. Came up as a "page not found"

Bonnie: I am 69. I am usually pretty active as my little farm keeps me busy.

Edited to add: Kefir (at least mine) is rather tart. I like it that way. Many people add fruit and/or a sweetener such as honey or maple syrup for that reason. I am not sure whether Doreen was saying that very fermented yoghurt is *really* too tart to be palatable or too tart for the palate of people who are used to sugary sweet product.

Wow, Mary, you're doing well. I'm not taking meds now & the lowest I can get my BG is 85. And that's with vlc & fasting. Generally it's higher than that.

Mary, here's the link: http://link.springer.com/article/10...2325-016-0334-5

Thanks Janet. That is an interesting article. I have not had time to read it in depth, but will do so later today.