Hi can anyone offer some advice. Been on a low carb diet for 4 months and lost 14 pounds. When I say low carb I mean no bread, pasta, patatoes, pizza, cakes, biscuits etc, about 30g carb per day or lower. I’m about 6 foot 1 with a BMI of 14. Had fish and nuts for lunch and fasting blood sugar was 7.2 at half six in the evening. This is the first time I have tested since cutting out the carbs.Why so high? Is it possible to not eat enough? Is it a liver dump meaning my hba1c is going to be high, was 6.8 at last test Any advice would be appreciated…..

you need to do you fasting blood sugar before breakfast, 6.30 is only about 5 or 6 hours after lunch. You will get a better result if you have gone 10 or 12 hours, but dont forget to have a small snack (cold meat or something light) before bed to prevent the ‘dawn phenonomen’. I think your BMI measurement is a bit out too, normal BMI is around 23, 14 is the BMI of a small child. How much do you weigh, put it into a BMI calculator.

Ooops sorry you’re right…..Body fat is 14%…….Thanks for the reply

Even that doesn’t sound right unless you are really thin. The average body fat for a man is between 18 and 24% so you must be really on the low side. Is it rude to ask how much you weigh.

At 66, my GP is wanting me to take statins, and refers me to the NICE cardiovascular risk calculator. This appears to be over-sensitive to the presence of diabetes, and have very low sensitivity to cholesterol ratio, BMI and systolic BP. So I thought “get the blood glucose down”. My HbA1C is good at 28, due to a low-carb diet for 5 years, so nothing occurred to my GP. I bought a meter, and was surprised to get morning fasting figures around 6.7, with the occasional 7.1 or 7.3 and very occasional 7.8. Searching the Web, a lot of people say “subtract 10% from finger-stick capillary readings to get equivalence with from-the-arm and sent-to-the-lab”. But even doing that, it would make me a high-end pre-diabetic. I work 12 hours a day sat at a computer, but do HIIT 3 times a week. Experimentation showed that a 3-egg breakfast would raise BG between 0.1 and 0.4. Adding 80gm. blueberries with 30gm. linseed and full-fat milk raised it by 4.0, both 1 hour after eating. So now I restrict blueberries and an apple, to lunch time after my muscles have worked a bit and can react to insulin by storing glycogen rather than letting the liver do that. Live yogurt replaces milk, to halve the lactose. If I walk 10 minutes after dinner, I can keep fasting between 6.2 and 6.8. I suspect intra-abdominal fat, and am losing weight. When bad weather prevents, doing 50 crouch-stands a day seems to work, provided 20 of them are around dinner time.

At 66, my GP is wanting me to take statins, and refers me to the NICE cardiovascular risk calculator. This appears to be over-sensitive to the presence of diabetes, and have very low sensitivity to cholesterol ratio, BMI and systolic BP. So I thought “get the blood glucose down”. My HbA1C is good at 28, due to a low-carb diet for 5 years, so nothing occurred to my GP. I bought a meter, and was surprised to get morning fasting figures around 6.7, with the occasional 7.1 or 7.3 and very occasional 7.8. Searching the Web, a lot of people say “subtract 10% from finger-stick capillary readings to get equivalence with from-the-arm and sent-to-the-lab. But even doing that, I would make me a high-end pre-diabetic. I work 12 hours a day sat at a computer, but do HIIT 3 times a week. Experimentation showed that a 3-egg breakfast would raise BG between 0.1 and 0.4. Adding 80gm. blueberries with 30gm. linseed and full-fat milk raised it by 4.0, both 1 hour after eating. So now I restrict blueberries and an apple, to lunch time after my muscles have worked a bit and can react to insulin by storing glycogen rather than letting the liver do that. If I walk 10 minutes after dinner, I can keep fasting between 6.2 and 6.8. I suspect intra-abdominal fat, and am losing weight. When bad weather prevents, doing 50 crouch-stands a day seems to work, provided 20 of them are around dinner time.

Thanks for the reply Mr A, sounds like you are on top of your HbA1c. I was surprised at the fasting value I tested, but the advice Im getting is my liver may be being raided as I hadn’t eaten all day. Im on top of my diet and sometimes just dont feel hungry……so nave a handful of nuts here and there. Not gonna test again as to be honest there isnt a great deal more I can do. I run, train at the gym, walk and not had any heavy or starchy carbs for months apart from a pint on a Friday so gonna wait for my next HbA1c in March…….perhaps Im just destined to remain on medication!!!!

Steven, you are not doomed to be on meds for life. Most people here are speaking from experience (in the sense we are diabetic too). I have reduced my HbA1c from 8.2 to 6.9 and that change happened 6 weeks into the diet, I am now at 5.9 and have reduced my meds dramatically from 38 units of insulin to 22 and got rid of one third of my glicazide. There are lots of people here who have stopped Metformin and not many of us take any notice of our doctors. Sometimes it is possible not to eat enough and your liver is pumping our glycogen (as you say, liver dump or the Dawn Phenomenon). Are you getting enough fats and protein in your diet, do you have Dr M’s book, are you following this plan or something else. Try to eat a full and varied diet (minus the bad carbs) and make sure you eat regularly, nut just a handful of nuts.

I have reached a certain weight right now and my body does not seem to want to lose any more but I can find faults in my diet when I look carefully, i.e. portion size, snacks getting more often and bigger, too much alcohol at weekends all mean I do well then spoil it for a treat. It is not an easy journey but much more promising than the alternative. Keep going and keep asking question.

Steven, I think its worth pointing out that a number of diabetes specialists, going back to Dr. Atkins, believe that the Beta Cells in the pancreas (in English, islet of Langerhans) become exhausted or diminished in number over a number of years of undiagnosed diabetes. When they are not called upon to produce ever increasing quantities of Insulin, they recover so that the Insulin output per unit of glucose in the blood rises again. So given enough time, you should be able, if you stay on a low-carbohydrate diet, to give up your medication. The extra concepts of a “fatty liver” or “intra-abdominal fat” complicate the recovery process. When my GP wanted to diagnose me as diabetic in 2002, I gave up beer for good, but for many years I drank 21 units of red wine per week, with my evening meal, and still drink 14. I kept passing glucose-load tests and had a lowish HbA1c, but nevertheless developed early diabetic retinopathy. That scared me so much that I lost 1.5 stone, walked every day, and switched to a strict low-carb diet, whilst up to that point I had just eaten more meat, cut out the more obvious heavy carbs like rice, potatoes and bread, and walked a lot more. I got down to 40 gms. carbohydrate a day, and the retinopathy disappeared. Then when I started HIIT two years ago, my blood-pressure dropped a lot, and initially my HbA1c dropped to 22 from 27. Then I suspect my brain did not like the low glucose after running, so it tricked me into increasing the fruit, and HbA1c rose to 28. I think I have intra-abdominal fat, and if I should ever get injured so I cannot run, then diabetes would be a problem again. So I need to lose that last stone. A number of specialists say it is important to reduce the glucose spikes after meals, at least to avoid retinopathy and related conditions. It may even be that doing that allows the pancreas to recover more quickly. So I try and do that. I get a retinal photograph every year, which showed very marked and continuous improvement. Last year they found a couple of dots in my right eye, but they think the retinopathy is so slight that it might disappear by the time of this year’s photo.
So I think you just need some patience. I would drop beer in favour of wine.

Thanks Mr A, thats a great reply with some useful tips…..patience is something I need to practice!

Saw my doctor on Monday and she is very pleased with my progress.
Am now starting the sixth week of the diet.
Have lost 15 pounds – from 13st 9 to 12st8.
Have reduced insulin from 36units to 12.
Glucose levels steady, mainly between 5 and 8.
My visceral fat level is at 13, which is within desirable range (just)
My ultimate goal is to reach 12 stone and come off insulin injections.
Any advice for my last 2 weeks?

Follow up.
My last two blood tests are quite high – 9.2 and 9.6. Hve increased insulin by 2 units. Quite worried.

I too have high fasting blood sugar level (6.8) despite losing 3 stone in 3 months on the BSD followed by 5:2. I was told I was prediabetic before xmas. My HbA1C has dropped (from 44 to 38) but cholesterol not changed at all, still 7.2, although triglycerides are improved. I am really depressed about this as I had hoped to avoid a diagnosis but GP just told me I am diabetic. She didn’t understand why I was upset and disappointed. Any suggestions how to improve fasting blood sugar levels anybody? Please.

Fast BG taken in the morning can be high due to liver dump. Try having a snack before bed, something counted in your calories and BSD friendly, recommend slice of cold meat or 2 oz of chicken or a boiled egg. I should stop the Dawn Effect.

Sperando, I dont know how you have reduced insulin from 36 units to 12, if you have 2 weeks to go then you have only been doing this for 6 weeks. Don’t believe all the hype surrounding this diet. If you have only just been diagnosed or have had diabetes for a short time you could possibly reverse it in 8 weeks but for most of us it takes a lot longer, just like losing the weight cannot always be super fast. Also, that prospect is for people who have been diagnosed and not put on medication but been able to try this dietary plan first. Not people who are on highish doses of insulin. I have been on this plan for 8 months and have got my HbA1c from 8.2 to 5.4 but I am still on 22 units of insulin, I started on 38 units. I would rather do it slowly than see my BG go back up again. If you reduce too quickly you will only see it shoot up again. The diet will give you days when it is lower but that is only a moment in time, you can only judge accurately by having the HbA1c test to cover a 12 week average.

Thanks sunshine-girl, I will try some protein b4 bed and see if that helps with morning BS level. Will also go back on BS diet for another 8 weeks and try to increase my activity levels further (easier said than done as I have arthritis and bad hip). Hopefully losing remaining visceral fat and doing more exercise will improve insulin resistance.

Thanks for advice sunshine-girl. My last three blood tests have been 5.4, 6.4, 6.7 and my last insulin injections were all 12 units morning and night. However, I am a bit worried that when I ease myself off the diet my glucose levels will shoot up. I don’t fancy being on the BSD for the rest of my life!

sperando, you are right to give yourself some wriggle room, there is always that party, glass of wine or slice of cake around the corner. Now I am officially down to 5.4 I am going to reduce from 22 to 21, I will leave it at 21 for maybe a week, if bg stays down I will reduce more, if not I will either leave it for a while or go back to 22. I would rather have the low BG with more meds than risk getting high readings again. When I started this I never expected to be off insulin for at least a year, coming into my 9th month now but have 2 holidays in the next month, a week in spain with family then a cruise, all inclusive, so I might just stick where I am for now.