Keto Diet: How Long Until Blood Sugar Stabilizes?

The ketogenic diet is a popular lifestyle choice for those looking to lose weight, manage their weight, or improve their overall health. The diet involves consuming 70-75% of daily calories from fat, 15-20% from protein, and 5% from carbohydrates. While many people have seen success with the keto diet, some have been surprised to find high levels of glucose in their blood. So, how long does it take to see glucose improvement on a keto diet?

• Exercise: Physical activity increases insulin sensitivity, which can help regulate glucose levels.
• Sleep: Getting adequate sleep is crucial for maintaining healthy glucose levels.
• Stress: Prolonged stress can raise glucose levels. | | Tips for improving glucose levels | - Fill up on healthy fats and protein.
• Choose high-fiber foods.
• Limit starchy carbs, empty calorie foods, and heavily processed products.
• Monitor glucose levels regularly. |

The relationship between ketones and glucose

Ketones and glucose are interconnected. When glucose availability is low, the body enters a state called ketogenesis, where ketone bodies are created from fatty acids and replace glucose as the primary source of energy. The relationship between ketones and glucose is inverse: as glucose rises, ketones fall, and vice versa.

Ketogenesis

When the body doesn't have enough glucose for energy, it switches from using primarily exogenous glucose to glycogen (stored glucose) for energy. This causes specific metabolic changes as the body adapts to the new energy source.

Gluconeogenesis

If the body's glucose levels drop too low, the liver can produce its own glucose through a process called gluconeogenesis. This ensures that organs that require glucose for energy, such as the brain and red blood cells, receive enough to function properly.

Ketosis and Ketoacidosis

Ketosis occurs when the body starts burning fat instead of glucose, resulting in an increase of ketones in the body. Nutritional ketosis is the goal of the ketogenic ("keto") diet, which is a high-fat, very-low-carb diet. However, it's important to distinguish ketosis from ketoacidosis, a dangerous condition that can be life-threatening.

Ketoacidosis occurs when the body produces dangerously high levels of ketones and is often a complication of type 1 diabetes. It can be caused by a lack of insulin, which is necessary to move glucose from the blood into cells for energy. As a result, both glucose and ketone levels can become dangerously high.

Monitoring Ketones and Glucose

Monitoring ketone and glucose levels is important, especially for people with diabetes or those following a keto diet. While there is no device that measures ketones continuously, a continuous glucose monitor (CGM) can provide real-time feedback on how diet and daily habits impact glucose levels, which may in turn affect ketone levels.

Tips for Keto Dieters

• Test your carb threshold: gradually increase your carbohydrate intake while monitoring ketone and glucose values through a CGM.
• Test your trigger foods: identify how specific carbs impact your glucose levels to optimize your diet.
• Test your protein threshold: the threshold for protein is typically high, but anything in excess will lead to energy storage. Monitor your glucose to catch subtle rises that may occur when too much protein is consumed.

The importance of testing glucose levels

Testing your glucose levels is important for several reasons, including managing diabetes, preventing other health conditions, and understanding how your body responds to specific foods. Here are some key reasons why testing glucose levels is crucial:

• Diabetes Management: Glucose levels are a primary marker for determining diabetes risk. High blood glucose levels indicate a higher risk for Type 2 Diabetes and other health issues. By testing regularly, you can monitor your glucose levels and take appropriate steps to manage your blood sugar, such as adjusting your diet, exercise, and lifestyle habits.
• Preventing Health Conditions: Elevated blood glucose levels are linked not only to diabetes but also to an increased risk of other life-threatening conditions, especially heart disease. Regular testing allows you to identify this risk factor and take preventive measures to protect your health.
• Understanding Food Sensitivities: Testing glucose levels before and after meals can help identify "trigger foods" or food sensitivities. Certain foods can cause spikes in your glucose levels, which may adversely affect your overall health. By testing, you can determine which foods cause these spikes and make informed dietary choices to maintain stable glucose levels.
• Monitoring Ketogenic Diet Progress: For those following a ketogenic diet, testing glucose levels is crucial. The keto diet aims to reduce carbohydrate intake and promote the use of fat as the body's primary energy source. By testing glucose levels, you can track your body's transition to using fat for energy instead of glucose. This is especially important as the keto diet can lead to "physiologic insulin resistance" or "adaptive glucose sparing," where your body becomes more resistant to insulin, causing higher fasting glucose levels.
• Personalised Dietary Choices: Testing allows you to make informed dietary choices. By understanding how your glucose levels respond to different foods, you can personalise your diet to maintain stable blood sugar. This is particularly beneficial for those with insulin resistance or type 2 diabetes, as they can use testing to find alternative ways to manage their blood sugar effectively.
• Identifying Underlying Health Issues: Regular glucose testing can help identify underlying health issues, such as latent autoimmune diabetes in adults (LADA) or type 1.5 diabetes. This information can guide your healthcare provider in making an accurate diagnosis and determining the best treatment approach.

In conclusion, testing glucose levels is essential for maintaining optimal health, especially for individuals with diabetes or those at risk of developing it. By testing regularly, you can make informed dietary and lifestyle choices, prevent health conditions, and manage your blood sugar effectively.

How to test for food sensitivities

Food sensitivity, or food intolerance, occurs when a person has trouble digesting certain foods. This can cause discomfort but is typically not life-threatening. Food sensitivities are different from food allergies, which are an immune system response and can trigger serious reactions such as hives, rashes, and difficulty breathing.

Common Food Sensitivities

Lactose and gluten intolerances are common, as well as sensitivities to histamines, which occur naturally in foods such as alcohol, aged cheese, bananas, and dried fruit. Additives such as sulfites, artificial colors, and MSG can also cause sensitivity.

Symptoms of Food Sensitivity

Food sensitivity symptoms include abdominal pain, bloating, and gastrointestinal distress. These symptoms can appear shortly after eating or up to several hours or even days later, making it difficult to determine which food caused the reaction.

Food Sensitivity Testing

Food sensitivity testing is typically done after a person has experienced symptoms of an adverse food reaction. Tests can be ordered to look for specific food allergies, intolerances, or sensitivities based on symptoms and the foods consumed before they occurred.

There is no single comprehensive test to check for all or most types of food sensitivities, so tests are usually tailored to match an individual's symptoms and health history.

Some specific intolerances, such as lactose intolerance, can be detected with lactose tolerance tests, including blood or breath tests. Celiac disease, an immune response to gluten, can be diagnosed through blood tests that analyze levels of specific antibodies.

For most other food intolerances and sensitivities, there is no reliable test, so other types of tests may be recommended:

• Oral food challenge: This involves consuming increasing amounts of a suspected allergen over a period of hours while being closely monitored for adverse reactions.
• Food elimination diet: This involves following a strict diet that excludes specific foods or additives for several weeks, then gradually reintroducing them one at a time to identify specific intolerances or sensitivities.

At-Home Food Sensitivity Tests

At-home food sensitivity tests are available, but their reliability is questionable. Many of these tests measure the body's immune response to various foods by testing antibody levels in the blood. However, research suggests that the presence of these antibodies may not be an accurate marker of food sensitivity.

The American Academy of Allergy, Asthma & Immunology (AAAAI) advises against using these tests to diagnose food sensitivities.

Recommended Course of Action

If you suspect you have a food sensitivity, it is recommended to consult a doctor or dietitian to rule out other potential causes of symptoms and determine the best course of action. They may suggest an elimination diet to help identify potential trigger foods.

If you decide to try an at-home food sensitivity test, it is important to follow up with a healthcare professional to ensure accurate interpretation of the results and establish a follow-up plan.

The impact of cortisol on blood glucose

Cortisol is a steroid hormone produced and released by the adrenal glands, which sit on top of the kidneys. It is often referred to as the "stress hormone" as it plays a key role in regulating the body's response to stress. Cortisol has glucocorticoid receptors, which are present in almost all tissues in the body, allowing it to affect nearly every organ system.

Cortisol has a direct impact on blood glucose levels. It acts on the liver, muscle, adipose tissue, and pancreas, increasing gluconeogenesis (the production of glucose from non-carbohydrate sources) and decreasing glycogen synthesis in the liver. This results in increased blood glucose availability to the brain. In the pancreas, cortisol decreases insulin production and increases glucagon, a hormone that stimulates the release of stored glucose. Thus, cortisol counterbalances the effect of insulin, leading to increased blood sugar levels. Chronically high cortisol levels can lead to persistent high blood sugar or hyperglycemia, which is a key feature of Type 2 diabetes.

Cortisol levels follow a natural circadian rhythm, with levels typically peaking in the early morning and declining throughout the day, reaching their lowest point around midnight. This pattern can be disrupted by factors such as shift work or chronic stress. Prolonged exposure to high cortisol levels can have detrimental effects on the body, leading to conditions such as Cushing syndrome, which is characterised by symptoms such as weight gain, fatty deposits, high blood sugar, and high blood pressure.

Understanding the impact of cortisol on blood glucose is particularly relevant for individuals following a keto diet, as stress can have a significant impact on blood glucose levels. Elevated fasting glucose levels, or "glucose sparing", is a common trend observed in individuals on a long-term keto diet, and this may be influenced by cortisol release during periods of stress.

Additionally, cortisol can affect insulin resistance, which is a key factor in the development of Type 2 diabetes. Cortisol can induce physiologic insulin resistance, where muscles resist the action of insulin, leading to slightly elevated but stable blood glucose levels. This is distinct from pathologic insulin resistance, which is caused by high levels of insulin and is associated with Type 2 diabetes and other chronic conditions.

In summary, cortisol has a direct impact on blood glucose levels by increasing gluconeogenesis and decreasing insulin production. Chronically high cortisol levels can lead to hyperglycemia and contribute to the development of Type 2 diabetes. Understanding the interplay between cortisol, blood glucose, and insulin is crucial, especially for individuals following a keto diet or managing diabetes.

The effect of high fasting blood glucose

High fasting blood glucose, also known as high fasting blood sugar, is a condition where an individual's blood sugar levels remain elevated after a period of fasting or not eating. This condition is often associated with insulin resistance or diabetes and can have several negative impacts on the body.

Causes of High Fasting Blood Glucose

High fasting blood glucose can be caused by a variety of factors, including:

• Insulin resistance: The body does not respond effectively to insulin, leading to elevated blood sugar levels.
• Type 1 or Type 2 diabetes: In Type 1 diabetes, the body does not produce enough insulin due to the attack on insulin-producing cells. In Type 2 diabetes, the body becomes resistant to insulin and may eventually produce less insulin.
• Hormonal changes: Hormones such as cortisol, growth hormone, and adrenaline can affect blood glucose levels, especially in the early morning hours.
• Medication: In some cases, diabetes medications can cause blood sugar levels to drop too low, triggering the body to release more glucose.
• Diet: A diet high in sugary foods, simple carbohydrates, and sweet snacks can contribute to high fasting blood glucose levels.

Symptoms of High Fasting Blood Glucose

High fasting blood glucose can cause a range of symptoms, including:

• Increased hunger and thirst
• Frequent urination
• Headaches
• Fuzzy vision
• Fatigue or tiredness
• Irregular heartbeat
• Loss of consciousness or seizures (in extreme cases)

Treatment and Management of High Fasting Blood Glucose

There are several strategies to manage high fasting blood glucose levels:

• Dietary changes: Adopting a healthy diet that includes fiber-rich foods, whole grains, high-protein foods, and non-starchy vegetables can help regulate blood sugar levels.
• Medication adjustments: Working with a doctor to adjust medication regimens, such as insulin doses, can help control blood sugar levels.
• Lifestyle changes: Incorporating physical activity, managing stress, and getting adequate sleep can positively impact blood sugar levels.
• Continuous glucose monitoring: Using devices such as continuous glucose monitors can provide real-time data on blood sugar levels, helping individuals make informed decisions about their diet and lifestyle.

Complications of High Fasting Blood Glucose

Untreated high fasting blood glucose can lead to serious complications, including:

• Retinopathy: Damage to the retina, an important tissue at the back of the eye.
• Nephropathy: A progressive form of kidney disease.
• Neuropathy: Damage to the nerves throughout the body.
• Heart disease: Including coronary artery disease, heart failure, and cardiomyopathy, which affects the heart muscle.

It is important for individuals with high fasting blood glucose to work closely with their healthcare team to monitor their blood sugar levels and make necessary lifestyle and medical adjustments to prevent these complications.

Frequently asked questions