I've been following the ketogenic diet since 2018, and it's truly transformed my life. I lost over 85 pounds and have maintained it for almost 6 years now. I'm currently experimenting with a similar scenario for myself, so I really appreciate the information.
@@alxmxlx I began the keto diet for health reasons. To answer your question, I'm not strict about it because I believe in being metabolically flexible. Feel free to watch about my success story. Wishing you a blessed day!
Patients must feel alone in dealing with their health sometimes. I mean, how could a trained MD not know this? I reversed gout, excessive weight and asthma by watching medics like Dr. Scher on youtube. Did this myself as the doctors I visited didn’t know what to do!
Most doctors get caught in an enormous cash flow situation. College bills, medical business insurance, staffing costs, legal costs, and having to align with all sorts of insurance companies who are allowed to change everything all the time. A GP has to know something about an immense number of problems. A specialist has to...well...specialize narrowly. So, yes, each of us needs to own learning and applying for ourselves as much as we can believe makes sense. Humans vary immensely, we can change over time, all we can go by is the odds and our constantly developing personal experience: a statistical case of n = 1.
@@rabokarabekian409 Sure, we need our own learning, but if we cannot rely on professionals to treat a common serious condition that we need to treat ourselves then the health system is sicker than us!
Why would a cell continue to take in sugar if it is full? Seems like insulin resistance is a protective measure to prevent cell death from too much sugar.
There is some debate about whether or not the cell is "full." In insulin resistance, it seems likely that there isn't enough glucose in the cell, and it struggles to bring more in due to the resistance to the insulin signal, which leads to more glucose in circulation and not in the cell.
To my mind, this suggests that many of the study results that we rely on, were done on "non-Keto" individuals. I'm pretty sure that many epidemiological studies would come up with different results if the subjects were living a low-carb / Keto lifestyle.
I've noticed the few times I went off of keto cold turkey to adding a significant amount of carbs that Day 1 was the worst and about an hour after eating carbs I would take about a 3 hour nap. From Day 2 on, I seemed to adjust fine, but obviously the joint inflammation and anxiety quickly returned and I don't go off keto for more than a couple days every few months because of this. I do like to trigger an insulin response about once per week because it seems to help get rid of a flat, apathetic mood that I've experienced with long-term ketovore. It almost feels as though the few carbs I do eat on one day of the week helps "turn the light on" in my brain and improves my mood.
Somebody explained this as well. You get a spike of dopamine or something. I got extremely horny for a few days but you go back to normal or worse after.
@hELLOGUY-gy5hg yeah it's very interesting. When eating near zero carbs, my energy still feels fine, but it's almost like a light is turned off in my head. When I add the few carbs (usually something like a cup of blueberries), it feels like a dopamine spike like you mention where you have that pleasure/excitement/reward response back. I don't like to add too many carbs though because it gives me the urge to start snacking.
I'm a type 1 diabetic on a ketogenic diet. Since I have to inject insulin, I can monitor my insulin sensitivity day by day, from hour to hour, actually. I can assure you that my insulin to carb ratio, in other words "insulin resistance", hasn't increased since going on a ketogenic diet.
Do you notice it easier getting into deep therapeutic ketosis with blood sugar around 70mg/dl after injecting sufficient insulin vs. (fasting) blood sugar levels around 90mg/dl? I can't get my fasting blood sugar below 90, so I always have high GKI. Thinking about using some insulin to lower GKI and get into deeper ketosis
@@nikolaussoundso I feel the same way: getting a low GKI can be a bit more difficult for us T1Ds. I think it's probably right to take a little insulin to bring fasting BG down further, that's what the pancreas would've done. Bring the ketones up is the easy part with T1D 😀. I always use Tresiba long acting insulin and no insulin pump while going into deep ketosis, just to be really sure there's always some background insulin, avoiding the risk of DKA from pump occlusion.
Insulin Resistance should not be diagnosed unless insulin is measured. High glucose MAY indicate IR but how to be sure unless insulin levels are measured? These ‘internet doctors’ who boldly declare keto causes IR should find studies where insulin is measured and frankly should know better than try to mislead the public!
Dear @Metabolic Mind, I kindly wanted to ask you if you thought MCT oil (a good and reputable brand like Sports Research) can be a good source of fat during a ketogenic diet. Thank you very much.
There are definitely different approaches to this, but the most common seems to be to try to get protein and fat sources from whole foods, but if someone needs more fat, then they can supplement with MCT oil. Or if they want to experiment with increasing their ketone levels, MCT can be helpful.
Dear @Metabolicmind I've been #lowcarb for 8 yrs and my fasting glucose is usually 7 mmol and Hba1c 5.9 mmol but I calculate my Homa-ir to be 1.2. Is this a similar phenomenon? Thanks
you taught me something. thanks. I do think it is silly to do a glucose tolerance test on someone who is on a ketogenic diet though, what's the purpose ?
Yes, I've noticed the Dawn Effect for some time now ... on Keto for several years. I've also noticed that if I have a diinner with some carbs ... say, Japanese Food, or some Italian Food ... Pasta, but not something with simple sugars, my glucose does not spike up much and the next day, if I have carbs again, the glucose looks pretty good.
I would be curious to hear about how HBA1C plays into this. Mine has been increasing into the upper 5s after several years of strict keto. It's certainly gotten my doctor's attention. I eat 90%+ meat, and I have heard carnivores often have longer-lived red blood cells, which would lead to a higher HBA1C, but I don't know of any evidence that supports that.
Because there is none. We will have to wait and see if it's maladaptive or not, either by research or anecdote. Probably won't become apparent for 10-15 years or more.
@@RoScoHutch they typically come with the argument that A1Cs in the mid or even upper 5s is ok if the continuous levels as measured by a CGM are ok; there are some blood markers to test for longer lifetime of RBCs in individuals, don't remember which exactly.
We have to acknowledge that A1c is a tool with limitations, just like any other tool. Many would suggest a confirmatory test like a CGM and then use all the data to make a decision rather than relying on a single test.
The ketogenic diet works. More then one doctors say basicly the same thing. Geting ride of Modern Suger, Seed Oils, and any modern Starch will help you lose weight.
I have slightly elevated fasting BG levels in the morning @ 105. But my insulin is ok at around 5-6 and Hba1c is 5.2, so I decided not to worry about it! I've been low carb/keto for 4.5 years now. Diabetes T2 in remission, 67 yrs old. I was worried at first when FBG rose from 85 to 105. But is (hopefully ) probably a good adaptation of lower insulin during the night. Or/and sluggish response to the morning dawn effect? I eat a hearty breakfast that should stimulate insulin production. Then a midday meal and stop by 2 or 3pm till 9-10am the next day. Seems to be working for me for now 😄 Also, I am much happier and content since I've been eating this way.
(4:57) "So if your doctor tells you that ketogenic diets cause insulin resistance, please share this video with them and see if they understand the normal physiology of being in ketosis. And we'll link to an article below." There is no linked article...
After a glucose test I said to my doctor that I don't eat carbs, but I was still diagnosed as Type 2 Diabetic... So now I'm for all other specialists a diabetic...
This is very upsetting. I think something is happening to people on carnivore/keto/etc, but it will be a long time before it is known if the higher blood sugar in keto causes the same problems as SAD. I have been carnivore/keto for 4 years. My levels are higher than I would like. I have to eat a lot less than I want to keep my sugars below 100.
Dr Shawn Baker showed a 120 level, I wouldn't sweat it how do you feel? Calorie restriction is not ideal are you getting enough fat? Too much protein can elevate glucose if you aren't getting enough fat
Yes, he says many people who have done the keto diet for long periods of time mimic type 1 diabetics in their blood work. He describes ways to address that specifically eating a bolus of protein periodically which will get the body back into an insulin secreting mode.
@@ellek6505 I don’t know for sure but I think it needs to be a rather large amount which not everyone would be doing no. I also think this was in reference to people doing keto. A while back it was common for people to recommend only 20-30% of calories to come from protein.
What about person who is insulin resistant (normal weight and fasting insulin of 4) and has been eating a ketogenic diet and fasting? Oral Glucose Tolerance Test caused a rise in blood glucose up to 380. Should this person continue keto and/or fasting?
FBG 100, ultra low carb so insulin is low, well of course BG is high....insulin is low. The question is why is gluconeogenesis making so much glucose, stress, poor sleep, poor fatty acid uptake ??
The dawn phenomenon is clearly defined as a physiological reaction to morning cortisol levels. It occurs physiologically but leads to a spike in insulin resistant individuals. The purpose of insulin is not to lower blood glu but to make glucose available for energetic use by the mitochondria. This is identified by a HOMA IR test that combines a fasting blood glucose with an insulin level It is at this level that insulin resistance occurs and adding blood glucose and insulin does not help burn the glucose, whether from neoglycogenesis or food.
These studies crack me up, I stopped believing them when I saw a review on a published study giving “beef” an insulin index of 15-51% and “fish” 12-59%. Are these researchers or meteorologists, and the fact that you need a highly equipped lab to conduct this research pretty much avoids any contradictions which I believe is the purpose behind it. With ranges like that it’s easy to just say beef/fish bad so eat our ultra processed foods that sponsored the study in secret.
I also want Experts to inform as laymen by exploring the following questions: a) Is high glucose level for a Keto practitioner , the same as high glucose levels for a prediabetic. Does the glucose just overconcentrate in the blood, but NOT in the cells or broader tissue, or it does in all ?. b) what actually causes the tissue damage in the diabetics, the high glucose in the blood or the high glucose in the cell. Or maybe both do damage but at different magnitudes. Is it mainly extracellular or intracellular damage? c) should an oral glucose test for Keto practitioners have a different time window? Like Ketosis , that takes time to achieve, the reverse might need an adaptive time period to change the primal fuel used from ketones to glucose. Or have an adaptive phase to the test, before the main test. The insulin sensitivity of a K.P may well be normal after a first initial glucose overdose, 24 or 48 hours later with a 2nd glucose test. And i that's the case what does it matter if there is metabolic flexibility. d) does it matter either way? Even if there is I.R for a period after practising Keto, what does it matter if the sugar intake is minimal or the neoglucogenesis is at low or tolerable levels, especially for diabetics that will be following the diet for life.
There are Olympic athletes who walk around with glucose in the 120 range normally.... I'm not convinced that we know everything but I think we try to put too many levels inside a box
I stopped listening to my doctor long ago and doubt he would listen to me. I just go for blood work and worry about interpretation on my own. I took a ton of backlash for not wanting a jab and they keep trying the same with statins since I'm a LMHR. I told them not unless they'll pay for CAC/LP A first.
The glucose tolerance test is still the gold standard for diagnosing diabetes. If the keto diet improves insulin resistance then there should be a normalisation of the GTT. The decrease in insulin levels as a result of a keto diet does not absolve the poor result of the GTT.
We appreciate your comment, but we contend that clinical experience says otherwise. Would you postulate that keto "causes" insulin resistance which then resolves completely with just a few days of eating carbs? That seems clinically unlikely. And how could a diet that puts DM2 into remission also cause insulin resistance? It doesn't seem to fit.
@@metabolicmind Diabetes is caused by fatty infiltration of the pancreas and the liver. This is caused by prolonged positive caloric balance . The cure for diabetes is negative caloric balance IE weight loss due to caloric restriction , so keto diets and high carb diets will both be effective as long as there is negative caloric balance. What is yet to be determined is whether or not a keto diet will be able to permanently reverse the fatty liver and fatty pancreas because diabetes is only “cured” when the fatty liver/pancreas is reversed
Here's a ChatGPT summary: - Emerging research and clinical experience indicate that ketogenic therapy can help put treatment-resistant depression, bipolar disorder, and anxiety into remission. - Ketogenic diets are believed by some healthcare providers to cause insulin resistance, but this is not true. - Insulin resistance is when cells don't react well to insulin, requiring higher levels to bring glucose into cells, leading to metabolic dysfunction. - Ketogenic diets are effective in improving metabolic health and reversing insulin resistance, with studies showing remission of type 2 diabetes. - Misinterpretation of medical tests, like the oral glucose tolerance test, leads to the belief that ketogenic diets cause insulin resistance. - The oral glucose tolerance test is designed for high-carb diets, and results can look similar for those on keto diets due to low insulin levels and unaccustomed high carb intake. - The dawn effect, where fasting blood sugar is higher than normal, can be a normal response for those on a keto diet, termed adaptive glucose sparing or physiologic insulin resistance. - Clinicians need to understand the normal physiologic adaptations in ketosis to avoid misdiagnosing insulin resistance. - Main message: Ketogenic diets do not cause insulin resistance; instead, they involve normal physiologic changes that can be misinterpreted without understanding the context of ketosis.
Perhaps it's more correct to say a ketogenic diet induces (dietary) glucose intolerance? A HOMA-IR might also be flawed for the same reasons as a glucose test. I guess to test insulin sensitivity per se you would need an insulin clamp; but even then you might say any resistance is adaptive or irrelevant. I guess as long as physiology (e.g. lipid distribution, inflammation, AGEs, etc.) maintains so may metabolic health.
Was this your fasting blood sugar, or your daily average? People on keto often find their morning sugar rises a little, but the rest of the day their sugar is far lower than previously for a net benefit in the daily average. That's where CGMs can be very helpful for people to better understand these specifics. Not sure if you tried that or not, but it may be worth it for some people.
I've been following the ketogenic diet since 2018, and it's truly transformed my life. I lost over 85 pounds and have maintained it for almost 6 years now. I'm currently experimenting with a similar scenario for myself, so I really appreciate the information.
did you stop sugar fuly 6 years? or sometime you eat something sweet like for cheat days?
@@alxmxlx
I began the keto diet for health reasons. To answer your question, I'm not strict about it because I believe in being metabolically flexible. Feel free to watch about my success story. Wishing you a blessed day!
Thank you for giving that perspective.
Patients must feel alone in dealing with their health sometimes. I mean, how could a trained MD not know this? I reversed gout, excessive weight and asthma by watching medics like Dr. Scher on youtube. Did this myself as the doctors I visited didn’t know what to do!
Most doctors get caught in an enormous cash flow situation. College bills, medical business insurance, staffing costs, legal costs, and having to align with all sorts of insurance companies who are allowed to change everything all the time.
A GP has to know something about an immense number of problems. A specialist has to...well...specialize narrowly.
So, yes, each of us needs to own learning and applying for ourselves as much as we can believe makes sense.
Humans vary immensely, we can change over time, all we can go by is the odds and our constantly developing personal experience: a statistical case of n = 1.
@@rabokarabekian409 Sure, we need our own learning, but if we cannot rely on professionals to treat a common serious condition that we need to treat ourselves then the health system is sicker than us!
Why would a cell continue to take in sugar if it is full? Seems like insulin resistance is a protective measure to prevent cell death from too much sugar.
There is some debate about whether or not the cell is "full." In insulin resistance, it seems likely that there isn't enough glucose in the cell, and it struggles to bring more in due to the resistance to the insulin signal, which leads to more glucose in circulation and not in the cell.
To my mind, this suggests that many of the study results that we rely on, were done on "non-Keto" individuals. I'm pretty sure that many epidemiological studies would come up with different results if the subjects were living a low-carb / Keto lifestyle.
I've noticed the few times I went off of keto cold turkey to adding a significant amount of carbs that Day 1 was the worst and about an hour after eating carbs I would take about a 3 hour nap. From Day 2 on, I seemed to adjust fine, but obviously the joint inflammation and anxiety quickly returned and I don't go off keto for more than a couple days every few months because of this. I do like to trigger an insulin response about once per week because it seems to help get rid of a flat, apathetic mood that I've experienced with long-term ketovore. It almost feels as though the few carbs I do eat on one day of the week helps "turn the light on" in my brain and improves my mood.
Somebody explained this as well. You get a spike of dopamine or something. I got extremely horny for a few days but you go back to normal or worse after.
@hELLOGUY-gy5hg yeah it's very interesting. When eating near zero carbs, my energy still feels fine, but it's almost like a light is turned off in my head. When I add the few carbs (usually something like a cup of blueberries), it feels like a dopamine spike like you mention where you have that pleasure/excitement/reward response back. I don't like to add too many carbs though because it gives me the urge to start snacking.
I bet exogenous ketones would have the same effect.
great video but the link in the description is missing
Sorry about that! Here is the link and it is also now in the description: www.dietdoctor.com/low-carb/the-dawn-effect
@@metabolicmind thanks you're awesome
I'm a type 1 diabetic on a ketogenic diet. Since I have to inject insulin, I can monitor my insulin sensitivity day by day, from hour to hour, actually.
I can assure you that my insulin to carb ratio, in other words "insulin resistance", hasn't increased since going on a ketogenic diet.
Has your blood sugar/a1c crept up over time, like it does for a lot of keto dieters?
@@ellek6505 Not really. It does happen to some people, but mine stayed in the low 5s.
That's a great example! Thank you for sharing.
Do you notice it easier getting into deep therapeutic ketosis with blood sugar around 70mg/dl after injecting sufficient insulin vs. (fasting) blood sugar levels around 90mg/dl?
I can't get my fasting blood sugar below 90, so I always have high GKI. Thinking about using some insulin to lower GKI and get into deeper ketosis
@@nikolaussoundso I feel the same way: getting a low GKI can be a bit more difficult for us T1Ds. I think it's probably right to take a little insulin to bring fasting BG down further, that's what the pancreas would've done. Bring the ketones up is the easy part with T1D 😀. I always use Tresiba long acting insulin and no insulin pump while going into deep ketosis, just to be really sure there's always some background insulin, avoiding the risk of DKA from pump occlusion.
Thank you, Dr Scher.
People in low carb diet high exercise or high output low fasting insulin can also have physiological insulin R and impair ogtt?
Insulin Resistance should not be diagnosed unless insulin is measured. High glucose MAY indicate IR but how to be sure unless insulin levels are measured? These ‘internet doctors’ who boldly declare keto causes IR should find studies where insulin is measured and frankly should know better than try to mislead the public!
Dear @Metabolic Mind, I kindly wanted to ask you if you thought MCT oil (a good and reputable brand like Sports Research) can be a good source of fat during a ketogenic diet. Thank you very much.
There are definitely different approaches to this, but the most common seems to be to try to get protein and fat sources from whole foods, but if someone needs more fat, then they can supplement with MCT oil. Or if they want to experiment with increasing their ketone levels, MCT can be helpful.
Dear @Metabolicmind
I've been #lowcarb for 8 yrs and my fasting glucose is usually 7 mmol and Hba1c 5.9 mmol but I calculate my Homa-ir to be 1.2.
Is this a similar phenomenon? Thanks
you taught me something. thanks. I do think it is silly to do a glucose tolerance test on someone who is on a ketogenic diet though, what's the purpose ?
We agree. It simply does not make sense.
Yes, I've noticed the Dawn Effect for some time now ... on Keto for several years. I've also noticed that if I have a diinner with some carbs ... say, Japanese Food, or some Italian Food ... Pasta, but not something with simple sugars, my glucose does not spike up much and the next day, if I have carbs again, the glucose looks pretty good.
I would be curious to hear about how HBA1C plays into this. Mine has been increasing into the upper 5s after several years of strict keto. It's certainly gotten my doctor's attention. I eat 90%+ meat, and I have heard carnivores often have longer-lived red blood cells, which would lead to a higher HBA1C, but I don't know of any evidence that supports that.
Because there is none. We will have to wait and see if it's maladaptive or not, either by research or anecdote. Probably won't become apparent for 10-15 years or more.
@@RoScoHutch they typically come with the argument that A1Cs in the mid or even upper 5s is ok if the continuous levels as measured by a CGM are ok; there are some blood markers to test for longer lifetime of RBCs in individuals, don't remember which exactly.
We have to acknowledge that A1c is a tool with limitations, just like any other tool. Many would suggest a confirmatory test like a CGM and then use all the data to make a decision rather than relying on a single test.
@@metabolicmind and others….Berry and Bikman had a great discussion on this yesterday.
ua-cam.com/users/liveDTkzhSCsTD8?si=gyXqao_oK7KsARus
The ketogenic diet works. More then one doctors say basicly the same thing. Geting ride of Modern Suger, Seed Oils, and any modern Starch will help you lose weight.
I have slightly elevated fasting BG levels in the morning @ 105. But my insulin is ok at around 5-6 and Hba1c is 5.2, so I decided not to worry about it! I've been low carb/keto for 4.5 years now. Diabetes T2 in remission, 67 yrs old. I was worried at first when FBG rose from 85 to 105. But is (hopefully ) probably a good adaptation of lower insulin during the night. Or/and sluggish response to the morning dawn effect? I eat a hearty breakfast that should stimulate insulin production. Then a midday meal and stop by 2 or 3pm till 9-10am the next day. Seems to be working for me for now 😄 Also, I am much happier and content since I've been eating this way.
(4:57) "So if your doctor tells you that ketogenic diets cause insulin resistance, please share this video with them and see if they understand the normal physiology of being in ketosis. And we'll link to an article below." There is no linked article...
I’m interested in finding that too
Its now up! Sorry about that
After a glucose test I said to my doctor that I don't eat carbs, but I was still diagnosed as Type 2 Diabetic... So now I'm for all other specialists a diabetic...
This is very upsetting. I think something is happening to people on carnivore/keto/etc, but it will be a long time before it is known if the higher blood sugar in keto causes the same problems as SAD. I have been carnivore/keto for 4 years. My levels are higher than I would like. I have to eat a lot less than I want to keep my sugars below 100.
Dr Shawn Baker showed a 120 level, I wouldn't sweat it how do you feel? Calorie restriction is not ideal are you getting enough fat? Too much protein can elevate glucose if you aren't getting enough fat
@@doddgarger6806 I'm talking about the glucose test and it's results...
@@ellek6505 Hi. Not sure I follow you, My blood sugar slowly went down over the years, seems to have leveled at 85.
Dr Cywes describes it as Insulin Suppression, not resistance. Since insulin levels are low, and FBS and a1c are increasing.
Yes, he says many people who have done the keto diet for long periods of time mimic type 1 diabetics in their blood work. He describes ways to address that specifically eating a bolus of protein periodically which will get the body back into an insulin secreting mode.
@@joeberrouard3743 Don't we all eat "a bolus protein periodically" when we are carnivore/ketovore?
@@ellek6505 I don’t know for sure but I think it needs to be a rather large amount which not everyone would be doing no. I also think this was in reference to people doing keto. A while back it was common for people to recommend only 20-30% of calories to come from protein.
What about person who is insulin resistant (normal weight and fasting insulin of 4) and has been eating a ketogenic diet and fasting? Oral Glucose Tolerance Test caused a rise in blood glucose up to 380. Should this person continue keto and/or fasting?
That's a very high level! That person should definitely work with an experienced keto clinician for individualized care.
Where's the linked article?
Here is the article! www.dietdoctor.com/low-carb/the-dawn-effect
FBG 100, ultra low carb so insulin is low, well of course BG is high....insulin is low. The question is why is gluconeogenesis making so much glucose, stress, poor sleep, poor fatty acid uptake ??
The dawn phenomenon is clearly defined as a physiological reaction to morning cortisol levels. It occurs physiologically but leads to a spike in insulin resistant individuals.
The purpose of insulin is not to lower blood glu but to make glucose available for energetic use by the mitochondria.
This is identified by a HOMA IR test that combines a fasting blood glucose with an insulin level
It is at this level that insulin resistance occurs and adding blood glucose and insulin does not help burn the glucose, whether from neoglycogenesis or food.
These studies crack me up, I stopped believing them when I saw a review on a published study giving “beef” an insulin index of 15-51% and “fish” 12-59%. Are these researchers or meteorologists, and the fact that you need a highly equipped lab to conduct this research pretty much avoids any contradictions which I believe is the purpose behind it. With ranges like that it’s easy to just say beef/fish bad so eat our ultra processed foods that sponsored the study in secret.
I also want Experts to inform as laymen by exploring the following questions:
a) Is high glucose level for a Keto practitioner , the same as high glucose levels for a prediabetic. Does the glucose just overconcentrate in the blood, but NOT in the cells or broader tissue, or it does in all ?.
b) what actually causes the tissue damage in the diabetics, the high glucose in the blood or the high glucose in the cell. Or maybe both do damage but at different magnitudes. Is it mainly extracellular or intracellular damage?
c) should an oral glucose test for Keto practitioners have a different time window? Like Ketosis , that takes time to achieve, the reverse might need an adaptive time period to change the primal fuel used from ketones to glucose. Or have an adaptive phase to the test, before the main test. The insulin sensitivity of a K.P may well be normal after a first initial glucose overdose, 24 or 48 hours later with a 2nd glucose test. And i that's the case what does it matter if there is metabolic flexibility.
d) does it matter either way? Even if there is I.R for a period after practising Keto, what does it matter if the sugar intake is minimal or the neoglucogenesis is at low or tolerable levels, especially for diabetics that will be following the diet for life.
No one knows that answers to these questions, since it hasn't been studied.
There are Olympic athletes who walk around with glucose in the 120 range normally....
I'm not convinced that we know everything but I think we try to put too many levels inside a box
I stopped listening to my doctor long ago and doubt he would listen to me. I just go for blood work and worry about interpretation on my own. I took a ton of backlash for not wanting a jab and they keep trying the same with statins since I'm a LMHR. I told them not unless they'll pay for CAC/LP A first.
Well written and explained.
The glucose tolerance test is still the gold standard for diagnosing diabetes. If the keto diet improves insulin resistance then there should be a normalisation of the GTT. The decrease in insulin levels as a result of a keto diet does not absolve the poor result of the GTT.
We appreciate your comment, but we contend that clinical experience says otherwise. Would you postulate that keto "causes" insulin resistance which then resolves completely with just a few days of eating carbs? That seems clinically unlikely. And how could a diet that puts DM2 into remission also cause insulin resistance? It doesn't seem to fit.
@@metabolicmind
Diabetes is caused by fatty infiltration of the pancreas and the liver. This is caused by prolonged positive caloric balance . The cure for diabetes is negative caloric balance IE weight loss due to caloric restriction , so keto diets and high carb diets will both be effective as long as there is negative caloric balance.
What is yet to be determined is whether or not a keto diet will be able to permanently reverse the fatty liver and fatty pancreas because diabetes is only “cured” when the fatty liver/pancreas is reversed
Here's a ChatGPT summary:
- Emerging research and clinical experience indicate that ketogenic therapy can help put treatment-resistant depression, bipolar disorder, and anxiety into remission.
- Ketogenic diets are believed by some healthcare providers to cause insulin resistance, but this is not true.
- Insulin resistance is when cells don't react well to insulin, requiring higher levels to bring glucose into cells, leading to metabolic dysfunction.
- Ketogenic diets are effective in improving metabolic health and reversing insulin resistance, with studies showing remission of type 2 diabetes.
- Misinterpretation of medical tests, like the oral glucose tolerance test, leads to the belief that ketogenic diets cause insulin resistance.
- The oral glucose tolerance test is designed for high-carb diets, and results can look similar for those on keto diets due to low insulin levels and unaccustomed high carb intake.
- The dawn effect, where fasting blood sugar is higher than normal, can be a normal response for those on a keto diet, termed adaptive glucose sparing or physiologic insulin resistance.
- Clinicians need to understand the normal physiologic adaptations in ketosis to avoid misdiagnosing insulin resistance.
- Main message: Ketogenic diets do not cause insulin resistance; instead, they involve normal physiologic changes that can be misinterpreted without understanding the context of ketosis.
Perhaps it's more correct to say a ketogenic diet induces (dietary) glucose intolerance? A HOMA-IR might also be flawed for the same reasons as a glucose test. I guess to test insulin sensitivity per se you would need an insulin clamp; but even then you might say any resistance is adaptive or irrelevant. I guess as long as physiology (e.g. lipid distribution, inflammation, AGEs, etc.) maintains so may metabolic health.
😃
It is not insulin resistance but rather toxic glucose level. The cells are full and cannot accept more of this nutrient.
Do you think this is the case when someone is in ketosis? I would be very interested to see that data. Thank you
My blood sugar sure went up on keto.
Was this your fasting blood sugar, or your daily average? People on keto often find their morning sugar rises a little, but the rest of the day their sugar is far lower than previously for a net benefit in the daily average. That's where CGMs can be very helpful for people to better understand these specifics. Not sure if you tried that or not, but it may be worth it for some people.
The real reason they say it is so they can keep you on statins and keep bilking the public.