I think I'm now pre diabetic, not sure what to do?

[Callmestar]

I got a Freestyle Libra 2 on a free trial. It's one of these blood glucose monitors that sits permanently on your arm so you can get a blood glucose reading whenever you need to.

I've had ongoing issues with ill health for several years now which I've posted elsewhere on this forum. With one of my main symptoms being extreme thirst and frequent urination, although m tests had never shown any sign of diabetes with my Hba1c always well within range. Recently though I had been having episodes where I'd start feeling very faint and weak, but also wired/simulated in the brain, so I thought perhaps it's low blood sugar along with adrenals pumping out which is making me feel stimulated. Hence I got this device to check.

I had one of the episodes of feeling faint and weak yesterday and testing my blood sugar and it was 5.8mmol/L / 104.4mg/dL, so it seems unlikely those symptoms are from low blood sugar but anyway other than the odd one of reading below 6, since using this blood glucose monitor, I can see my blood sugar even when fasting seems to sit well above 6.0mmol/L / 108mg/dL, which going by most information I can find, is classed as pre diabetes. I also wonder if i'm very sensitive to a very slight drop in blood sugar now, given the symptoms i'm having of feeling faint and weak which gradually subside somewhat after eating.

I just don't know what to do anymore. Many hear say, eat high carb, peat type foods, and they do in the short term make me feel a bit better. But equally my cholesterol is high, and my blood sugar looks to be a mess as well. My functional medicine doctor wants me to eat paleo type diet and is adamant on no orange juice etc which I said I was drinking via some of the ideas here. I do think i'm probably going to have to go paleo / low carb as I can't risk developing diabetes on top of everything else but it just seems a nightmare finding any solution or knowing what the right thing to do is.

I'm 80kg, 5'9, carry a decent bit of muscle but have a slight layer of fat over belly and chest.

 

[GreekDemiGod]

High-dose Aspirin, B vitamins, especially B1, B2, B3 to optimise glucose oxidation.

 

[philalethes]

I do think i'm probably going to have to go paleo / low carb as I can't risk developing diabetes on top of everything else but it just seems a nightmare finding any solution or knowing what the right thing to do is.

That's going to make the diabetic condition even worse; all you're doing in that case is avoiding the sugar your body so desperately needs while making the underlying insulin resistance even worse.

What you need to do is not just to eat more sugar, but also cut fat consumption to near zero for a while until you restore proper insulin response; I'd aim for 10-20 grams of fat daily maximum until you start to see your insulin sensitivity come back.

 

[Callmestar]

That's going to make the diabetic condition even worse; all you're doing in that case is avoiding the sugar your body so desperately needs while making the underlying insulin resistance even worse.

What you need to do is not just to eat more sugar, but also cut fat consumption to near zero for a while until you restore proper insulin response; I'd aim for 10-20 grams of fat daily maximum until you start to see your insulin sensitivity come back.

This is what I mean, 90% of doctors would tell me to do the opposite. I'm not saying I have any faith in most doctors but eating higher carb recently and trying Peat eating again in recent months seems to have got me to this worsened position.

Fasting is demonstrated to reverse pre diabetes and type 2 diabetes in many cases but I should eat more carbs?

I seem to have fat malabsorption anyway, so perhaps cutting that down isn't a bad idea but does that relate to improving insulin sensitivity?

 

[philalethes]

This is what I mean, 90% of doctors would tell me to do the opposite. I'm not saying I have any faith in most doctors but eating higher carb recently and trying Peat eating again in recent months seems to have got me to this worsened position.

Well, my opinion is that most medical doctors have zero idea what they're talking about when it comes to most topics. If you ask me, they should primarily focus on emergency medicine, like surgery and intensive care in cases of acute injuries.

As for you eating "higher carb", that tells me very little, because if you are e.g. still consuming a lot of fat it's still going to be tough, and if e.g. a lot of that carbohydrate is starch it's going to be even worse. There are a lot of variables to consider.

Fasting is demonstrated to reverse pre diabetes and type 2 diabetes in many cases but I should eat more carbs?

Fasting is a very tricky topic. Most people should be extremely wary of it, because overdoing it is going to be very harmful to your metabolism, and can take a lot of time to recover from. That being said, a single short-term fast (no longer than a day or two) in cases like yours can potentially be beneficial to improve insulin sensitivity, provided that you still keep fat consumption near zero afterwards until you see that your blood sugar and insulin response have normalized at good levels. However, you would typically see the same benefits (in some cases even more pronounced) by simply cutting fat to near zero for a while, so I would certainly not say fasting is something you should consider necessary at all.

I seem to have fat malabsorption anyway, so perhaps cutting that down isn't a bad idea but does that relate to improving insulin sensitivity?

That definitely sounds consistent with prediabetic conditions, since such conditions are strongly linked with fat malabsorption and steatorrhea.

The reason this links into insulin sensitivity is because fat and toxic fat metabolites are accumulating in your body and blood, which blocks the action of insulin and prevents sugar from being properly metabolized. Your cells are still craving sugar, but without a proper insulin response your body is going to keep signalling that you need to eat more of it even if you do eat what would otherwise be sufficient.

Note that it's not simply a matter of consuming any form of carbohydrate either, as mentioned in passing above, because starches are pure glucose and will be more trouble for the body to exclusively utilize, whereas fructose and sucrose (which is a dimer of fructose and glucose) will lessen insulin requirements due to fructose not being an insulin secretagogue and even aiding the body in metabolizing glucose. Ray Peat himself wrote at length about this, such as e.g. in his classic article Sugar issues:

«P. A. Piorry in Paris, in 1864, and Dr. William Budd in England, in 1867, treated diabetes by adding a large amount of ordinary sugar, sucrose, to the patient's diet. Glucose was known to be the sugar appearing in the diabetics' urine, but sucrose consists of half glucose, and half fructose. In 1874, E. Kulz in Germany reported that diabetics could assimilate fructose better than glucose. In the next decades there were several more reports on the benefits of feeding fructose, including the reduction of glucose in the urine.

[...]

If fructose can by-pass the fatty acids' inhibition of glucose metabolism, to be oxidized when glucose can't, and if the metabolism of diabetes involves the oxidation of fatty acids instead of glucose, then we would expect there to be less than the normal amount of fructose in the serum of diabetics, although their defining trait is the presence of an increased amount of glucose. According to Osuagwu and Madumere (2008), that is the case. If a fructose deficiency exists in diabetes, then it is appropriate to supplement it in the diet.»

 

[Callmestar]

Well, my opinion is that most medical doctors have zero idea what they're talking about when it comes to most topics. If you ask me, they should primarily focus on emergency medicine, like surgery and intensive care in cases of acute injuries.

As for you eating "higher carb", that tells me very little, because if you are e.g. still consuming a lot of fat it's still going to be tough, and if e.g. a lot of that carbohydrate is starch it's going to be even worse. There are a lot of variables to consider.



Fasting is a very tricky topic. Most people should be extremely wary of it, because overdoing it is going to be very harmful to your metabolism, and can take a lot of time to recover from. That being said, a single short-term fast (no longer than a day or two) in cases like yours can potentially be beneficial to improve insulin sensitivity, provided that you still keep fat consumption near zero afterwards until you see that your blood sugar and insulin response have normalized at good levels. However, you would typically see the same benefits (in some cases even more pronounced) by simply cutting fat to near zero for a while, so I would certainly not say fasting is something you should consider necessary at all.



That definitely sounds consistent with prediabetic conditions, since such conditions are strongly linked with fat malabsorption and steatorrhea.

The reason this links into insulin sensitivity is because fat and toxic fat metabolites are accumulating in your body and blood, which blocks the action of insulin and prevents sugar from being properly metabolized. Your cells are still craving sugar, but without a proper insulin response your body is going to keep signalling that you need to eat more of it even if you do eat what would otherwise be sufficient.

Note that it's not simply a matter of consuming any form of carbohydrate either, as mentioned in passing above, because starches are pure glucose and will be more trouble for the body to exclusively utilize, whereas fructose and sucrose (which is a dimer of fructose and glucose) will lessen insulin requirements due to fructose not being an insulin secretagogue and even aiding the body in metabolizing glucose. Ray Peat himself wrote at length about this, such as e.g. in his classic article Sugar issues:

Why / how does eating less fat improve insulin sensitivity?

Yeah, I don't particularly want to fast it's one of the things that probably get me into this mess but I just cannot work out what to do.

 

[philalethes]

Why / how does eating less fat improve insulin sensitivity?

As I wrote above:

The reason this links into insulin sensitivity is because fat and toxic fat metabolites are accumulating in your body and blood, which blocks the action of insulin and prevents sugar from being properly metabolized. Your cells are still craving sugar, but without a proper insulin response your body is going to keep signalling that you need to eat more of it even if you do eat what would otherwise be sufficient.

It's due to this that fat consumption is the primary cause of insulin resistance in the first place in the vast majority of cases. When you eat less fat, less fat and toxic fat metabolites accumulate in the blood, and the body starts to properly metabolize sugar again. In prediabetic and diabetic conditions the sugar accumulates in the blood along with insulin, because the fat and toxic fat metabolites block the action of insulin; double whammy. When the fat and toxic fat metabolites are gone, the insulin works as intended, so the sugar gets absorbed into the cells, so both blood sugar and insulin go down. This is how the body is supposed to work.

Yeah, I don't particularly want to fast it's one of the things that probably get me into this mess but I just cannot work out what to do.

Well, I can only advise what I advised above: cut fat consumption to near zero for a while until insulin response is normalized, fasting shouldn't really be necessary at all. After that you can try adding in some coconut fat (since it's rich in rapidly metabolizable medium-chain triglycerides, as much as ~60% by composition) in controlled amounts and see how you respond.

 

[Momma]

“Stress hormones desensitize the insulin receptor...
With chronic stress comes many things, all of which desensitizes the insulin receptors.

…stress hormones flooding your system over time, have desensitized the insulin receptor so, insulin cannot drive glucose into the cell anymore”.

 

[Callmestar]

“Stress hormones desensitize the insulin receptor...
With chronic stress comes many things, all of which desensitizes the insulin receptors.

…stress hormones flooding your system over time, have desensitized the insulin receptor so, insulin cannot drive glucose into the cell anymore”.

Yep, I don't doubt that is a major factor. Problem is, i'm stressed due to my physical symptoms and ill health. I don't tend to stress about general life.

 

[miraddo]

Some things you might want to consider:
- How did you actually feel prior to finding out your blood sugar was on the high side? Did you feel like you were getting worse rather than better?
Feeling good is a better indicator of health than a number on a screen.
- How old are you? are you male or female? Older men and post menopausal women tend to have iron overload, which itself can trigger diabetes.
- how is your diet? are you getting full nutrition? regular oysters and liver, daily protein requirements etc.
- have you considered supplemental thyroid? high cholesterol is a pretty reliable indicator of low thyroid function.

 

[Jonk]

I don't have much knowledge about diabetes but I would assume you need a more specific approach than just amounts of macros. I don't believe I'm pre-diabetic or anything, but increasing the rate and efficiency of metabolizing glucose is a corner stone in probably everyone inspired by Dr. Peat. If you haven't read this you might want to: Glucose and sucrose for diabetes.
"The supplements that most often help to correct diabetes-like conditions are niacinamide, thiamine, thyroid, and progesterone or pregnenolone. Vitamins D and K are clearly protective against developing diabetes, and their effects on many regulatory processes suggest that they would also help to correct existing hyperglycemia."
He also mentions sodium and calcium as important in raising co2 and suppress PTH.
"The beta-cell protecting effect of glucose is supported by bicarbonate and sodium. Sodium activates cells to produce carbon dioxide, allowing them to regulate calcium, preventing overstimulation and death."

In my own experience, I'm at day 8 of a high dosing thiamine regimen, and it does seem to help with fatigue, and I am actually starting to have a mild craving for sugary things again. I've always kind of forced myself to eat fruits and drink juice because I know I need the carbs, but I think that cravings are important to listen to. If you don't crave sweet things, overdoing it with high carb/low fat seem excessive to me, and probably a wiser choice to increase sugar tolerance with some things like mentioned above. Just my 2c.

 

[Herbie]

Atleast 3 grams of aspirin a day

 

[Callmestar]

Some things you might want to consider:
- How did you actually feel prior to finding out your blood sugar was on the high side? Did you feel like you were getting worse rather than better?
Feeling good is a better indicator of health than a number on a screen.
- How old are you? are you male or female? Older men and post menopausal women tend to have iron overload, which itself can trigger diabetes.
- how is your diet? are you getting full nutrition? regular oysters and liver, daily protein requirements etc.
- have you considered supplemental thyroid? high cholesterol is a pretty reliable indicator of low thyroid function.

I feel like crap, permanently. I can't say I feel as though I'm getting better. I'm 34, male. My iron is on the higher side. My diet is ok, but it's ever changing as I can't seem to work out what's right. I eat plenty of protein. I take thyroid, it's helped get my cholesterol down somewhat.

 

[Callmestar]

Atleast 3 grams of aspirin a day

What does that do?

 

[Peater]

Don't forget Ray helped his father's diabetes with brewer's yeast (Chromium)

 

[Peatress]

Is it possible you have radiation damage? You've had a lot of x-ray and CT scans - they can cause long term damage to tissue. Radiation damage causes fibrosis

Radiation Damage Information and Remedies

Please add any useful articles, videos, and treatments. Thoughts and personal experiences welcome too. On Radiation Ray Peat said: It starts a chain of inflammation-related events, and the process can be interrupted, to reduce the degree of fibrosis, cell death, and cancerization. Helpful...

raypeatforum.com

 

[ubiety]

Intermittant fasting and lower your carbs. I'm NOT saying fast for days or eliminate carbs, I'm saying fast for at least 12-14 hrs a day every day. I lost 29 pounds in 3 months (all the weight gain started of course with eating lots of carbs) and haven't felt this good in many years. All my insulin resistant symptoms went away - hypoglycemia, not feeling full no matter how much I ate, hungry again shortly after I ate, carb cravings, etc. - all gone. My pre-diabetes symptoms also went away - constant thirst, frequent urination, super dry eyes, kidney pain, etc. Doing this won't take long to start showing solid results - give it a week, but you need to maintain it for as long as you want the benefits.

 

[Momma]

I feel like crap

This IS a stressed state.

 

[Momma]

Https://www.lifespan.io/news/low-carb-intake-linked-to-insulin-resistance/

https://www.lifespan.io/news/low-carb-intake-linked-to-insulin-resistance/ Conclusion This study is one of the first to investigate the metabolic effects of carbohydrate consumption on lean, healthy, and relatively young people. While for all groups, the measured markers remained in their...

raypeatforum.com

 

[Callmestar]

This IS a stressed state.

Yeah, I feel like crap because of the symptoms. They are relentless and extremely uncomfortable. Not a lot I can do about that. Ask me about money, finances, work, general life, you couldn't find someone any more laid back.