Lean Diabetic

[rogue_farmer]

To anyone who reads and responds to this...thank you!

I've recently discovered this forum and am new to the ideas of Ray Peat. I was self diagnosed (ordered the tests myself) with diabetes June of 2018 when I started having unquenchable thirsts and frequent urination. Previous to that, I had no other discernible symptoms of diabetes and always felt great and healed quickly. I am 6 foot 1 and weigh anywhere from 140-145. My first test my fasting blood glucose was 304, I followed that up with a more comprehensive test and had an HBA1C of 12.4, an insulin level of 2.1 uIU/mL, and a c peptide of .63 ng/mL. I also have had optimal triglycerides (74) from the start.

Instead of going the medication route, after researching and discovering the KETO diet; I decided to adopt that strategy along with supplements. In 6 months I had reduced my FBG to 111 and HBA1C to 7.1 (though my cholesterol did go up), this was fantastic news for me and confirmed to me I was on the right path. I have continued that diet and practiced intermittent fasting and extended water only fasts. until December of 2019 and have been happy with the results. I also discovered the Root Cause Protocol and did the test Morley Robbins recommended and added Cod Liver oil into my diet as well as regular blood donations. In that time, I always had questions in the back of my head
1. Why was there no rhyme or reason to my blood glucose levels at times?
2. Why even on very low carb was I still experiencing elevated blood glucose levels?
3. Why would my levels always be much higher in the mornings?
4. Why when I did extended fasts would my blood glucose levels balance properly? (I noticed they would increase, but then would come right back down normally as opposed to when just increasing and never coming back to any baseline when I wasn't fasting, indicating my "homeostasis" was working properly).

In December, I was now encountering higher fasted blood glucose levels in the mornings and a sharp decline in my tolerance for even minimal carbs.
Supplements I was taking at the time
-Cod Liver Oil
-Benfotaiamine
-Chromium
-Biotin
-Vitamin D3
-Digestive Enzymes
-Magnesium
I was also cooking everything in bacon grease, eating keto bars, exercising, and drinking "fat coffees".

I came across the ideas of Ray Peat in December and his articles on diabetes and sugar were a complete shock to me, but it all started to make sense the more research I did (I discovered Danny Roddy, Matt Blackstone, and Chris Masterjohn, and now Haidut's postings on here). The Randle Cycle seemed to explain every question I had in the back of my head and showed me that I was being counterproductive in my approach to this. Since then I have started to add more carbs (OJ, fruit, milk, potatoes) into my diet with the knowledge that I needed to revert my cells back to glucose oxidation (starting slow, I am up to about 60g a day now) and cutting my fat consumption way back (no more cooking in bacon grease, I use coconut oil as my oil now, and grassfed buffalo tallow); though I still have MCT oil in my coffee in the morning...as I understand it, that doesn't alter the Randle Cycle (correct?). I also have removed Cod Liver Oil from my supplementation and added Vitamin E (Pufa protect), aspirin (White willow bark), and Niacinimide to my supplementation. I have noticed much better carb tolerance, and realize I am no longer waking up in the middle of the night in a sweat; though I am still seeing an increase in my blood glucose levels in the morning. I notice that my blood glucose levels (I test religiously, multiple times a day for the last 2 years) seem to drop better during the day, but with the added carbs into my diet I am still staying at 200+ and have not been in the 100s but a few times in the past month. I am confident though now that I am on the right path.

Please if anyone would be so kind as to voice their opinion, I appreciate any input and am open to trying new things. Now that I have a better understanding of this, I still don't plan on taking medications and am not afraid of the high blood sugars in this "experiment". Looking at my c-peptide and insulin levels, I am thinking that is a result of the Randle Cycle/PUFA consumption and as I add in carbs I should see those levels come up; as well as continue to improve my insulin sensitivity? If my triglycerides were low from the start...would it still be insulin resistance in the liver? Am I on the right path here?

I've also attached all my test results, if anyone would like to take a look at them and give me any input or recommendations.

Thank you!

 

[rogue_farmer]

To add on to this, two things:

I also notice that if I consume alcohol with carbs, I don't get nearly the increase in blood glucose. This confirms to me that the real culprit as I've learned here is unregulated gluconeogenesis from the liver...insulin resistance in the liver correct? Is there anything counterproductive about consuming alcohol every so often with carbs to blunt gluconeogenesis at the moment?

I did find a fasting blood glucose from a physical i did in 2010, it was 96 at that time.

 

[tara]

I'm not an expert, so please take comments I make with plenty of salt, and research further yourself. I have not been diagnosed with diabetes.

I am 6 foot 1 and weigh anywhere from 140-145.

From context, I'm assuming that's an extremely lean 140-odd pounds, not a solid 140ish kg?

Diabetes is a wasting disease.
I'm suspecting you may be past insulin resistance and into low insulin. In which case, protection and support for the pancreas is key. I think PUFAs may be particularly hard on the pancreas, and that it needs some glucose amongst other things to regenerate? Sounds like you're making glucose available. Possible PUFA could be reduced for a bit? Can't remember what else. I'm no expert.

Peat mentioned that his father recovered from diabetes by eating a lot of brewers yeast - I think it may have been for a few weeks. He's also said hot water extract of brewers yeast could get the water solubles and leave behind some of the estrogenic substances.

IIf you had thyroid test resutlts there, I didn't see them. Could be worth checking if you are having more tests in the future?
If it were me, I'd be thinking about B-vits particularly, but maybe other vits too.
And good mineral density.
I might experiment with lowish fat diet for a bit, and see if that helps get the glucose oxygenation going. (There's at least one poster here for whom this approach did not work against diabetes, but there are also people for whom it has been helpful..)
Personally, I know too much sugar seems to mess me up - but some people recover fine on sweet food - experiment.
Liver, oysters, really low PUFA?
My own personal experience from before reading Peat was that lentils etc were quite good for sustaining me over time without such big swings.
I wouldn't assume that what works for someone else will be the same for me/you. Some people do well with lots of sugars; others don't - see what works for you.
Other possible general tactics:
Check breathing/hyperventilation habits.
Get enough sleep and sunshine.
Possibly measure UpH, and try to keep it more or less in range using foods etc to allow healing: ~ 6.2 - 6.8. (Reams/RBTI and also the range Peat favoured.)

You're likely to get plenty of conflicting advice here, so keep using your own judgement and research to sift out what you think may be worth trying.
Welcome and good luck.

 

[Zigzag]

Do I see it correctly that your first test showed 304 fbg and very low on insulin?

 

[Vinny]

To add on to this, two things:

I also notice that if I consume alcohol with carbs, I don't get nearly the increase in blood glucose. This confirms to me that the real culprit as I've learned here is unregulated gluconeogenesis from the liver...insulin resistance in the liver correct? Is there anything counterproductive about consuming alcohol every so often with carbs to blunt gluconeogenesis at the moment?

I did find a fasting blood glucose from a physical i did in 2010, it was 96 at that time.

Adding slowly sugar to my diet did not improve my glucose metabolism and I became morbidly obese. Not sure about dibetic yet, hopefully not.

I think using alcohol to correct glucose numbers is insanity.

Good luck to find ur way to recovery.

 

[rogue_farmer]

Thank you guys for reading and offering your responses. I guess I forgot to put my age as well in case that has any bearing, I am 37.

From context, I'm assuming that's an extremely lean 140-odd pounds, not a solid 140ish kg?

Yes, 140 pounds

IIf you had thyroid test resutlts there, I didn't see them. Could be worth checking if you are having more tests in the future?
If it were me, I'd be thinking about B-vits particularly, but maybe other vits too.

I have not done any thyroid testing, but after looking into Ray Peat and reading this forum...it is definitely going to be added to my next tests. I am going to start monitoring my temperatures. And since adding in carbs...I am very impressed that I no longer wake up in the middle of the night sweating. I have been drinking a glass of milk before I go to bed lately and no matter how high my blood sugars are at the time(sometimes 300+), it seems I am consistently waking in the 250s when I do that.

Check breathing/hyperventilation habits.
Get enough sleep and sunshine.
Possibly measure UpH, and try to keep it more or less in range using foods etc to allow healing: ~ 6.2 - 6.8. (Reams/RBTI and also the range Peat favoured.)

I do have some pH strips, I'll start checking that in the morning...or should I be doing it more or at different times? Also...I've never had breathing or hyperventilation issues and breath through my nose just fine throughout the day. Did I understand that correctly?

I will give lentils a shot, I know rice doesn't help me any. And I have had decent response to quinoa. I'll also take a look at brewers yeast, I recall Ray writing something about that.

Do I see it correctly that your first test showed 304 fbg and very low on insulin?

Yes, I didn't post the test result I realize...but also in June of 2018 I tested my insulin (not my c peptide at that time) and it was at 2.1...so there was actually a slight decline in the six months to 1.8. Though in that time, my HOMA-IR also went from a 1.58 to a .49...this seemed to be a vast improvement and I equated the lowering in insulin to the decrease in carbs in my diet.

Adding slowly sugar to my diet did not improve my glucose metabolism and I became morbidly obese. Not sure about dibetic yet, hopefully not.

I think using alcohol to correct glucose numbers is insanity.

I wouldn't mind gaining some weight, I feel about out of place being a lean (been that way my whole life) diabetic and it seems everything I read is about losing weight to regain insulin sensitivity or lower insulin. Ihave seen small increases in my glucose metabolism, hoping for more. I agree, I would definitely not use it as a crutch to eat carbs, but I did find it very interesting and backing up of the idea that the problem is gluconeogenesis out of control...but is that a result of insulin resistance of my liver or just too low of insulin on my part is the question.

Thanks again everyone, the experiment continues...

 

[Zigzag]

Yes, I didn't post the test result I realize...but also in June of 2018 I tested my insulin (not my c peptide at that time) and it was at 2.1...so there was actually a slight decline in the six months to 1.8. Though in that time, my HOMA-IR also went from a 1.58 to a .49...this seemed to be a vast improvement and I equated the lowering in insulin to the decrease in carbs in my diet.

Wouldn't that be actually bad? There's not enough insulin being secreted to push all that glucose into the cells.

 

[rogue_farmer]

Wouldn't that be actually bad? There's not enough insulin being secreted to push all that glucose into the cells.

It could be, but from what I understand is that the real reason a person has high blood sugars is because the liver is constantly creating and dumping glycogen (reinforced by my experiences with alcohol, alcohol stops gluconeogenesis) because the brain is telling it that there isn't enough glucose in the blood. Not sure where I read it, but it seems that if the liver isn't getting properly filled with glycogen (from carbs) this will continue to happen. Without the added carbs in my diet, the insulin I do have has been sufficient to keep up with my liver, but this is not a good strategy long term and never "fixes" the problem. As I understand it by cutting back on PUFAs and increasing my carbs (I may experience higher blood sugars for awhile) my beta cells will increase (I think I read that it takes anywhere from 14-20 days for beta cells to duplicate) and my insulin will increase as well, resulting in two things 1. my insulin levels continuing to keep up with my carb intake 2. my liver starting to store glycogen and not continue to endlessly dump.

 

[Zigzag]

I wonder if liver healing substances like NAC or TUDCA could help you.
Please inform us on your journey in here.

 

[rogue_farmer]

I'm not familiar with NAC or TUDCA, but will look into them, thank you!

I'll keep this updated as I continue and try other suggestions as well.

 

[tara]

And since adding in carbs...I am very impressed that I no longer wake up in the middle of the night sweating.

I had a period of night sweats years ago. I wasn't on any deliberate low card diet, but possibly under-eating a bit. They stopped when I got more systematic about eating enough - which included more carbs. Too low glycogen > higher stress hormones.

I do have some pH strips, I'll start checking that in the morning...or should I be doing it more or at different times?

Peat said 24 hr UpH should ideally be in the range 6.3-6.7. Reams said healing range was 6.2 - 6.8, and I think he did have specific times he favoured, not first thing in the morning or before breakfast or straight after meals. I have a vague memory of coming across 11am or 2pm , but not sure about those - might depend on meal schedule. When I was measuring, I aimed for an hour or two after meals.
RBTI folk also talked about meal timing and the cortisol cycle - eat more as cortisol is low or falling, less when it rising or high. That means eating a decent breakfast, main meal around midday, and lighter in the evening. Might be something else to experiment with. My experience seems to be that I make better use of food late morning - early after noon, but it's hard to maintain myself and my sleep without more meals/snacks and supper.

Also...I've never had breathing or hyperventilation issues and breath through my nose just fine throughout the day. Did I understand that correctly?

That's good that you are breathing nasally. SOme peolpel slip at night - there are ways to address that.
Nose breathing is step one. Beyond that, ther may still be gains to make - if you are interested in checking it out, read about Buteyko and his Control Pause method of measuring for chronic hidden hyperventilation. (I think getting minerals in to help support pH balance can be related to this too.)

but is that a result of insulin resistance of my liver or just too low of insulin on my part is the question.

Wouldn't that be actually bad? There's not enough insulin being secreted to push all that glucose into the cells.

That's how I read it too.

It could be, but from what I understand is that the real reason a person has high blood sugars is because the liver is constantly creating and dumping glycogen (reinforced by my experiences with alcohol, alcohol stops gluconeogenesis) because the brain is telling it that there isn't enough glucose in the blood.

I guess you read the article Peat wrote about diabetes and sugar - this seems consistent with that doctor aiming to keep the sugar up.
I suspect a relevant focus is: what environmental conditions does your pancreas need to be able to restore/regrow beta cells in the islets of langerhans, and what can you do to move your system in that direction? That is, how do you set you system up to be in healing mode?
In that early sugar/diabetes success case, it was in the context of adding sugar to a robust diet. I'm guessing that diet would have been significantly higher in minerals, vitamins, etc than the average diet now, just because soils and food are so depleted these days. I would not count on just adding sugar to solve your issues without also providing sufficiently all the other nutritional needs (brewers yeast, liver, oysters, high quality/brix veges an fruit, check calcium, magnesium, potassium, and other minerals and vitamins ...?)

Again, these are my speculations, not expertise.

 

[Kingpinguin]

To add on to this, two things:

I also notice that if I consume alcohol with carbs, I don't get nearly the increase in blood glucose. This confirms to me that the real culprit as I've learned here is unregulated gluconeogenesis from the liver...insulin resistance in the liver correct? Is there anything counterproductive about consuming alcohol every so often with carbs to blunt gluconeogenesis at the moment?

I did find a fasting blood glucose from a physical i did in 2010, it was 96 at that time.

added a time stamp listen the latest episode with danny roddy and haidut. First start out talking bout ketosis and then cortisol, glucose metabolism and diabetes. Imo just keep doing what you are doing. Your body will likely take some time to heal. The problem is cortisol in your case. I would maybe add in a potent cortisol blocker like pregnenolone, progesterone, DHEA and cyphroheptadine. Use them in low doses recommended by haidut. 5mg per day. Do this and continue increase sugar consumption, eat saturated fats moderately and keep PUFA close to 0. Other supplements other than the ones you mentioned are taurine. I would also focus on getting plenty of protein. You need to rebuild your body, liver etc from all those years letting cortisol basically break down your body. I would aim to get between 100-150 grams protein, 20-50 grams of the good saturated fats like coconut oil, stearic acid oils like cacao butter etc. Then just get plenty of sugar all the time. Never give your body reason to have a shortage of energy. And it will learn to heal itself.

 

[danishispsychic]

Parasite infections can cause diabetes. Just something to investigate

 

[Peater Piper]

Insulin is required to store glucose in the liver as glycogen. I recall Chris Masterjohn suspecting that excessive gluconeogenesis could be the result of NAFLD. Basically, the fat deposits decrease the storage area for glycogen, which causes the liver to go crazy in order to prevent running out of glucose. It would be useful to see what your glucose and insulin levels are after a carbohydrate meal, maybe an OGTT? You may just have a frank shortage of insulin. Even in the insulin sensitive, a large first phase insulin release is needed to keep glucose from excessively spiking. A weak first phase release causes the insulin levels to lag behind the glucose, which can cause chronically elevated glucose levels. If insulin is chronically low even with a glucose test, it could be an autoimmune issue like LADA or MODY (although Peat's not crazy about autoimmune theories), an infection, or lack of necessary micro-nutrients needed for insulin synthesis. If insulin spikes significantly after a glucose test but glucose still refuses to come down, then you're dealing with insulin resistance.

 

[scoobydoo]

I would really suggest going to a specialist in this area. More tests and scans should be taken to get a better idea. Sounds almost like an autoimmune issue as stated above.

 

[rogue_farmer]

Thank you tara, I'll do some looking into Buteyko and UpH monitoring as well. I admit, I have not heard of the "cortisol cycle" before, but that sounds like something that would help too.

I'm guessing that diet would have been significantly higher in minerals, vitamins, etc than the average diet now, just because soils and food are so depleted these days. I would not count on just adding sugar to solve your issues without also providing sufficiently all the other nutritional needs (brewers yeast, liver, oysters, high quality/brix veges an fruit, check calcium, magnesium, potassium, and other minerals and vitamins ...?)

Haha...I agree our soils are massively depleted these days, I am an organic/biodynamic farmer and fully understand that one! Well before I discovered my blood sugar issues I was already eating healthy and the highest quality I could find, so that won't be a problem. But will definitely look into brewers yeast and i do like oysters; I am already taking Ancestral Supplements Beef organs and have wanted to start eating liver regularly. I have never done a vitamin/mineral test, may add that to my next round of tests as well.

I would maybe add in a potent cortisol blocker like pregnenolone, progesterone, DHEA and cyphroheptadine. Use them in low doses recommended by haidut. 5mg per day. Do this and continue increase sugar consumption, eat saturated fats moderately and keep PUFA close to 0. Other supplements other than the ones you mentioned are taurine.

I have looked into DHEA, but have not used any of those yet, is there any that is better than the other? I'll look into taurine too, thanks!

Parasite infections can cause diabetes. Just something to investigate

I did come across this as a possible cause as well, and "The cure for all disease" by Hulda Clark; and have been eating figs regularly, both for carbohydrate and in case of her theory of Pancreatic Fluke. Is there other parasites that could cause this or a parasite "cleanse" method that you are familiar with?

It would be useful to see what your glucose and insulin levels are after a carbohydrate meal, maybe an OGTT?

I have often thought that myself, and figured my insulin and c-peptide were low because of low carb and if I am challenging it I might see higher levels. I'm hoping by getting carbs back into my diet, it increases those levels as my body realizes I need them again. Or, yes...it has crossed my mind that I could be autoimmune; my gut tells me I'm not though and as many 5 day fasts as I have done I should have reset that to some degree if so. I may look into autoimmune in the future if this new way of eating doesn't pan out; but plan on sticking with this for quite a bit more time to see if any changes happen. So far, I can tell I am sleeping better, and can tolerate carbs a bit better.

Thanks everyone!

 

[TibRex]

To add on to this, two things:

This confirms to me that the real culprit as I've learned here is unregulated gluconeogenesis from the liver...insulin resistance in the liver correct?

I came to a similar conclusion recently ... that the liver, most likely NAFLD, is the culprit after struggling with T2DM for 20+ yrs. Found it practically impossible to keep BG at a satisfactory level until I tried this supplementing with "Milk Thistle Plus" which contains a standardized extract of 4 botanicals : Silymarin, dandelion root, burdock root, sarsparilla root. I've had 4-5 successive drops in BG so far - amazing to find something that truly works after all these years. Silymarin is most likely the primary active agent in the combo as I've tried the other 3 separately before and didn't experience any noticeable difference. It will take a while for me to get the BG to the desired target level as I only started taking Milk Thistle Plus about 7 weeks ago.

Perhaps you could add to your diabetic arsenal silymarin or rather the more bioavailable phytosome form of silymarin/silibin (e.g. Siliphos phytosome sold on iherb.com : Natural Factors, Siliphos Phytosome, Clinical Strength Milk Thistle, 160 mg, 60 Vegetarian Capsules ).

The metabolic demon seems to be fat/free fatty acids, implicated in the Randle cycle. It is wise to ditch cooking oils altogether. Here are some articles of interest :

High-fat diet and gut bacteria linked to insulin resistance
Fatty meal interrupts gut's communication with the body, but why? If that second helping of prime rib stuns your gut into silence, is that good or bad?
Nearly 40 percent of Americans have fatty liver – here’s how to treat it
Obesity-induced fatty liver disease reversed in mice
Soy protein alleviates symptoms of fatty liver disease, study suggests

 

[rogue_farmer]

Thank you TebRex, I will read through these links and and was only slighly familiar with the benefits of Milk Thistle. I will check out that product and if its as good as you say, will definitely give it a try and see what happens. How long were you taking it and in what quantity before you saw your first real drop? Interesting on the soy protein too, I'll have to do a bit more research on that...and it seems to be a bit contradictory of most views on this forum (PUFAs).

For anyone else following this, I am still increasing my carbs (mostly eating more fruit), though I did slip up and have a old fashioned sour cream doughnut with my girlfriend the other day with plain coffee (very low fat to high carb)...and surprisingly noticed that I reacted pretty decent to it (blood glucose wise). I have been taking my morning temps and temps throughout the day and have noticed that it seems to be going backwords some or fluctuate a lot...warmer in the morning(97.4/97.6), then it goes down(96s), then it seems to go up towards the evening(mid 97) (thyroid issues? or maybe I need a better thermometer, I've only been using an digital thermometer orally). I've also been working on my breathing. Though my blood glucose numbers are still staying elevated in the upper 100s and low 200s on average, I am not as concerned anymore as I continue to read that even the kidney issues are most likely due to fatty acid oxidation. I have reduced my PUFA exposure (maybe not with the doughnut though) a lot and with what I learn on this forum and in my continued resesarch, I am continuing this healing journey without being so scared of my blood glucose levels.

I am not too concerned with my HBA1C anymore, but will most likely be doing an insulin test here soon to see if adding carbs back in has had any affect on my insulin levels. I am thinking it is best to do the insulin test after eating carbs to see what response I am having (how long if so?) or is it better to do it fasted? I want to do the basic metabolic panel as well to make sure I am not harming my kidneys or other health markers as well. And, would it make sense to do a thyroid test with my temps to see where I am at...or just keep checking my temps?

Any other tests anyone recommends?

Thanks for all your input and knowledge!

 

[tara]

I have been taking my morning temps and temps throughout the day and have noticed that it seems to be going backwords some or fluctuate a lot...warmer in the morning(97.4/97.6), then it goes down(96s), then it seems to go up towards the evening(mid 97) (thyroid issues? or maybe I need a better thermometer, I've only been using an digital thermometer orally)

Be aware tat it can take 5-10 mins for thermometer to stabilise at body temps, and the digitals often say they are done much quicker than that, before they are up to temp.
You can see if this is happening by testing repeatedly (not removing thermometer from its measuring spot in between). I usu test until I get 2 consecutive readings the same, which often takes more than 5 mins.

 

[rogue_farmer]

Thank you tara...I'll give that a shot before I look for another thermometer.