I do not have a diagnosis of diabetes and my A1C tends to the high normal - 5.4, 5.3, and 5.5. Nevertheless, I am extremely fascinated/interested/committed to learning about glucose’s and insulin’s role in disease genesis and progression.
I follow Peter Attia closely as well as others that many on here do as well (Rhonda Patrick, Jason Fung, Bret Scher, and so on). I believe we are finally learning (or as Taubes may argue, re-learning) so much that is truly useful. Still, we have a long way to go toward educating the public.
Two or three times a year, I will fast for 24-36 hours. Yesterday, I “fasted” for 22 hours, and I broke it by eating three portions of different types of salads from the salad bar at Whole Foods, a large handful of homemade chips, and 2 pieces of white toast. And a vegetable-rich smoothie. At about 50 minutes, I checked my sugar and it was 214. I have never seen my BG that high. At 1 hour 25 minutes after the last bite (30 min after the first BG check of 214), it was 99.
While I would like to do CGM, I think that that’s maybe taking things too far. My question is, is a BG of 214 followed by a 99 reading 30 minutes later an indication, in your opinion, of insulin resistance/hyperinsulinemia? Are there other “proxies” for understanding what one’s insulin outflow may be?
For what it’s worth, here’s what Peter Attia has to say about blood sugar after a fast:
"A group out of Japan in 2017 took 10 healthy adults, provided them with continuous glucose monitors (CGMs), and provided them with isoenergetic meals for 4 consecutive days. On days 1, 2, and 4, participants ate a higher carbohydrate diet (i.e., 3 meals/day of ~120 gm CHO/meal for males), while on day 3, they ate a CHO-restricted diet (i.e., 3 meals/day of ~10 gm CHO/meal for males).
"What they found was that one day of almost complete CHO-restriction led to post-meal glucose surges the next day when eating a higher carbohydrate diet. I must confess, I was surprised to see this result after such a modest period of CHO-restriction.
“As squishy as the term insulin resistance can be, what I think is going on here is some form of insulin resistance occurring in the muscle. Fasting or CHO-restricted diets lower insulin levels, which leads to more circulating FFAs that can be utilized by muscle, and triggers insulin resistance in those muscles, sparing more glucose for the brain and red blood cells in the bargain.”
I’m just interested in hearing peoples’ opinions, if any. Thanks!