Low-Carb, No Sugar=High Sugar Reading

I’ve been diabetic for about thirty years. Actos.25 mg and good diet kept me around 110 for years and years. Tried very low carb and no sugar diet and sugar was over 200. Dr explained that my body was creating glucose to compensate. Nine years ago I woke up from a coma and they were injecting me with insulin. Sugar was 180 but I was on a feeding tube! Asked for Actos and within a week I was at 100.

Recently I’ve been eating no sugar and very low carbs. Dr prescribed and my sugar runs 200-300. I continually say that the diet is making my body send glucose to my pancreas. I pull up articles from the Mayo Clinic and other sites that state low carb/no sugar can push your sugar up.

My doctor won’t believe me and put on my medical records that I’m not following her orders with diet. Anger can’t describe the feelings that I have, being called a liar. I left and have a new doctor, appointment on Wednesday.

So … I’m being extremely good yet high sugar. How can I prove that my body needs some sugar— a cookie or two — of around twenty grams of sugar, to maintain a healthy sugar level?

I’m sorry for rambling but felt that you needed information to respond.

Thank you

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Personally 20 grams of sugar would be a hell of lot for me, and an awful spike.
Now if 20 grams is what your body is use to. Then it will want it.
My thoughts.

Aside from your base query, I can’t tell you how much it disgusts me that a doctor would write on your chart that you were non compliant. Clearly this person doesn’t have a clue.

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I get more and more of a feeling that individual treatment for people with diabetes II is hit and miss.


i refused to go back to my original endo because he wanted to put me on the medications that made me sick. My doctor around that time put in my chart non compliant. I switched to a new doctor who sent me to the new endo that was hired and she immediately tested me for type 1, which it turned out I was.

Thank goodness I refused what those doctors were prescribing and thank goodness I switched doctors. And that non compliant? It isn’t looked at as it was years ago and no one cares. I don’t even list that doctors name on anything anymore.

I would say normally how you find out you need sugar is by eating that sugar and having your numbers come down that you can then show your doctor. But since your appointment is Wednesday, it’s kind of late to do that. So maybe just tell the doctor your diet and that before it was better but you ate some higher carbs. Give the new doctor a chance, maybe they will be really good for you.

BTW my next doctor was a blessing, testing me and getting properly diagnosed made all the difference. And it turned out she was a type 1 too. I am now on an insulin pump and CGM and doing great.


Wow, that would certainly put my BG through the roof and 20g would require 7 units of fast acting insulin to keep me in control. What do you consider “very low carb” for a meal? 20g is more total carb than I budget for any given meal.

Hopefully your new doctor can work with you for the proper diet and medication(s) you need to get into proper control, Just keep the faith, there is always a solution. Sounds like it is likely you will need to go on insulin. A CGM would also help with answers.

It’s difficult to understand what’s going on with you without knowing what your numbers represent. Are they fasting? After eating? After exercise? How many carbs do you eat when “very low carb”?

Why were they injecting you with insulin if your BG was 180? Is it possible your meter isn’t accurate?

Whatever, if your doctor won’t believe you, you do need another doctor.


I like your name DiabeticSquirrel.

Could you ask them to put you onto a CGM for a week so that they can actually look at the data? Otherwise, you will have to keep manual BG records. You may need to take 5 BG per day to kinda prove to them that you are running high.

Is it possible that these meds aren’t working well for you? Are you becoming more diabetic than you used to be? Your body just might be changing. If so, they ought to address that.

20g of carb is next to nothing, its slightly more than one piece of bread. I would ask them if they are able to regularly get patients that are SO compliant that they are eating ONLY one slice of bread worth of carb per meal. Of course they are not.

Tell them that you think you are producing too much glycogen. Maybe you need some Metformin or something.

I agree that you need a new Doc.


I also agree you need a new doctor.
Here is some Actose information:
Pioglitazone is used with proper diet and exercise to treat high blood sugar levels caused by type 2 diabetes. It may be used alone or with other medicines such as insulin, metformin, or sulfonylurea agents. Pioglitazone works by helping your body use insulin better. This medicine does not help patients who have insulin-dependent or type 1 diabetes.

This medicine is available only with your doctor’s prescription.
My question is should you consider trying metformin? Also talking with a CDE and the CGM sounds like a good idea to me.
Good luck figuring out the puzzle.

As a t2 I eat less than 40 carbs a day and definitely nothing that would spike my BG. Yes people do live very well on Low Carb WOE. Plus my control is based on diet and exercise only, no medications. Diagnosed with An A1c of 12 10 years ago. I have been at 6.0 or less for the last 8 years. This last year had a lot of family issues, so I was not as focused and my last AIC was 6.2!
Of course there is no way I include bread of any form in my WOE

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You should request a c peptide test with your new doctor to see how much insulin you are producing. Also very low carb is too vague for most endocrinologists, at least the better ones. My favorite one would pick a recent week and find out exactly what I ate, analyzing glycemic index, etc in her head, work or activities, etc, and make suggestions accordingly. It sounds more like fat and protein may be rising your glucose levels(type 1 diabetics using a pump have a dual wave bolus to compensate releasing over a 3 or 6 hour period), also remember your liver will break down glucagon and can produce some glucose that will raise your sugar levels aka dawn phenomenon… black coffee will raise mine a little also, but it sounds like different meds may help.

That also happens to me. Fat and protein will raise my blood sugar significantly. I eat smaller amounts. There is a group I was following on this site that documented this effect and figured out a formula for bolusing with this factor in mind. The rise is significantly delayed, compared to a fast acting carb rise. However, it can raise it significantly, and be just as much a factor in my BG control. I’ve learned to be aware of it and don’t eat too much animal fat or protein at a time. If I ate a normal sized serving of steak and a vegetable, my BG would also rise into the two hundred range after four or five hours.

But I’m Type 1, just for the record.

About 50-60% of the protein one eats turns to sugar, but it takes a while for that to happen, typically 3-5 hours after it is eaten, but it can be sooner. Not everyone has their levels rise due to protein, but a good deal of people do have that happen. It could be that with eating low carb, you are eating more protein and that protein is what is raising your levels. I do not eat low carb, but even still, I need to bolus for protein, I just bolus for it a while after I eat it since it raises my levels later on. I find protein much harder to bolus for than carbs, as the rise from carbs comes and goes quickly, whereas the rise from protein takes a while to come and lasts much longer. If I eat a lot of protein for dinner, my levels will be higher than usual all day the next day. Protein is hard, fats are even harder, as they slow the absorption of carbs causing a rise to come even later than the rise from protein. Sucks when doctors do not understand this and only focus on what carbs do, as they are not the only food that affects levels. Good luck.


From the sounds of things, a new doctor might be best for you. It sounds like you and the last doc don’t see eye to eye. Everybody is different with regards to their blood sugars. What works for one person may not work for another. One thing, you need to check your sugar frequently. You didn’t mention your A1c. If you woke up in the hospital on a feeding tube, it doesn’t seem to go along with the rest of your situation. It’s good to go to a CDE and diabetes classes. They take the time to explain how things work. Good luck to you.

You glucose ration is puzzling. The way to get a better idea of what is going on is the put on a Freestyle Libre - either the personal or pro would work and do your experiment. Track your glucose, diet and medications and see what happens.

Thank you so much for the information and questions. I’m seeing a new doctor and I like him as he listens to me. He put me on insulin and I believe it’s ten mgs or one hundred mgs of … amnesia won’t let me remember that but I’ll ask tomorrow. Tonight I didn’t get a shot and now I’m worried about that. I will mention it tomorrow as this is the first time that happened in the week I’ve been getting it. It’s late so tomorrow night I’ll post again with more information. I’m seeing an endocrinologist tomorrow for this and PCOS so should know more , too. My bg has been just under two hundred in the morning which is better but I’m unhappy with that. This very low carb and no sugar diet is not good for me but maybe my pancreas is not functioning well. I’m trying not to panic but I’m a bit frazzled. Again thank you

I agree with you. I’m assuming you meant 20g of total carbs, which would be about 1 Oreo or 2 smaller chocolate chip cookies.

My body goes into glucose production mode (your liver starts breaking down fat cells) if I go carbless, like the start of South Beach or Atkins. I do much better with a small carb count at each meal. Like eating 6 ritz crackers or one small dinner roll with each meal. Or even a serving of fruit.

Also, when I am low carbing, I eat healthy proteins. But keep a couple of portions of cheese or avocado or nuts with lunch and for a morning snack. It helps me from being ravenous. Hope your dr situation gets worked out. They didn’t sound super knowledgeable about diabetes and nutrition, if insisting a common diabetes occurrence is wrong. I would recommending asking for an NP or CDE at the same office or looking for a second opinion.


Just to point out that I recognize what you have experienced. It took my body 8,5 weeks (!) to go from carb to keto mode (first high sugars going up to 325). I have litterally experience all detox problems that exist. Now after 6 months in keto mode (10 grams of carbs per meal max! That’s 30gr a day of slow carbs; no cookies or any other sugars;erythritol if needed; eat, measure glucose, learn, adapt diet etc) my A1c dropped from 9,8mmol to 6,3mmol (176 to 113). I am in the process of quiting metformin now since we expect that diet has more impact than metformine.
So pretty happy with the result at the moment. Most days feeling good.


Congratulations @Marcel_Nagtegaal!! And welcome to the forum!