Went Low Carb but Have Higher Hba1c, so Frustrating

Type 2
#1

Last year I was diagnosed with pre-diabetes. The doctor wasn't quite sure what type of diabetes I was pre- since I wasn't a typical Type II at all (great cholesterol numbers, low body fat etc) and I tested negative for Type I and LADA antibodies. What did happen was that I spiked high after eating anything with carbs including 100% oat bran.

So I went on a low-carb/paleo-ish diet. Testing myself after every meal and just not eating anything that spiked my sugar. So I eat lots of veggies, tree nuts for snack, eggs, cottage cheese and meat. Ive been pretty strict about this for a year, the only dessert I have is 2 squares of 90% dark chocolate which is low in sugar anyway and doesn't spike me.

I felt pretty good about everything, I felt great, lost weight, have nice muscle tone from working out more. Then I went to my endo and my Hba1c is higher now than before I started low carb. What's going on? Is there nothing I can do to stop this train? Has anyone else gone low carb and had the Hba1c go up, especially this early on?

#2

What were your HbA1c percentages?

Are you on any medication?

What is your fasting BG? Has it changed over the last year?

What are your typical pre-meal readings and your post meal spikes?

#3

Im still early on the hba1c curve, so I went from 5.4 before the diet to 5.6, 1 year later, after dramatically reducing carbs. What makes any increase surprising is that I'm usually in the 90's fasting, go up to 110-120 after food and that's it. Its been stable throughout the year without any increase. Given that I no longer have spikes going into the 160-180 range, I would have thought I would be lower, since my fasting is where it was before.

#4

I would say the "increase" is so negligible as to possibly be meaningless. At 5.4 the average BG is about 109 and at 5.6 the average is about 115. Those are very close to normal numbers. The fact that you've reduced your carbs could support the conclusion that you don't actually have a problem processing carbs, but your body simply has a higher set point for your BG. I think that's one of the problems with the medical community deciding to use the "pre-diabetes" label.

#5

I agree with Shadow Dragon. If you still have your readings try computing an average and see where it falls.

In my case my last HbA1c was 4.7 and my average BG is around 85 mg/dl. The 'equivalent' glucose is 88 mg/dl. Note that you should not expect exact agreement since the mapping of HbA1c to mg/dl is a statistical relationship.

Another possibility is that HbA1c lab results can vary especially if your two reading were from different labs.

#6

But when I would eat carbs I would get a pretty high spike in my BG so I dont think I have no problem processing carbs. It seems that mathematically if I have cut out those spikes, I should have a lower hba1c, not a higher one.

#7

But what's a "pretty high spike?" I'm suggesting that your current experience might be an indication that what you consider spikes were simply your body demonstrating that your BG gets a little higher than some other people after you eat. Your numbers also suggest that an hour or two at an elevated number might have no appreciable effect on A1C. All in all, it could be telling you there's nothing to worry about with regard to your pancreas and blood sugar.

#8

The A1c check is not perfect. The science is based on the fact that red blood cells live about 90 days. Well, that's an average, and some of us have red blood cells that last longer and some of us have red blood cells that die more quickly.

In your case, the difference from a 5.4% and 5.6% A1c is negligible. You are doing your metabolism a favor by not giving it big BG challenges with a higher carb diet. Doing more of what you've been doing is a good tactic, in my opinion.

Don't look to your A1c as feedback for your dietary changes. It's not that precisely dependable.

#9

Thanks Terry!

#10

Huh? Just so we are clear, labs that are accredited to the NGSP standards (re +/- 7%) would be expected to give test results of 5.1-5.9% with an actual A1c of 5.5%. Please don't read into the test more information that is actually there.

#11

It could be that your prediabetes is progressing. If you were eating sad diet your a1c would have progressed much higher, but with this diet you are holding ground and staying essentially the same.

I think you sound like slow onset autoimmune type diabetes (regardlezz of the test results). If you are happy with the diet and your bs numbers then keep up the good workn. if you are n
not happy with your numbers then you could try convincing your Dr to give you a prezcription for long acting to bring down the baseline (a small dose is still legitimate - i started on 4 units of long acting - 6.5 years later I am on 15 units) or fast acting tonprevent post spikes - except when pregnant I’ve alway been 1 unit to 20g of carbs, 1 unit to drop 20 points). Some drs will support early treatment with insulin.

#12

The previous 5.4% could have been in error low and now the new one an error high. And both numbers are very good. Your meter is showing that you are on the right track and should continue.

#13

It sounds like your diabetes is progressing, but that ,whatever type it is, at this point a low carb diet is keeping you in normal range mostly. Are you on meds?

I disagree that your body has a higher set point for bg, you shouldn't have to eliminate most high carb foods to get normal bg ranges. My father for instance, who is in his 80's, can eat over 80g, end up at 80-90 2 hours later. I'm not sure how high your spike is but the highest I've ever seen him go was 150 when he was sick and in the hospital.

#14

Animal proteins can actually make you more insulin resistant. Check out the work of Dr. Gabriel Cousens for more information on this because I can't explain why that is without getting the book out. (His book is called "There is a cure for diabetes"- sounds gimmicky, I know, but it's not- the book is so packed with scientific information that I still haven't read the whole thing cover to cover.)

Keep in mind that I am type 1, but I have noticed a huge difference in my sensitivity to insulin when eating animal protein versus not. I am mostly vegan but I have a deep love for cheese and sometimes omlettes. About once a month I treat myself to some cheese or eggs and for about 48 hours afterwards (despite all else being normal), I get blood sugars that are over 100 points above what my average would be. I have dealt with this by just turning my pump up to 125% for the basal rate, but that's cause I have no way to avoid diabetes at this point- LOL- you are not in that position! I highly recommend doctor cousens- he has almost a 100% success rate of reversing pre-diabetes and really high success rates of getting type 2s off of all medications and managing their BG with diet and exercise.

Also, I don't want to incite a larger debate about low carb versus not-- cause I totally get that low carb works for a lot of people! Different bodies, different solutions :)

#15

I've not seen any scientific evidence that animal proteins or proteins in general have anything to do with insulin resistance. And I did skim through his book. If you want something that is written to make you feel better and is basically "woo" then maybe it is for you.

Gabriel Cousens is a new age practioner who has a really shady past and is now part of the animal rights circle. He did a movie that claimed that a raw diet cured T1 and T2, I won't even mention the name of that movie. I have written about him before a number of times. I'm glad that this diet has worked for you, but I would advise anyone considering spending there money on this be very very skeptical.

#16

Hi Max: could it be that the prediabetes is evolving it's way into diabetes, independent/in spite of the diet? couldn't the addition of some Metformin (or something else) help to lower your A1c?
wish you well!