Eat to your Meter
Hey there Jamie here from Keto Saved me, hope you’re doing well, thanks for tuning in I really appreciate it. So today’s topic is eating to your meter and how to better manage your Blood Glucose on a Ketogenic Diet. Let’s jump right in.
So let’s talk about your diabetes medication. Before we start, I must advise you that I am not a medical professional and I am only offering my opinion not direct medical advice. I do recommend that you notify your physician and let them know of your plans to reduce or remove carbs from your diet. You will need to drastically reduce or even eliminate some of your medications when you begin a ketogenic diet. Your current dosing is based on eating a high carb diet, the needs for these medications will be drastically reduced once you eliminate carbohydrates from the diet. It’s better to run a bit high than a bit low during the initial period of adaptation. Insulin induced Hypoglycemia can be very dangerous and life threatening if you’re not in a deep enough level of ketosis. Drugs like glipizide, glimepiride and glyburide are sulfonylureas and work by increasing insulin production and can cause serious complications and hypoglycemia once carbs are removed. Drugs like metformin or Glucophage work by lowering blood sugar through a different mechanism and are far less likely to cause hypoglycemia. Injectables like Byeta and Victoza are incretin mimetics and work by stimulating insulin and suppressing glucagon these are also less likely to cause hypoglycemia.
Finally, let’s talk about exogenous insulin. This is the one that is the most dangerous. Please be sure to reduce your insulin and consistently monitor glucose levels. If your type one, please visit the type one grit group, they can help you adjust. Type 2s, go to a very minimal dose while working through this. Please remember I am not a Doctor and cannot offer medical advice. But I can tell you I have been right where you are right now scared to unknowing what to do. Again, I just went to the minimal dose and ran a bit high until I was off all of it. The most important thing to understand is that it is all trial and error, you must be ever vigilant in checking your glucose levels the entire time and make adjustments as you go.
Now that that’s out of the way, we are always talking about BG management and tighter control as a Diabetic, and how we do it. These strategies can be used for T1, but this is more specially geared to T2, with the only difference being exogenous insulin. Obviously we start out be reducing or eliminating carbs. But beyond that what do we do? So there are several tactics we use. They are eating to our meter, meal timing, meal composition and exercise.
So before we talk about the how, let’s discuss the why. We all know that eating carbs, sugar will elevate blood glucose for obvious reasons, but we have eliminated carbs, so why is our BG spiking all we are eating is protein, non-starchy veggies and fat. So let’s start with the veggies, they are after all carbs right. Well so to speak, however the more fiber usually the lower the spike, remember that for later. That said, tomatoes spike me more than strawberries, we are all different with what and how much we spike from certain foods. If you suspect anything in particular, do elimination testing. Eat it by itself and test to see the spike. We all know fat is negligible on BG, buts that’s as a standalone, when combined with other foods it can easily exacerbate BG levels by way of the additionally FFAs for insulin to deal with before clearing BG. We already have too much insulin and fat in the blood, more is not always better. That said, some fat will help shunt BG spikes.
Now the most important reason we spike as a T2 on Keto is protein. I know it sounds crazy, but it’s true and here’s why. When we eat protein, Muscle protein synthesis is activated, this is how we break down the amino acids in the food to build, grow and repair. The body does this through mTOR, and insulin. You know those two dirty words floating around lately. Well guess what? They are not bad, without them we die. High levels however are not so good. So that in mind, eating protein spikes insulin so it can do its job, ok no big deal. But insulin lowers BG. The body has a very tight control over BG levels in the body and this is called glucose homeostasis. So the body releases glucagon when you eat protein to counteract the effect of insulin because glucagon raises BG by signaling a hepatic glycogen response, that’s basically your glucose storage in the liver. So in a normal metabolism, this is a non-effect to BG, it’s even, balance. Now enter dysregulation in a T2 like you or me, well all the years of high glucose and high insulin have affected our first phase insulin response. So glucagon does its job, but insulin either can’t hear the signal or can’t provide the needed insulin, the liver hears the call from glucagon and you have a hepatic glycogen release and immediate BG spike.
So know we understand the why, let’s talk about the how. What does eating to your meter mean? Well its simple, we want to test our BG before and after we eat, these are called the pre-prandial and post-prandial blood glucose or blood sugar readings. Our goal is to limit our spikes to a 20 point spike or less. Let’s use 30 points as a maximum. This means we want try and keep the spike between preprandial and the postprandial to 20 or less, again with 30 being the threshold. Test frequently and eliminate foods that cause you the biggest spikes.
So let’s talk about how to stay in that sweet spot of 20 points, let’s call this the safe zone. This is done by meal composition. The perfect meal would be the most amount of protein tolerated, a good amount of fibrous veggies and a little fat to cook or flavor. Too much protein will really spike your BG, not enough veggies will not help enough with spikes and too much fat will hinder the proper needed insulin response and will keep BG high for too long. So you can see this how complicated this can be and how much effort is involved in this whole process. Another thing that will help a lot is a tablespoon or two of Apple cider vinegar a few minutes before the meal.
Another important factor is when we eat and how often. The trick is to eat as few times as possible to let insulin levels fall, however in the beginning you may have to split your protein out over several meals. In the beginning I could only tolerate about 30 grams of protein per meal to stay in the BG safe zone. Now however by following these strategies I’m teaching you, I can eat over 100 grams in one sitting and stay in the safe zone. No matter how many meals you want to eat your last meal 4-5 hours before bed time. This will also help minimize FBG, more about that in a few. The goal is to get to the point where you are eating 2 meals inside of a 6 to 8 hour window, again with the last meal 4-5 hours before bed.
The next thing we want to incorporate as a Diabetic is exercise. This again is something to be careful with because it will elevate BG, so we want to wait until morning BG falls. That said the spike in BG is a good thing and we want to do it intentionally. T1s want to monitor throughout a workout more closely since you have no insulin on board. The goal here is actually to spike BG by way of a hepatic glycogen response and then clear that glycogen in a very specific manner. Here’s how. High intensity interval training followed by resistance bands. The HIIT workout will stimulate the BG spike rather well, pulling all the glucose/glycogen out of the liver as well as muscles into the blood stream to fuel the work out. Then while BG is elevated we will move directly into a band workout. This will clear all the glycogen into the muscle, not back into the liver and not into the cells and organs. You can do any style of HIIT you can tolerate or are comfortable with.
Another valuable method for BG control is the post meal walk. Just a nice leisurely stroll to help burn off the glucose spike from the meal and again the walking will help move the glucose into muscles. Not as effective as bands, but it will help. It will also help with digestion.
The next thing we want to work on is our fasting blood glucose, or as some call this the Dawn Phenomenon. This is our Blood Glucose levels upon first waking in the morning. First let’s look at what exacerbates fasting glucose levels. Food, cortisol or stress, poor sleep, liver dumps and gastroparesis. First, is food, or more specifically eating too late, eating too much the day before, eating too much fat the day before. Next is Cortisol, this is the fight or flight hormone that signals a glycogen release from the liver and this turns up as glucose in the blood. What drives cortisol? Stress. Try to read a book, meditate anything you can do to reduce it. So if you’re always stressed or always fatigued like most of us Type 2s are, you can bet on a high fasting glucose. Poor sleep, this is a big one. Things like blue screens, travel, going to bed too late, lumpy mattress all affect sleep and a lot of those things affect our cortisol levels and a few other things that drive fasting glucose up. Then there is the periodic unpredictable liver dumps, driven perhaps by stress or some other unknown event, this is when the liver dumps glycogen into the blood stream. Another thing is something called gastroparesis, or stomach emptying, this is where the stomach contents actually release into the small intestine slowly or unexpectedly. So the normal postprandial spike actually happens again. The other thing to help is some supplements, taking magnesium glycinate is not only recommended to follow a ketogenic diet but it will help with Blood glucose as well. Some D3 and B complex will help with the fatigue and thus the glucose levels. I also suggest taking berberine and ashwagandha and even some more apple cider vinegar at bedtime to help both manage blood glucose and cortisol thus helping glucose. You can take the berberine up to 3 times per day.
If you would like to find out how to get started on a ketogenic diet join us in our Facebook Group Keto Saved Me Group on, it’s a private group so you have to request to join, but no worries someone will approve your request promptly.
And as always remember we are all individual as such our journey, and keto saved me and it can save you too!