I noticed this this effect when I was diagnosed T2 7months ago. I was already going keto for the weight loss, its why I got the blood test done at the start of the diet. Those results hit me like a mack truck. Anyway, for the first 4-5 months my blood sugars were still ranging into the 120s with less than 20g of total carbs a day. I did intermittent fasting 16:8 and a 72 hour fast every month. After every long fast my fasted blood sugars would be lower then stay at that level until the next months long fast. I wasn't eating the carbs so they had to be coming from my liver. I pushed through. Now my morning blood sugars are between 88-98 most mornings. My Doctor wanted to put me on meds as soon as she got the results back 7months ago. But I refused cause I wanted to do this with lifestyle changes. Maybe, it could have been easier with a doctors help and meds, but my doctor gave me the skeptical stink eye when i said I wanted to try diet first. And she refused to order an insulin test with the blood test anyway. So I figured I was better off doing it my way. The funny thing is, the same doctor checked my insulin with blood work 15 years ago when my blood sugar was normal but my insulin was through the roof. I was obese as well. She said, "thats nothing to worry about, it happens sometimes in people with PCOS" If someone had told me then when I had to learn on my own now, I never would have become diabetic. I am still very angry about this. Insulin was obviously the problem.
I also was lied to by my then Dr. Years ago regarding fasting insulin. She told me it was normal. I now know it could not possibly have been normal. Also I was never told when I was pre- diabetic. Absolutely angry about it. I am now loosing my sight. I would never have become diabetic. Lucky I have found a wonderful low carb doctor who is helping me. He is interested, honest, and knowledgeable.
It is very encouraging that you were able to make it on your own. I don't think a lot of doctors are on board with the no carb approach. The subject of this video is fine tuning by the doctor. Probably a help if you can get it. Most doctors just want to treat you until you are dead, not help you get healthy.
Thanks doc. About 8-10 years ago I started eating very low carb and had to up my basal rates in my pump. I stayed focused on eating low carb and eventually had to lower my basal rates. I’m T1 30+ years. I went from averaging 100 units per day to currently 15 total units per day. I’ve been carnivore for 6+ years. A1c is 5.6
@@Jack-hy1zq in the past my basal rates that are programmed into my pump (they are tweaked occasionally but once set, stay consistent) were around 24 units and my bolus insulin was about 60-80 units a day. When I changed how I eat that drastically changed. Now I take (bolus and basal) 14-16 units total a day.
I started carnivore 10 months ago with 15 carbs or less a day. My A1C today tested in the high 5 range. For the first time in 15 years I am diabetic free! Very exciting ! This was achieved with no sugar! I would have never thought going with this plan would have ever given me these results!
IMO the easiest way to deal with diabetes and most issues is to go carnivore. It has done so many good things for us. We no longer take any meds and we feel wonderful. All of our labs are outstanding!
@@victoriad882 it does initially but after the glucose is “burned off” it drops. Just like when fasting. You used that as an excuse. “From a biochemistry standpoint, if you're eating only meat, you're largely not taking in glucose, so your blood glucose levels would not be affected,” says Dr. Darria Long Gillespie, clinical assistant professor at the University of Tennessee School of Medicine.”
@@jrowlove7328 I tried. I gave it six months. My a1C went from 5.8 to 6.3. I felt like I couldn’t continue. I’ve added some green vegetables that allow me to add lots of fat to them. Blood sugar lower, losing weight after a yearlong stall and more energy.
I did not overeat carbs: I overate meat! In 1997, when diagnosed with type 2, I said I don't abuse carbs. My doctor said "What do you abuse?" I had to say meat, and said I thought meat was protein. He said meat is at the top of the food chain. Your body takes what protein it needs, then converts the excess to blood sugar and circulates it! POW! Blood sugar from meat!?!?! Yes! I am still a carnivore, I am on the pump, I just got a Dexcom a few months ago, and I have noticed that my blood sugar goes up when I overeat meat!!! So I need to reduce my portion sizes, even if they are carnivorous!
It makes total sense to me! I did the deep dive into keto/carnivore without a doctor's involvement and I was pretty sure I was in the diabetic category for A1C when I started. After 4 months, I did go get my annual blood work and my A1C went down to 5.0. I'm doing carnivore now, and I am down 50 lbs. I won't give up thanks to doctors like you! I still have a ways to go.
Angie, I share almost the exact same story. I think I had a high A1C 18 months ago, based on what I’ve learned from docs like this. I should have, based on what I was consuming. I lost 45 lbs and don’t need to lose more. My A1c is now around 5. Now they are freaking out on LDL and Total Cholesterol, look right past Triglycerides of 70 and HDL of 72. Pretty amazing,I think, to lose all that weight and never once be ravenously hungry. All from just cutting carbs.
@@MarkSmith-js2pu That’s the same with me!! My total cholesterol is 258 with HDL of 72 and triglycerides of 51. My A1C is 5.1, so what’s the problem, guys? I just ignore them and continue with what I know is best for me- the Carnivore diet!!
Fascinating, engrossing lecture, as usual. IMO, you're a stand-out among all your colleagues in this space. Personally, you've been a God-send to my life. More, please and thank you! ❤️
THANK YOU for emphasizing carbohydrate overconsumption as opposed to the seed oils/PUFAs. There are just too many people losing hundreds of pounds and reversing a long list of metabolic health problems while still including condiments with soybean oil, canola oil, etc. I'm not saying we should gorge on these oils, but they haven't stood in the way of many, many thousands of people losing enormous amounts of weight and regaining excellent health. Not everyone can afford $9 for a jar of avocado oil mayonnaise, and they don't need to.
Amazing timing doc, Just went back on metformin after doing keto carnivore after over a year, because even though my A1c is at 5.5 my morning sugars are still 105 to 115. It's still takes me half a day to get the sugars down to the 80s and that is ten grams of carbs a day OMAD
One of the men I work with has dm 2. He came into my office so upset his blood sugars were running almost 400. He just got prescribed 2 more diabetic meds so he was on 4 including metformin 2 day. Anyway his new insurance wouldn't cover 2 of them and he was running out. His endocrinologist wanted to put him on insulin his insurance wouldn't cover. I said to him why are you taking medicine when you could get off them and control with diet. He said what do u mean? He goes to a endocrinologist and she told him watch what you eat and watch your carbs, he didn't understand. He really thought he had to live forever with dm. Anyway he was interested I'm what I had to say amazingly. Started him slow explained labels, food. I'm a RN so I said keep your carb count 130 a day. He was previously eating potato chips,fast food cup cakes cookies etc. He is not fat he was about 20 pounds overweight. His a1c went from 9.4 to 6.2 in 3 months. The dietician where I work is constantly making jabs at me about low carb. Moderation anyone could lose weight etc. I almost feel ganged up on lol Now I'm helping someone else just teaching about labels etc. She pissed and acts like I don't know what I'm talking about and she has the education. Well nurses are teachers too.
I know someone who you just explained in this video, past all the tests for diabetes but is overweight After doing a fasting insulin and Homa-IR on my advice after listening to your advice and others The results were fasting insulin 35 and homa of 8. She is now listening I will definitely show her this video👌
All biology professors should just play Dr. Cywes video on lecture days. So easy to understand. My ucla professor back then just absolutely sucked. Thank you Dr Cywes
As a type 1 diabetic, I’ve been able to stop covering meals as long as I keep my carb intake only to non-starchy vegetables. My Endo is on board because my A1c runs 5-5.3. He said he’s never had a type 1 with that low an A1c consistently. I do use long acting since my pancreas is dead, but much less than I had to prior to admitting/confronting my carbohydrate/food addiction.
I’ve always ran high fasting blood glucose levels with normal A1C. Once I messed up and got a blood glucose one hour after consumption of a entire delicious coconut cream cake. Not a bite but the whole cake. Only went to 134. I was running 10K’s back then and weight wasn’t a problem. I carb loaded all the time. When the weight gain became a problem I took it off with intermittent fasting and less than 20g of carbs per one meal a day. Thanks for this breakdown. I’m sure it will provide another missing puzzle piece for my edification. 🙏
I have a (step) family member who is Type 1.. it drives me crazy that they still say "eat whatever and cover with insulin". It just makes no sense. They have gained a lot of weight and get congratulated when their AIC is below 7 (as in 6.9). The most infuriating part is they get criticized from their endocrinologist for their weight gain. I went carnivore (long story) around the same time they were diagnosed and lost 60 lbs. They mentioned it to their doctor and was told it was too dangerous to try. Silly. Great video, thanks for all you do.
My adult son is iddm. He is also taking trulicity because of the weight gain. He never met a carb he didn’t love. We relied on his physician to give good direction. But he just kind of failed unknowingly because big Pharma said it was ok. So…. Ugh.
I have a colleague at work who is T1D. He says exactly the same as your folks, and he is appears to be too skinny. Most doctors everywhere seems to teach the same.
Most doctors are bought and paid for (whether they know it or not). We have to be our own doctors...with the help of the actual, low carb doctors, of course.
2 years of minimal carbs ( 0-40 grams) intermittent fasting and I stopped losing weight after 6 months. No matter what I did I could not break 180 lbs. Blood sugars dropped to prediabetic levels but I got sicker and sicker. Light headedness, nausea, a weird anxiety, loss of appetite, never before experienced serious constipation , cold all the time and now I have a non-cancerous thyroid nodule that they can't explain. Have never been on insulin but was on metformin. Came off when I started I.F. . Started eating carbs again and feel considerably better. Can't get anyone to diagnose me beyond saying it is stress. No kidding! Someone please help me. I am trying my best with limited resources.
Lacking in some nutrients, my guess would be potassium, maybe folate, magnesium. I've tried full carnivore and it put me in hospital with gallbladder disease. I like low carb, but I need leafy vegetables and vitamin C! But the plain fact is, this didn't work for you, you feel healthier now you're taking carbs again, go with god.
Very informative. My sugars, and most of my labs (done by a functional doctor) have always been normal and still are, but I've never understood diabetes or glucose issues. I didn't need to. But you explained this in a way that a non-medical person can comprehend. Thank you very much
This is making some sense. I'll neeed to watch it again to be sure I've got it. I'm a T2D for 18 years now and have been doing low carb and IF the last 7 months. My A1C has dropped 3 points to the middle 5s and I stopped metform about 6 weeks ago. In light of this video I wonder if I stopped too soon.
Read the comments, as a 10 year controlled type 2, with 17 units daily and 5.6 hba1c, I think the low carbohydrates is misleading and should be natural vegetables excluding potatoes and rice, but no processed foods. Essentially what we all ate back in the 1950's, home cooked meals with meat or fish as 1/3 and vegetables as 2/3. Occasional treat of processed food but limited.
Dear Dr. Cywes, I think that you are right my friends. Stabilizing insuline is crucial and when you got it under control you can move to the next part and that is a weight loss. I did my own WL experiment based on my own research (some Dr. Baker, Dr. Berg, Dr. Fung, Dr. Ekberg and many more). I've went from persising 100 straight to planned 68.8. At this point of My life I'm strong, healthy , fit and happy. My goal was to get healthy to reduce weight, not the other way. I do not need any meds, any doctors, nothing special and believe me, I was not only obese, I had depression, high blood pressure and all metaboli markers of t2d. Plan, stick to the plan, do not give up and expect more.
Type 2. A1c was 8.3 (average blood glucose of about 190). Ketovore for about 109 days now. Take Metformin but quit glimepiride at day 61. A1c is 5.6, average glucose is 120 (I paid for a CGM 14 days ago) and down 28 lbs (6', 176 lbs). I consume
It is interesting what you have to say. I manage insulin in a postprandial manner. It was when I fasted I had rather high blood sugars. I went carnivore and my fasting blood sugar remained high. I had poor tolerance to fatty meats. I consumed a very lean carnivore diet I have a poor gastric tolerance to fatty animals products. My doctor figured i was converting protein to glucose. I wasn't stimulating my insulin on this diet. I went on a more atkins like diet. I ate very complex carbohydrates along with a fair amount of fat and protein. I lost 90 pounds and had a fairly good increase in daily energy. I am considered a high insulin secreter, but need a small amount of carbohydrate to encourage the secretion of insulin. Perhaps years of carbohydrate addiction led to a blunted insulin response. No insulin secretion,, doesn't work for me, but a controlled small amount allows me to thrive.
Agree with you doc. I got my mother onto low carb finally but her fasting blood sugar remained elevated for some weeks after. Even higher elevations for dawn effect. She wasn't taking any exog insulin but couldnt understand why. Her doc refuses to order a fasting insulin blood test so. But you may right that gluco neogenesis is activated while her cells are already full of glucose
I was diagnosed type 1 in 1962. Until 2 years ago, I never once had a doctor want me to reduce or eliminate carbs. I have a good doc now, thankfully, one who advocates 15 or fewer carbs per day. I’m still having a great deal of trouble keeping my blood sugar normal. I use a tandem insulin infusion pump along with DexCom CGM. I’m still overweight by 30-40 lbs. I think my last A1c was 6.4 or 6.5. What’s more important to me than A1c is time in range. Anyway, long story short , do you see patients virtually? I’m clearly missing some vital information that could help me lose the weight and keep my BGs in range.
I am the conundrum. Very low carb ketogenic diet for two and a half years and I’ve yet to put type 2 in remission. I fast 16-18 hours a day, eat two meals, no junk or sugar what’s so ever and my fasting blood sugar remains in the mid 200’s. My fasting insulin is 9 and C peptide is good. Been tested for LADA, I do not have it. Exercise (Walk)30 minutes a day. I have asked several well known “keto” doctors about this and they don’t have a clue as to why I’m not responding like other type 2’s. I’ve had type two for twenty four years with a strong family history of both type one and type two. My father and his siblings all having died of complications of type two in their 60’s. I’m about to turn 67 in December the same age my dad was hen he died. The first two years keto I did improve some and my A1C was 6.3 and trending down very slowly. Now it’s 8.4 and slowly trending upwards. Last December I took two serious falls with injuries then contracted the Omicron virus in spite of being vaxed and boosted. That’s when things took a turn downward in spite of my diligence. I can’t begin to express how frustrating this is. The only thing that could explain it is something I heard Dave Feldman say. He said that there’s a small number of people that have this issue after being on an extremely low carb diet for an extended length of time. He said their body’s are so used to burning fat for energy that they are no longer getting an insulin response. He called it hypoinsuliniema. Anyway I really need a consult with you but sadly I’m on a fixed income and you don’t take Medicare, so that will have to wait until my budget allows. I would really appreciate you doing a video on this subject. There’s so very little info out there on this and I’m sure I’m not the only one racking my brain over this. Thanks for all you share on your channel, it’s greatly appreciated. Oh I might add that I’ve continued to take 2,000 mil of Metformin and was on insulin before going keto. Went off insulin after the first two weeks because of lows in the 40’s.
In my opinion, we are so early into the "carnivore era" that we do not really know the possible adverse long term health effects of this diet on humans, especially with our animal testing models being so limited. Therefore, I suspect good questions like yours just can't be answered fully now. Dr. Cywes says he occasionally doses his 2 year old with carbs so he does not develop what you labeled "hypoinsuliniema". Is that good or bad? I do not think we have the answers to that question yet.
Kim Congratulations on working so hard. First I would say stay the course, as noted it can take Years 2 repair the Damage of Years. Also on fixed income & stuck w horrible Kaiser . You are actually lucky if you have classic Medicare. One of the carb docs - Berg??- has a list of keto docs. You might be able 2 find one that takes Medicare. Very important however - your post contains the seeds of a possible answer. Things started 2 change w injuries. B.s. always rises due to injury or illness. So injury + illness (c19). On top of that a shot & booster that are now known not to stop or decrease severity of illness. Plus there is now plenty of hardcover evidence they actually diminish your immune system, spread throughout the body to every cell AND cross the blood/brain barrier. So in the last year your body has had significant insults to the body & immune system ,all of which feeds rising b.s.. Have you completely recovered from the injuries. Check into long covid & treatments there is now some thinking that the shots play a role in it. Were shots b4 Omicron? At a minimum if it were me I would not be lining up for more jabs, you have enuf to deal w now.
Perhaps it will just take longer than 2 years to reverse your T2 after being diabetic for so many years. The inflammation from contracting covid certainly won’t help bring your fasting insulin or A1C down, either. I wish you the best of luck.
I have severe RT ankle pain x 8 years which was greatly improved with oral semaglutide purchased online without a prescription (a dry, 5 mg/vial powder with neither reconstitution nor dosage instructions). My numerous physicians have turned a deaf ear to my pleas for a brief trial of prescription semaglutide (Rybelsus, Ozempic, Wegovy) which is available with small copays for me. As a T2Diabetic w CAD (NSTEMI, 3 vessel CABG), cannot tolerate metformin (diarrhea) nor Jardiance (kidney stones) I qualify for Ozempic. But because I fasted & carb restricted to 5.2 hbA1c, there is no interest in providing me w/semalgutide!
I can not afford a CGM and no insurance to pay for it. Interesting thoughts, I lost 70-lbs on Keto/carnivore and fast thrre days a week no food! Bummer way to live, but so much better than death! Thanks
Call Abbott and ask about a 12-month coupon for the freestyle libre 3. As a type 1 my insurance doesn’t cover because I refuse to go on an insulin pump. The cost will be $37.99 per sensor. I don’t feel $75 a month is too bad.
Thank you for continuing to educate yourself and the world about this insulin / carb crisis we have put ourselves into since Ancel Keys. - I believe you are in Florida? I hope you and your family are safe from Hurricane Ian.
@@robertcywes2966 Please do a review on Mounjaro (tirzepatide). A lot of friends and co workers are getting on it to lose weight. They say it works better and Drs are prescribing it instead of gastric bypass. Thoughts??
Now I understand why my obese husband was never diagnosed as diabetic. He went low carb, lost 80 lbs, but then lost his discipline and the carbs all around in society won over. Sadly, he had a quad bypass in April and now is diagnosed with heart failure. The medical community does not support low carb for him and even suspect his heart disease is worsened by low carb, high fat diet He will not go low carb now, and his insulin is never measured. However, now I am more at peace with my low carb high fat eating. It's there if he wants it but he has to choose. Thanks for your explanation.
sorry for.your frustration. I can relate. I can't get my husband to change his diet or exercise properly either. he has a fit body but a big belly which is a tell tale sign of fatty liver and visceral fat. I just won't allow carbs in the house at all. the kitchen is carnivore. he eats whatever outside but I won't feed him anything but meat and some veggies to balance out his crap food.
So you suspect that the high insulin production caused his heart problems? My father had quadruple bypass surgery, yet he never had blood sugar problems
@@nickbardan3867 The medical system never measures his insulin because his A1C is in the normal range. Metabolic Insulin Resistance Syndrome is a prime cause of heart disease, and one look at his very fat body suggests he has MIRS. I always wondered how he never had diabetes, but this presentation explains it. Canadian docs are discouraged from exploring this further and are stuck in the low fat/statins protocols.
I started doing Keto on day one of my T1 diagnosis. It took me around 4 to 6 months (Keto Omad and 2 days of complete fasting per week) to get my A1c down from over 12 to 5,x , where it stayed since then. Never had any "rollercoaster". Never used any medications or insulin. The first two years, it took 8 - 12 hrs. for my body to get under 100 BG. Since 2 years or so he got faster. Sometimes I`m under 100 after 2 - 3 hrs. now. I`m doing a VERY lazy kind of carnivore. Fun fact : I LOVE chocolate, and when I`m sometimes eating some Keto-chocolate ( which HAS 21g of sugar per 100g), my BG lowers down FASTER ! Strange.
@@kathleengempel5814 I have indeed ! And the honeymoon stays. Since 2018. But, unfortunately, the process off selfdestruction got slowed down from "1000 times higher than normal" (as the endo said in the beginning) to "50 times higher than normal" last winter. It didn`t stop. So therefore there will be a time in a future nearer or farer where I`ll be forced to take insulin. If that is availlable then anymore. But not now !
Yeah you can have insulin resistance eating no carbs. It manifests as excessive gluconeogenesis. The insulin resitant liver hears the glucagon signal but not the insulin signal. ME. Doc, give some thought to what happens when the liver sees dietary fat via unemptied chylomicrons.
I will need to review this video several times to try to gain an understanding of what you are trying to tell us. I sense you are so intelligent that as a consumer I am not able to comprehend what you are attempting to convey to us. I will need to study and unpack all of the terms you use. I am trying to understand how this applies to a pre-diabetic (A1C
Agree with you KETO by George. This explanation went over my head -just as I was so proud of having thought I had all this too high of insulin thing figured out. Now I am worried I am doing something wrong with my low carb intermittent fasting life style. 🙁🙁🙁 I know the doctor means well by us but I am left frustrated by this particular video. I am like you simply pre-diabetic with no Metformin or insulin taking going on.
Makes sense (to me) that (after years of training) it may take metabolic machinery to come back to normal functioning, and that special monitoring of various metabolites would be advised, and that this would be highly specific to each person.
I often wonder how many morning rush hour auto accidents can be attributed to a perfectly sober driver (in terms of drugs and alcohol) having been under the influence of a fruit and fiber breakfast, such as cereal that's topped with bananas (lightheadedness, fatigue, poor concentration). Call it the "Cap'n CRUNCH" effect if you will. Perhaps cops should start carrying some kind of portable CGM device in addition to the devices they use for field sobriety checks. Sadly, also, a lot of young people are known to eat cereal for dinner and then get behind the wheel - so the problem isn't necessarily restricted to just morning traffic. Stick with a high protein breakfast to help you and the others on the road to stay safe
So for these patients that have sugars in the 200's and you have them on Insulin therapy and they greatly reduce their carbs, I have two questions: 1. If they become hypoglycemic, how do you tell them to treat this? (ADA recommends the 15/15 rule) Do you recommend something different? 2. They don't feel good with a blood sugar of 120 at first.... Do you have them treat this with consuming any carbs?
My father had neuropathy. He was never diagnosed with Insulin resistance or type 2 diabetes but he also had Alzheimer's. He always thought his neuropathy was a side effect of medication.
Dr Cywes, from aprox 08:00 in the video you describe 2 groups of people. For the 2nd group with High production of Insulin, but Not elevated blood sugars, but high body weight, what is the terminology for that condition and how can it be tested for ? Eg in U.K. I’m assuming testing fasting Insulin, C-Peptide and BG but anything else to test for this and how to manage such a hormone condition ? Thank you for everything you do for the community
It makes total sense. It just seems paradoxical to increase insulin as that would make you hungry. I still don't quite understand how the satiety part works. What happens to insulin and hormone sensitive lipase on a keto diet if you don't eat carbs, but have a glp agonist?
I am 71 years old I have suffered from hypoglycemia for as long as I can remember, I am 1.8 m tall and weigh 58Kg. when I did consume carbs I could never gain weight and when increasing fat intake, lots or little ,still no weight gain. When I dont eat I get tired and grumpy and as soon as I eat something sweet my energy picks up almost immediately and I am more grounded so for me sugar helps except that I sometimes this sets up a craving. I have been strict carnivore for the last 3 years because I found that vegetable fibres were irritating the small intestine but still an energy crash when I go too long between meals. I have no health problems that I know of unless hypoglycemia is a symptom of a health problem. Also even though I pay attention to electrolyte consumption I have for the last year been suffering awful nocturnal leg cramps to which I have found no solution and which rob me of a good nights sleep 2 or 3 times a week,
GLP-1 agonists/dexcom life-changing for me. My insurance covers (for now) because I am t2d...but so many are turned away and it is a crime. For the longest time I thought I would need to go on some insulin, wasn't afraid because i was gestational and my dad is t1d...took awhile this time around but from going from fasting over 200 to now fasting in high 90''s/100ish...since July, I know I am making progress. I need the meds and the diet, exercise and CGM.
Thank you for your videos about diabetes. I’m learning so much. I am a type 2 diabetic who went undiagnosed for many years. I am currently eating carnivore. I don’t feel like my doctor has the answers to my questions and it is frustrating. He did prescribe a CGM at my request but I had to self pay because insurance would not cover. I am not on any medication and I’ve noticed my blood sugars going up to the 150’s no matter what I eat. Now all the sudden my average is 128. I am seeing not high spikes but my lows are finally going into the 80’s. It is working slowly but should I be concerned that I’ve never even been or on metformin? I did order my own c-peptide and fastening insulin. I think it is time for me to text you.
I have only recently heard that type 1 diabetics could also be type 2. It totally makes sense. Just bolus more insulin!! What I wish I knew to educate my son sooner. Hope the message gets to him from sharing this.
Hi Dr. Cywes...10 years ago I lost 50 lbs and was 20 pounds from my goal weight by eating pretty much the same thing daily: flax seed pancakes with some blueberries, 1/4 cup raspberry snack, lunch spinach chicken salad, dinner was chicken thighs with peas, tablespoon of butter. Then...lost my home in a flood (I really hope you are doing okay in Florida today!!) and lived in an oilrig camp for six months built by the government...we had Red Seal chefs and with the stress and surrounded by cheesecake and all sorts of goodies every day well I gained it all back. Been a sugar addict since childhood. Now, I've been very low carb (no fruit/veg/grain) and even carnivore and the weight will not move. I am so frustrated. I'm wondering if I need to go back to what I did before. I really hope that the entire treatment paradigm for diabetes/obesity shifts soon...it is tragic what the old food pyramid has wrought upon the US and here in Canada. Thank you!
I never heard Dr Fung or others say they withdrew medications on patients who still had high blood glucose levels. I believe that type 2 diabetes should be a diagnosis based on fasting insulin and/ or glucose. As you said before treating the glucose is akin to treating fever
I'm so bummed out. I have relatives that are convinced that type two diabetes is just a normal part of growing old just because their parents had diabetes..they continue to plow through the chips, potatoes, rice, cinnamon buns etc. These are educated folks stuck in the dogma that it's their lot in life. They look at my ultra low carb ( medication free) lifestyle like im from Mars. Ugh.
Guess what on keto 5 years still diabetic as my liver joins the morning party and the dawn effect happens. I go carnivore the liver makes glucose from the protein. Stuffed either way. I have lost eight stone in 7 years. I exercise, swim mostly what else can i do?
29yrs, went into acidosis Feb this year with A1C 10.9. Got out, used insulin for a month but then started having issues going too low. So i stopped medication and switched to keto diet. A1C around 5.5 now but seems I have to stay keto because my IR is so bad if I spike sugar with anything I get an extreme hypo just less than an hour after meal down to 50’s and 60’s mg/dl. I’m very active and quite lean so I wanted to incorporate some carbs back into diet for recovery but it seems that’s not viable because of the reactive hypoglycemia I get (I’m talking less than (60gtams carbs per day, mainly from fruit). I need to understand my intercellular gradient relationship to my insulin and cortex that. I made the call to stop the insulin I made the decision to go keto because of the hypo, my endocrinologist did not understand why I’m going hypo without medication shorty after a meal when I’m T2 and no meds. I need to work with someone on this because my lows feel dangerous. In the 80s is whenI get very clamy and start feeling like pass out. But overall, I think your video assures my that my decision to go keto was the right way, and maybe my body just needs more time to improve: I was in the icu for 10days, came in not breathing from the acidosis. It seemed to be very accurate from pancreatitis which I recovered from extremely quickly. I had been heavy binge drinking the year prior to my hospitalization because I did not know I had diabetes and misinterpreted my hypo and hyper glycemia as anxiety: I was predefined anti depressants, had tests run on my heart, only once during routine blood work did my fasting blood sugar show a little bit high, guess my doc never requested an A1C or they would have caught that. Anyways, you’re helping me learn a lot. I’d like to work with a medical professional who understands the issue more though. The dietary recommendations from my endo and from the hospital weren’t very helpful. Taking things into my own hands was much more effective but made me weary that I might be doing something wrong. Please put me in contact with someone. I had been telling my doc for years I did not feel right and something was seriously wrong, so in that sense it was a blessing to have the acidosis incident, which confirmed I wasn’t crazy and I kicked all psych meds (very little) and alcohol. Keep up the good information! From Orlando, Fl not far from you. I’d be willing to drive a few hours to an appointment if needed every few months or so whatever the cadence need be.
I would like to hear more on this subject. I eat less than 10 carbs a day most days and have been having blood sugars above 180 and sometimes above 200. CGM and verified with fingerstick. I’m on no meds. Had been on insulin but stopped it after about 6 weeks of keto/Carnivore because everything I was seeing said a type 2 shouldn’t be treated with insulin. So, I should start it back? I don’t really want to be on it, but if it will help in the long run I could start it back. 90 day average BS 146. But the last month has increased 30 day average 160.
Hello Dr Cywes, If you get a moment, I wonder if you would address the latest confusion that is going around; that is that there is no such thing as insulin resistance and that the effects that we see is actually the Randle Cycle. For a layperson like me, the detail of the biochemistry is interesting but probably doesn’t matter as whatever the cause cutting out carbs is the solution. But in any case, I wonder if you might speak to it?
guess i shouldnt fear the insuling went low carb about a week ago started getting morning sugars in teh 100-113 range instead of 200 range. but keeping the same insulin levels feels scary at this point. of course doctors just say lower it one point a day till it starts to go back up stop there so wish me luck
Dr Cywes, if you have a high AST ALT should you still do carnivore or will it keep going up on carnivore?? Thanks just watched your video from three days ago
I don't understand why increasing someone's insulin would help if a high level of insulin is the initial cause of insulin resistance. I'm sure it is much more complicated than that and that is why I truly don't understand. I thought you want to have a low insulin to glucagon ratio. So, I would think that it would be good to have lower insulin if your glucagon was high. So why add more insulin? Thanks for all of the information that you provide on TH-cam.
What would it mean if I have a low insulin of 2. Have had normal fasted glucose/hba1c. Have been on high carb diet/binge eating, stayed at a moderate weight but have high cholesterol, and neuropathy vascular issues and now pain in upper right abdomen. I am pretty sure I have a burnt out pancreas and am insulin resistant from many years of over eating but also exercising. Doctors just assume because I’m not overweight that I’m making it up. Is a low insulin a sign of something? I ate carnivore for a couple of days blood sugar went low I missed vegetables and ate a salad with some grains/olive oil etc and blood sugar spiked right up. I have been monitoring after bingeing and it has strangely been lower than normal like 4.3 etc.
Almost 80 days with no carbs stopped losing weight after the first 15 lb and now I just bounce up and down 3 lb every day, and my blood sugar has not gone to normal, in fact, it still high, though I've stopped taking any of the medication trying to get my body to do what it's supposed to do. I am eating carnivore. I have lowered my protein and increased my fat in the hopes that that will do the trick if it doesn't, guess I will lower my fat and increase my protein, or I'll just go Keto.
@@robertcywes2966 I have a standing order for bloodwork after 90 days, so I'll get it all checked then. I really expected something different, like weight loss and lower glucose readings. :) Thank you for responding.
My 93 year old carb addict father fits in that category of obesity without an HbA1c in the type II formal range. Still one can argue that decades of hyperinsulinemia is likely the reason for chronic heart deficiency, macular degenerative disease, kidney damage etc. Am I right to think that chronic excess insulin is just as bad as chronic excess sugar? OK to go UP in order to later go DOWN but must be monitored by an informed doctor on a motivated patient. No hope to help reduce the rate of damage done to my father’s health who reside in a retirement semi autonomous home where the institutional recommended food pyramid is observed.
My A1c used to be 7.2 for a long time, after 2 months of keto it dropped to 5.8. Now, after 4 months of keto it is up to 6.2 :/ Morning sugar is high up to 130, 2 hours after meals it is 120-138. I feel lost, don't know what to do. I am on Metformin, gave up Jardiance. Should I start taking Jardiance again??? Pointless to ask my doctor, he knows nothing about keto :(
QUESTION: is my exogenous insulin (type 1 on 17,3 units of basal daily via pump) any good at blocking glucagon? And if my hdl/trig ratio, blood pressure and weight are stable/normal what indications of insulin resistance might I look for? I am low carb but could go lower if I thought my health would benefit. HBA1c 48 or lower (6.5%) but after 40 years of abnromal bgs I suppose my micro/macro vascualr system is screwed already. You are always v. interesting btw!
The practical implication of treating a Type 2 diabetic by reducing carbs to basically zero but increasing insulin over a time period is confusing -- treating that "gradient" problem. Also, some terminology is confusing, long-acting insulin and a "pump" Greek to me. 18 months to 2 years to reverse T2D?? Surely with aggressive treatment 6 months is achievable?
If you aren't on insulin and are looking to keep getting your sugars down but even with low carb/keto/carnivore for years could you potentially spike your insulin yourself with things like cauliflower which are a bit higher on the insulin index to bring the sugars down?
@@pittsburgh-gal Rather than GI there is an insulin index of how foods affect insulin. From memory it may have been an Australian paper? I know Marty Kendall has covered it a couple of years ago.
carnivore is cap. when i went carnivore the animal proteins were giving me as many diabetic rushes as if I were eating chocolate cakes and caramelized nuts all day!!!
@@durango4624 sure our digestion might be compromised a bit, but still that doesn't make the diet safe for everyone. Especially for histamine intolerant people
My mom is not statistically significant or peer reviewed but her experience has had real significance among her circle of friends and family. 2 years ago, my 80 year old mother finally had a follow up appointment with her physician which was delayed for months because her doctor has been in charge of treating Covid patients in the hospital and in nursing homes and was not able to meet with her. She had a full blood panel taken for this visit and her doctor was astounded at the progress she had made during the last year. She is now no longer diabetic and she was instructed to stop taking insulin after having been on it for 12 years. Her doctor also praised her kidney function which has never looked better. Also, she couldn't believe that her total cholesterol was only 139, with LDL of 67, HDL of 60, and triglycerides of 82 which is a big improvement for her. According to the Framingham Heart Study, these numbers mean that she is virtually "heart attack proof" as many plant based doctors have noted. Her physician mentioned that she is reconsidering the diet for her family based on this experience. She also asked my mom to share her experience with our community after the pandemic. All of these results are exactly what I had hoped would occur. Here is the menu that I had developed for her to try to mimic what she was used to eating -> "GSP Mother's Menu" - While this menu is not a pure whole foods plant based diet, it appears to be health promoting enough to work for her. I plugged her bloodwork test values into the Levine Biological Age Calculator (free online) and she has aged minus 15 years during the last 3 years. I joke with her that she may be required to give up her Social Security benefits if she keeps going like that. My understanding is that low carb diets are a workaround that do not address the root cause of diabetes which is excess intramyocellular lipids (also fatty liver/pancreas) and the resulting insulin resistance (excess saturated fats and refined sugar/flour are the most common cause of this metabolic system failure). Cheers!
I'd love to hear your thoughts on histamine accumulation through consumption of slow-cooked keto/carnivore foods (bone broth, collagen peptides, braised meats, etc), and the resulting reflux, nausea, etc. Perhaps a pressure cooker is the better option to slow cooking (less histidine-histamine conversion).
Some strict Ketos avoid Collagen (Oxalates) and Bone Broth (Glutamate) Need very high quality sat and poly fats - don't follow the meat heads 70 grams protien / day max women
The problem is not the carbs or fat or protein. The problem is overeating. The modern society population eat a lot more than our grandparents ate. That is the problem. Eat less , people. The 2000 calories needed is overestimated. You don't need 2000 cal especially when sitting on your ass all day .
I noticed this this effect when I was diagnosed T2 7months ago. I was already going keto for the weight loss, its why I got the blood test done at the start of the diet. Those results hit me like a mack truck. Anyway, for the first 4-5 months my blood sugars were still ranging into the 120s with less than 20g of total carbs a day. I did intermittent fasting 16:8 and a 72 hour fast every month. After every long fast my fasted blood sugars would be lower then stay at that level until the next months long fast. I wasn't eating the carbs so they had to be coming from my liver. I pushed through. Now my morning blood sugars are between 88-98 most mornings. My Doctor wanted to put me on meds as soon as she got the results back 7months ago. But I refused cause I wanted to do this with lifestyle changes. Maybe, it could have been easier with a doctors help and meds, but my doctor gave me the skeptical stink eye when i said I wanted to try diet first. And she refused to order an insulin test with the blood test anyway. So I figured I was better off doing it my way. The funny thing is, the same doctor checked my insulin with blood work 15 years ago when my blood sugar was normal but my insulin was through the roof. I was obese as well. She said, "thats nothing to worry about, it happens sometimes in people with PCOS" If someone had told me then when I had to learn on my own now, I never would have become diabetic. I am still very angry about this. Insulin was obviously the problem.
I also was lied to by my then Dr. Years ago regarding fasting insulin. She told me it was normal. I now know it could not possibly have been normal. Also I was never told when I was pre- diabetic. Absolutely angry about it. I am now loosing my sight. I would never have become diabetic. Lucky I have found a wonderful low carb doctor who is helping me. He is interested, honest, and knowledgeable.
You probably already know this, but you can order your own blood tests online at pretty reasonable rates.
It is very encouraging that you were able to make it on your own. I don't think a lot of doctors are on board with the no carb approach.
The subject of this video is fine tuning by the doctor. Probably a help if you can get it. Most doctors just want to treat you until you are dead, not help you get healthy.
👍❤️
Hope you found a new doctor.
Thanks doc. About 8-10 years ago I started eating very low carb and had to up my basal rates in my pump. I stayed focused on eating low carb and eventually had to lower my basal rates. I’m T1 30+ years. I went from averaging 100 units per day to currently 15 total units per day. I’ve been carnivore for 6+ years. A1c is 5.6
Could you explain what you mean by "lowering my basal", please, and why.
@@Jack-hy1zq in the past my basal rates that are programmed into my pump (they are tweaked occasionally but once set, stay consistent) were around 24 units and my bolus insulin was about 60-80 units a day. When I changed how I eat that drastically changed. Now I take (bolus and basal) 14-16 units total a day.
@@debranelson6756
Thanks 👍
I started carnivore 10 months ago with 15 carbs or less a day. My A1C today tested in the high 5 range. For the first time in 15 years I am diabetic free! Very exciting ! This was achieved with no sugar! I would have never thought going with this plan would have ever given me these results!
IMO the easiest way to deal with diabetes and most issues is to go carnivore. It has done so many good things for us. We no longer take any meds and we feel wonderful. All of our labs are outstanding!
Did not work for me. Excess protein raised glucose
@@victoriad882 it does initially but after the glucose is “burned off” it drops. Just like when fasting. You used that as an excuse. “From a biochemistry standpoint, if you're eating only meat, you're largely not taking in glucose, so your blood glucose levels would not be affected,” says Dr. Darria Long Gillespie, clinical assistant professor at the University of Tennessee School of Medicine.”
@@jrowlove7328 I tried. I gave it six months. My a1C went from 5.8 to 6.3. I felt like I couldn’t continue. I’ve added some green vegetables that allow me to add lots of fat to them. Blood sugar lower, losing weight after a yearlong stall and more energy.
I did not overeat carbs: I overate meat! In 1997, when diagnosed with type 2, I said I don't abuse carbs. My doctor said "What do you abuse?" I had to say meat, and said I thought meat was protein. He said meat is at the top of the food chain. Your body takes what protein it needs, then converts the excess to blood sugar and circulates it! POW! Blood sugar from meat!?!?! Yes! I am still a carnivore, I am on the pump, I just got a Dexcom a few months ago, and I have noticed that my blood sugar goes up when I overeat meat!!! So I need to reduce my portion sizes, even if they are carnivorous!
Just add more fat with your meals.
It makes total sense to me! I did the deep dive into keto/carnivore without a doctor's involvement and I was pretty sure I was in the diabetic category for A1C when I started. After 4 months, I did go get my annual blood work and my A1C went down to 5.0. I'm doing carnivore now, and I am down 50 lbs. I won't give up thanks to doctors like you! I still have a ways to go.
Angie, I share almost the exact same story. I think I had a high A1C 18 months ago, based on what I’ve learned from docs like this. I should have, based on what I was consuming. I lost 45 lbs and don’t need to lose more. My A1c is now around 5. Now they are freaking out on LDL and Total Cholesterol, look right past Triglycerides of 70 and HDL of 72. Pretty amazing,I think, to lose all that weight and never once be ravenously hungry. All from just cutting carbs.
@@MarkSmith-js2pu That’s the same with me!! My total cholesterol is 258 with HDL of 72 and triglycerides of 51. My A1C is 5.1, so what’s the problem, guys? I just ignore them and continue with what I know is best for me- the Carnivore diet!!
Fascinating, engrossing lecture, as usual. IMO, you're a stand-out among all your colleagues in this space. Personally, you've been a God-send to my life. More, please and thank you! ❤️
THANK YOU for emphasizing carbohydrate overconsumption as opposed to the seed oils/PUFAs. There are just too many people losing hundreds of pounds and reversing a long list of metabolic health problems while still including condiments with soybean oil, canola oil, etc. I'm not saying we should gorge on these oils, but they haven't stood in the way of many, many thousands of people losing enormous amounts of weight and regaining excellent health. Not everyone can afford $9 for a jar of avocado oil mayonnaise, and they don't need to.
Amazing timing doc,
Just went back on metformin after doing keto carnivore after over a year, because even though my A1c is at 5.5 my morning sugars are still 105 to 115.
It's still takes me half a day to get the sugars down to the 80s and that is ten grams of carbs a day OMAD
One of the men I work with has dm 2. He came into my office so upset his blood sugars were running almost 400. He just got prescribed 2 more diabetic meds so he was on 4 including metformin 2 day. Anyway his new insurance wouldn't cover 2 of them and he was running out. His endocrinologist wanted to put him on insulin his insurance wouldn't cover. I said to him why are you taking medicine when you could get off them and control with diet. He said what do u mean? He goes to a endocrinologist and she told him watch what you eat and watch your carbs, he didn't understand. He really thought he had to live forever with dm. Anyway he was interested I'm what I had to say amazingly. Started him slow explained labels, food. I'm a RN so I said keep your carb count 130 a day. He was previously eating potato chips,fast food cup cakes cookies etc. He is not fat he was about 20 pounds overweight. His a1c went from 9.4 to 6.2 in 3 months. The dietician where I work is constantly making jabs at me about low carb. Moderation anyone could lose weight etc. I almost feel ganged up on lol Now I'm helping someone else just teaching about labels etc. She pissed and acts like I don't know what I'm talking about and she has the education. Well nurses are teachers too.
I know someone who you just explained in this video, past all the tests for diabetes but is overweight
After doing a fasting insulin and Homa-IR on my advice after listening to your advice and others
The results were fasting insulin 35 and homa of 8.
She is now listening
I will definitely show her this video👌
Boy,I have to watch this about 4more times to understand this mechanism! Thanks, doctor.
haha yes, some of this didn't stick. I've saved it in 'notebook'. I'll try again when my brain isn't aching.
Agreed!
All biology professors should just play Dr. Cywes video on lecture days. So easy to understand. My ucla professor back then just absolutely sucked. Thank you Dr Cywes
As a type 1 diabetic, I’ve been able to stop covering meals as long as I keep my carb intake only to non-starchy vegetables. My Endo is on board because my A1c runs 5-5.3. He said he’s never had a type 1 with that low an A1c consistently. I do use long acting since my pancreas is dead, but much less than I had to prior to admitting/confronting my carbohydrate/food addiction.
I’ve always ran high fasting blood glucose levels with normal A1C. Once I messed up and got a blood glucose one hour after consumption of a entire delicious coconut cream cake. Not a bite but the whole cake.
Only went to 134. I was running 10K’s back then and weight wasn’t a problem. I carb loaded all the time. When the weight gain became a problem I took it off with intermittent fasting and less than 20g of carbs per one meal a day. Thanks for this breakdown. I’m sure it will provide another missing puzzle piece for my edification. 🙏
I have a (step) family member who is Type 1.. it drives me crazy that they still say "eat whatever and cover with insulin". It just makes no sense. They have gained a lot of weight and get congratulated when their AIC is below 7 (as in 6.9). The most infuriating part is they get criticized from their endocrinologist for their weight gain. I went carnivore (long story) around the same time they were diagnosed and lost 60 lbs. They mentioned it to their doctor and was told it was too dangerous to try. Silly. Great video, thanks for all you do.
My adult son is iddm. He is also taking trulicity because of the weight gain. He never met a carb he didn’t love. We relied on his physician to give good direction. But he just kind of failed unknowingly because big Pharma said it was ok. So…. Ugh.
I have a colleague at work who is T1D. He says exactly the same as your folks, and he is appears to be too skinny. Most doctors everywhere seems to teach the same.
Most doctors are bought and paid for (whether they know it or not). We have to be our own doctors...with the help of the actual, low carb doctors, of course.
2 years of minimal carbs ( 0-40 grams) intermittent fasting and I stopped losing weight after 6 months. No matter what I did I could not break 180 lbs. Blood sugars dropped to prediabetic levels but I got sicker and sicker. Light headedness, nausea, a weird anxiety, loss of appetite, never before experienced serious constipation , cold all the time and now I have a non-cancerous thyroid nodule that they can't explain. Have never been on insulin but was on metformin. Came off when I started I.F. . Started eating carbs again and feel considerably better. Can't get anyone to diagnose me beyond saying it is stress. No kidding! Someone please help me. I am trying my best with limited resources.
Would need much more info to make an educated suggestion.
Lacking in some nutrients, my guess would be potassium, maybe folate, magnesium. I've tried full carnivore and it put me in hospital with gallbladder disease. I like low carb, but I need leafy vegetables and vitamin C! But the plain fact is, this didn't work for you, you feel healthier now you're taking carbs again, go with god.
Very informative. My sugars, and most of my labs (done by a functional doctor) have always been normal and still are, but I've never understood diabetes or glucose issues. I didn't need to. But you explained this in a way that a non-medical person can comprehend. Thank you very much
Brilliant. I hope you publish this stuff somewhere!!!
This is making some sense. I'll neeed to watch it again to be sure I've got it. I'm a T2D for 18 years now and have been doing low carb and IF the last 7 months. My A1C has dropped 3 points to the middle 5s and I stopped metform about 6 weeks ago. In light of this video I wonder if I stopped too soon.
Read the comments, as a 10 year controlled type 2, with 17 units daily and 5.6 hba1c, I think the low carbohydrates is misleading and should be natural vegetables excluding potatoes and rice, but no processed foods. Essentially what we all ate back in the 1950's, home cooked meals with meat or fish as 1/3 and vegetables as 2/3. Occasional treat of processed food but limited.
Dear Dr. Cywes, I think that you are right my friends. Stabilizing insuline is crucial and when you got it under control you can move to the next part and that is a weight loss. I did my own WL experiment based on my own research (some Dr. Baker, Dr. Berg, Dr. Fung, Dr. Ekberg and many more). I've went from persising 100 straight to planned 68.8. At this point of My life I'm strong, healthy , fit and happy.
My goal was to get healthy to reduce weight, not the other way. I do not need any meds, any doctors, nothing special and believe me, I was not only obese, I had depression, high blood pressure and all metaboli markers of t2d.
Plan, stick to the plan, do not give up and expect more.
Very interesting theory. Certainly something to discuss within the medical world. CGM should definitely be part of any diabetes treatment.
"If you do not have carbohydrates in your diet you cannot have insulin resistance." amen.
Type 2. A1c was 8.3 (average blood glucose of about 190). Ketovore for about 109 days now. Take Metformin but quit glimepiride at day 61. A1c is 5.6, average glucose is 120 (I paid for a CGM 14 days ago) and down 28 lbs (6', 176 lbs). I consume
It is interesting what you have to say. I manage insulin in a postprandial manner. It was when I fasted I had rather high blood sugars. I went carnivore and my fasting blood sugar remained high. I had poor tolerance to fatty meats. I consumed a very lean carnivore diet I have a poor gastric tolerance to fatty animals products. My doctor figured i was converting protein to glucose. I wasn't stimulating my insulin on this diet. I went on a more atkins like diet. I ate very complex carbohydrates along with a fair amount of fat and protein. I lost 90 pounds and had a fairly good increase in daily energy. I am considered a high insulin secreter, but need a small amount of carbohydrate to encourage the secretion of insulin. Perhaps years of carbohydrate addiction led to a blunted insulin response. No insulin secretion,, doesn't work for me, but a controlled small amount allows me to thrive.
Agree with you doc. I got my mother onto low carb finally but her fasting blood sugar remained elevated for some weeks after. Even higher elevations for dawn effect. She wasn't taking any exog insulin but couldnt understand why. Her doc refuses to order a fasting insulin blood test so. But you may right that gluco neogenesis is activated while her cells are already full of glucose
I was diagnosed type 1 in 1962. Until 2 years ago, I never once had a doctor want me to reduce or eliminate carbs. I have a good doc now, thankfully, one who advocates 15 or fewer carbs per day. I’m still having a great deal of trouble keeping my blood sugar normal. I use a tandem insulin infusion pump along with DexCom CGM. I’m still overweight by 30-40 lbs. I think my last A1c was 6.4 or 6.5. What’s more important to me than A1c is time in range. Anyway, long story short , do you see patients virtually? I’m clearly missing some vital information that could help me lose the weight and keep my BGs in range.
I am the conundrum. Very low carb ketogenic diet for two and a half years and I’ve yet to put type 2 in remission. I fast 16-18 hours a day, eat two meals, no junk or sugar what’s so ever and my fasting blood sugar remains in the mid 200’s. My fasting insulin is 9 and C peptide is good. Been tested for LADA, I do not have it. Exercise (Walk)30 minutes a day. I have asked several well known “keto” doctors about this and they don’t have a clue as to why I’m not responding like other type 2’s. I’ve had type two for twenty four years with a strong family history of both type one and type two. My father and his siblings all having died of complications of type two in their 60’s. I’m about to turn 67 in December the same age my dad was hen he died. The first two years keto I did improve some and my A1C was 6.3 and trending down very slowly. Now it’s 8.4 and slowly trending upwards. Last December I took two serious falls with injuries then contracted the Omicron virus in spite of being vaxed and boosted. That’s when things took a turn downward in spite of my diligence. I can’t begin to express how frustrating this is. The only thing that could explain it is something I heard Dave Feldman say. He said that there’s a small number of people that have this issue after being on an extremely low carb diet for an extended length of time. He said their body’s are so used to burning fat for energy that they are no longer getting an insulin response. He called it hypoinsuliniema. Anyway I really need a consult with you but sadly I’m on a fixed income and you don’t take Medicare, so that will have to wait until my budget allows. I would really appreciate you doing a video on this subject. There’s so very little info out there on this and I’m sure I’m not the only one racking my brain over this. Thanks for all you share on your channel, it’s greatly appreciated. Oh I might add that I’ve continued to take 2,000 mil of Metformin and was on insulin before going keto. Went off insulin after the first two weeks because of lows in the 40’s.
In my opinion, we are so early into the "carnivore era" that we do not really know the possible adverse long term health effects of this diet on humans, especially with our animal testing models being so limited. Therefore, I suspect good questions like yours just can't be answered fully now. Dr. Cywes says he occasionally doses his 2 year old with carbs so he does not develop what you labeled "hypoinsuliniema". Is that good or bad? I do not think we have the answers to that question yet.
Kim Congratulations on working so hard. First I would say stay the course, as noted it can take Years 2 repair the Damage of Years. Also on fixed income & stuck w horrible Kaiser . You are actually lucky if you have classic Medicare. One of the carb docs - Berg??- has a list of keto docs. You might be able 2 find one that takes Medicare.
Very important however - your post contains the seeds of a possible answer. Things started 2 change w injuries. B.s. always rises due to injury or illness. So injury + illness (c19). On top of that a shot & booster that are now known not to stop or decrease severity of illness. Plus there is now plenty of hardcover evidence they actually diminish your immune system, spread throughout the body to every cell AND cross the blood/brain barrier. So in the last year your body has had significant insults to the body & immune system ,all of which feeds rising b.s.. Have you completely recovered from the injuries. Check into long covid & treatments there is now some thinking that the shots play a role in it. Were shots b4 Omicron? At a minimum if it were me I would not be lining up for more jabs, you have enuf to deal w now.
A lot of people got their diabetes out of control after the cov vaxes. It's a fact but no doctors will tell you that
Perhaps it will just take longer than 2 years to reverse your T2 after being diabetic for so many years. The inflammation from contracting covid certainly won’t help bring your fasting insulin or A1C down, either. I wish you the best of luck.
I have the same problem. 4.5 years carnivore. MY doctor says insulin. I'm going to push for GLP-1. I don't think carb loading is the answer.
I have severe RT ankle pain x 8 years which was greatly improved with oral semaglutide purchased online without a prescription (a dry, 5 mg/vial powder with neither reconstitution nor dosage instructions). My numerous physicians have turned a deaf ear to my pleas for a brief trial of prescription semaglutide (Rybelsus, Ozempic, Wegovy) which is available with small copays for me. As a T2Diabetic w CAD (NSTEMI, 3 vessel CABG), cannot tolerate metformin (diarrhea) nor Jardiance (kidney stones) I qualify for Ozempic. But because I fasted & carb restricted to 5.2 hbA1c, there is no interest in providing me w/semalgutide!
CGM feedback made all the difference in adhering to keto.
Is there any brand better than others on this Stephanie? I'm thinking of getting one.
I can not afford a CGM and no insurance to pay for it. Interesting thoughts, I lost 70-lbs on Keto/carnivore and fast thrre days a week no food! Bummer way to live, but so much better than death! Thanks
Call Abbott and ask about a 12-month coupon for the freestyle libre 3. As a type 1 my insurance doesn’t cover because I refuse to go on an insulin pump. The cost will be $37.99 per sensor. I don’t feel $75 a month is too bad.
Thank you for continuing to educate yourself and the world about this insulin / carb crisis we have put ourselves into since Ancel Keys. - I believe you are in Florida? I hope you and your family are safe from Hurricane Ian.
All safe tx
@@robertcywes2966 Please do a review on Mounjaro (tirzepatide). A lot of friends and co workers are getting on it to lose weight. They say it works better and Drs are prescribing it instead of gastric bypass. Thoughts??
Now I understand why my obese husband was never diagnosed as diabetic. He went low carb, lost 80 lbs, but then lost his discipline and the carbs all around in society won over. Sadly, he had a quad bypass in April and now is diagnosed with heart failure. The medical community does not support low carb for him and even suspect his heart disease is worsened by low carb, high fat diet He will not go low carb now, and his insulin is never measured. However, now I am more at peace with my low carb high fat eating. It's there if he wants it but he has to choose. Thanks for your explanation.
sorry for.your frustration. I can relate. I can't get my husband to change his diet or exercise properly either. he has a fit body but a big belly which is a tell tale sign of fatty liver and visceral fat. I just won't allow carbs in the house at all. the kitchen is carnivore. he eats whatever outside but I won't feed him anything but meat and some veggies to balance out his crap food.
@@habibahq4272 8
So you suspect that the high insulin production caused his heart problems? My father had quadruple bypass surgery, yet he never had blood sugar problems
@@nickbardan3867 The medical system never measures his insulin because his A1C is in the normal range. Metabolic Insulin Resistance Syndrome is a prime cause of heart disease, and one look at his very fat body suggests he has MIRS. I always wondered how he never had diabetes, but this presentation explains it. Canadian docs are discouraged from exploring this further and are stuck in the low fat/statins protocols.
@@marthabeach5318 I'm in Canada too. I had the fasting insulin done because I asked for it. I was able to reduce it from 90 to 40-50 by going low carb
I started doing Keto on day one of my T1 diagnosis. It took me around 4 to 6 months (Keto Omad and 2 days of complete fasting per week) to get my A1c down from over 12 to 5,x , where it stayed since then. Never had any "rollercoaster". Never used any medications or insulin. The first two years, it took 8 - 12 hrs. for my body to get under 100 BG. Since 2 years or so he got faster. Sometimes I`m under 100 after 2 - 3 hrs. now. I`m doing a VERY lazy kind of carnivore. Fun fact : I LOVE chocolate, and when I`m sometimes eating some Keto-chocolate ( which HAS 21g of sugar per 100g), my BG lowers down FASTER ! Strange.
have you had a c-peptide test, wonder if you preserved some of your beta cell function?
@@kathleengempel5814 I have indeed ! And the honeymoon stays. Since 2018. But, unfortunately, the process off selfdestruction got slowed down from "1000 times higher than normal" (as the endo said in the beginning) to "50 times higher than normal" last winter. It didn`t stop. So therefore there will be a time in a future nearer or farer where I`ll be forced to take insulin. If that is availlable then anymore. But not now !
Yeah you can have insulin resistance eating no carbs. It manifests as excessive gluconeogenesis. The insulin resitant liver hears the glucagon signal but not the insulin signal. ME.
Doc, give some thought to what happens when the liver sees dietary fat via unemptied chylomicrons.
I will need to review this video several times to try to gain an understanding of what you are trying to tell us. I sense you are so intelligent that as a consumer I am not able to comprehend what you are attempting to convey to us. I will need to study and unpack all of the terms you use. I am trying to understand how this applies to a pre-diabetic (A1C
Agree with you KETO by George. This explanation went over my head -just as I was so proud of having thought I had all this too high of insulin thing figured out. Now I am worried I am doing something wrong with my low carb intermittent fasting life style. 🙁🙁🙁
I know the doctor means well by us but I am left frustrated by this particular video. I am like you simply pre-diabetic with no Metformin or insulin taking going on.
Makes sense (to me) that (after years of training) it may take metabolic machinery to come back to normal functioning, and that special monitoring of various metabolites would be advised, and that this would be highly specific to each person.
I often wonder how many morning rush hour auto accidents can be attributed to a perfectly sober driver (in terms of drugs and alcohol) having been under the influence of a fruit and fiber breakfast, such as cereal that's topped with bananas (lightheadedness, fatigue, poor concentration). Call it the "Cap'n CRUNCH" effect if you will. Perhaps cops should start carrying some kind of portable CGM device in addition to the devices they use for field sobriety checks. Sadly, also, a lot of young people are known to eat cereal for dinner and then get behind the wheel - so the problem isn't necessarily restricted to just morning traffic. Stick with a high protein breakfast to help you and the others on the road to stay safe
You are always a great source of accurate information. TYVM
So for these patients that have sugars in the 200's and you have them on Insulin therapy and they greatly reduce their carbs, I have two questions: 1. If they become hypoglycemic, how do you tell them to treat this? (ADA recommends the 15/15 rule) Do you recommend something different? 2. They don't feel good with a blood sugar of 120 at first.... Do you have them treat this with consuming any carbs?
My father had neuropathy. He was never diagnosed with Insulin resistance or type 2 diabetes but he also had Alzheimer's.
He always thought his neuropathy was a side effect of medication.
Dr Cywes, from aprox 08:00 in the video you describe 2 groups of people. For the 2nd group with High production of Insulin, but Not elevated blood sugars, but high body weight, what is the terminology for that condition and how can it be tested for ? Eg in U.K. I’m assuming testing fasting Insulin, C-Peptide and BG but anything else to test for this and how to manage such a hormone condition ?
Thank you for everything you do for the community
It makes total sense. It just seems paradoxical to increase insulin as that would make you hungry. I still don't quite understand how the satiety part works. What happens to insulin and hormone sensitive lipase on a keto diet if you don't eat carbs, but have a glp agonist?
I am 71 years old I have suffered from hypoglycemia for as long as I can remember, I am 1.8 m tall and weigh 58Kg. when I did consume carbs I could never gain weight and when increasing fat intake, lots or little ,still no weight gain. When I dont eat I get tired and grumpy and as soon as I eat something sweet my energy picks up almost immediately and I am more grounded so for me sugar helps except that I sometimes this sets up a craving. I have been strict carnivore for the last 3 years because I found that vegetable fibres were irritating the small intestine but still an energy crash when I go too long between meals. I have no health problems that I know of unless hypoglycemia is a symptom of a health problem. Also even though I pay attention to electrolyte consumption I have for the last year been suffering awful nocturnal leg cramps to which I have found no solution and which rob me of a good nights sleep 2 or 3 times a week,
GLP-1 agonists/dexcom life-changing for me. My insurance covers (for now) because I am t2d...but so many are turned away and it is a crime. For the longest time I thought I would need to go on some insulin, wasn't afraid because i was gestational and my dad is t1d...took awhile this time around but from going from fasting over 200 to now fasting in high 90''s/100ish...since July, I know I am making progress. I need the meds and the diet, exercise and CGM.
I also had an insulin test and it was 30 (on low carb for a month or so) so I knew I was making enough.
Thanks
Thank you for your videos about diabetes. I’m learning so much. I am a type 2 diabetic who went undiagnosed for many years. I am currently eating carnivore. I don’t feel like my doctor has the answers to my questions and it is frustrating. He did prescribe a CGM at my request but I had to self pay because insurance would not cover. I am not on any medication and I’ve noticed my blood sugars going up to the 150’s no matter what I eat. Now all the sudden my average is 128. I am seeing not high spikes but my lows are finally going into the 80’s. It is working slowly but should I be concerned that I’ve never even been or on metformin? I did order my own c-peptide and fastening insulin. I think it is time for me to text you.
Do so
I have only recently heard that type 1 diabetics could also be type 2. It totally makes sense. Just bolus more insulin!! What I wish I knew to educate my son sooner. Hope the message gets to him from sharing this.
Hi Dr. Cywes...10 years ago I lost 50 lbs and was 20 pounds from my goal weight by eating pretty much the same thing daily: flax seed pancakes with some blueberries, 1/4 cup raspberry snack, lunch spinach chicken salad, dinner was chicken thighs with peas, tablespoon of butter. Then...lost my home in a flood (I really hope you are doing okay in Florida today!!) and lived in an oilrig camp for six months built by the government...we had Red Seal chefs and with the stress and surrounded by cheesecake and all sorts of goodies every day well I gained it all back.
Been a sugar addict since childhood. Now, I've been very low carb (no fruit/veg/grain) and even carnivore and the weight will not move. I am so frustrated. I'm wondering if I need to go back to what I did before.
I really hope that the entire treatment paradigm for diabetes/obesity shifts soon...it is tragic what the old food pyramid has wrought upon the US and here in Canada. Thank you!
PS I have no gallbladder and find going too high fat difficult.
Thank you! 🙂
Love it! "Paradoxical gluconeogenesis". I need to remember this term!
I never heard Dr Fung or others say they withdrew medications on patients who still had high blood glucose levels. I believe that type 2 diabetes should be a diagnosis based on fasting insulin and/ or glucose. As you said before treating the glucose is akin to treating fever
Thank you so much, you are very interesting and helpfull🤗
I'm so bummed out. I have relatives that are convinced that type two diabetes is just a normal part of growing old just because their parents had diabetes..they continue to plow through the chips, potatoes, rice, cinnamon buns etc. These are educated folks stuck in the dogma that it's their lot in life. They look at my ultra low carb ( medication free) lifestyle like im from Mars. Ugh.
Guess what on keto 5 years still diabetic as my liver joins the morning party and the dawn effect happens. I go carnivore the liver makes glucose from the protein. Stuffed either way. I have lost eight stone in 7 years. I exercise, swim mostly what else can i do?
29yrs, went into acidosis Feb this year with A1C 10.9. Got out, used insulin for a month but then started having issues going too low. So i stopped medication and switched to keto diet. A1C around 5.5 now but seems I have to stay keto because my IR is so bad if I spike sugar with anything I get an extreme hypo just less than an hour after meal down to 50’s and 60’s mg/dl. I’m very active and quite lean so I wanted to incorporate some carbs back into diet for recovery but it seems that’s not viable because of the reactive hypoglycemia I get (I’m talking less than (60gtams carbs per day, mainly from fruit). I need to understand my intercellular gradient relationship to my insulin and cortex that. I made the call to stop the insulin
I made the decision to go keto because of the hypo, my endocrinologist did not understand why I’m going hypo without medication shorty after a meal when I’m T2 and no meds. I need to work with someone on this because my lows feel dangerous. In the 80s is whenI get very clamy and start feeling like pass out. But overall, I think your video assures my that my decision to go keto was the right way, and maybe my body just needs more time to improve: I was in the icu for 10days, came in not breathing from the acidosis. It seemed to be very accurate from pancreatitis which I recovered from extremely quickly. I had been heavy binge drinking the year prior to my hospitalization because I did not know I had diabetes and misinterpreted my hypo and hyper glycemia as anxiety: I was predefined anti depressants, had tests run on my heart, only once during routine blood work did my fasting blood sugar show a little bit high, guess my doc never requested an A1C or they would have caught that. Anyways, you’re helping me learn a lot. I’d like to work with a medical professional who understands the issue more though.
The dietary recommendations from my endo and from the hospital weren’t very helpful. Taking things into my own hands was much more effective but made me weary that I might be doing something wrong. Please put me in contact with someone. I had been telling my doc for years I did not feel right and something was seriously wrong, so in that sense it was a blessing to have the acidosis incident, which confirmed I wasn’t crazy and I kicked all psych meds (very little) and alcohol.
Keep up the good information! From Orlando, Fl not far from you. I’d be willing to drive a few hours to an appointment if needed every few months or so whatever the cadence need be.
I would like to hear more on this subject. I eat less than 10 carbs a day most days and have been having blood sugars above 180 and sometimes above 200. CGM and verified with fingerstick. I’m on no meds. Had been on insulin but stopped it after about 6 weeks of keto/Carnivore because everything I was seeing said a type 2 shouldn’t be treated with insulin. So, I should start it back? I don’t really want to be on it, but if it will help in the long run I could start it back. 90 day average BS 146. But the last month has increased 30 day average 160.
@Kathryn Lee I hope so! I thought about texting the number he gave. Good luck! I hope he will address this more.
Hello Dr Cywes,
If you get a moment, I wonder if you would address the latest confusion that is going around; that is that there is no such thing as insulin resistance and that the effects that we see is actually the Randle Cycle.
For a layperson like me, the detail of the biochemistry is interesting but probably doesn’t matter as whatever the cause cutting out carbs is the solution.
But in any case, I wonder if you might speak to it?
guess i shouldnt fear the insuling went low carb about a week ago started getting morning sugars in teh 100-113 range instead of 200 range. but keeping the same insulin levels feels scary at this point. of course doctors just say lower it one point a day till it starts to go back up stop there so wish me luck
Dr Cywes, if you have a high AST ALT should you still do carnivore or will it keep going up on carnivore?? Thanks just watched your video from three days ago
Such a good talk.
Excellent perspective and guidance, thanks!
How does all this relate to the Randle Cycle?
Won't metformin also help as it mostly shuts down glucose production in the live? So a ketogenic diet plus metformin might accomplish the restoration.
I don't understand why increasing someone's insulin would help if a high level of insulin is the initial cause of insulin resistance. I'm sure it is much more complicated than that and that is why I truly don't understand. I thought you want to have a low insulin to glucagon ratio. So, I would think that it would be good to have lower insulin if your glucagon was high. So why add more insulin? Thanks for all of the information that you provide on TH-cam.
Both Bart Kay and Robert Cywes are great. For some reason Bart is the terrier and Cywes is the Rottweiler.
How do you figure out how much long acting insulin to give yourself ?
Set up a visit
What would it mean if I have a low insulin of 2. Have had normal fasted glucose/hba1c. Have been on high carb diet/binge eating, stayed at a moderate weight but have high cholesterol, and neuropathy vascular issues and now pain in upper right abdomen. I am pretty sure I have a burnt out pancreas and am insulin resistant from many years of over eating but also exercising. Doctors just assume because I’m not overweight that I’m making it up. Is a low insulin a sign of something? I ate carnivore for a couple of days blood sugar went low I missed vegetables and ate a salad with some grains/olive oil etc and blood sugar spiked right up. I have been monitoring after bingeing and it has strangely been lower than normal like 4.3 etc.
Almost 80 days with no carbs stopped losing weight after the first 15 lb and now I just bounce up and down 3 lb every day, and my blood sugar has not gone to normal, in fact, it still high, though I've stopped taking any of the medication trying to get my body to do what it's supposed to do. I am eating carnivore. I have lowered my protein and increased my fat in the hopes that that will do the trick if it doesn't, guess I will lower my fat and increase my protein, or I'll just go Keto.
Set up a visit to check bloodwork
@@robertcywes2966 I have a standing order for bloodwork after 90 days, so I'll get it all checked then. I really expected something different, like weight loss and lower glucose readings. :) Thank you for responding.
My 93 year old carb addict father fits in that category of obesity without an HbA1c in the type II formal range. Still one can argue that decades of hyperinsulinemia is likely the reason for chronic heart deficiency, macular degenerative disease, kidney damage etc. Am I right to think that chronic excess insulin is just as bad as chronic excess sugar?
OK to go UP in order to later go DOWN but must be monitored by an informed doctor on a motivated patient. No hope to help reduce the rate of damage done to my father’s health who reside in a retirement semi autonomous home where the institutional recommended food pyramid is observed.
what about the Randle Effect?
How does this compare or add by adding a glp1 product like ozempic ?
Watch previous video. Good idea
@@robertcywes2966 I did. I’m clearly needing to add the glp inhibitor.
I am curious if you would recommend a GLP1 agonist for a type one diabetic with insulin resistance?
My A1c used to be 7.2 for a long time, after 2 months of keto it dropped to 5.8. Now, after 4 months of keto it is up to 6.2 :/ Morning sugar is high up to 130, 2 hours after meals it is 120-138. I feel lost, don't know what to do. I am on Metformin, gave up Jardiance. Should I start taking Jardiance again??? Pointless to ask my doctor, he knows nothing about keto :(
Set up a visit. Still have IR
@@robertcywes2966 I wish I could but it's a bit far from Poland.
QUESTION: is my exogenous insulin (type 1 on 17,3 units of basal daily via pump) any good at blocking glucagon? And if my hdl/trig ratio, blood pressure and weight are stable/normal what indications of insulin resistance might I look for? I am low carb but could go lower if I thought my health would benefit. HBA1c 48 or lower (6.5%) but after 40 years of abnromal bgs I suppose my micro/macro vascualr system is screwed already. You are always v. interesting btw!
@dr.cywes Is this insulin resensitization?
Wow! I learned a lot. Thank you.
Good one Doc..👍
I got lost. Will have to re-watch.
The practical implication of treating a Type 2 diabetic by reducing carbs to basically zero but increasing insulin over a time period is confusing -- treating that "gradient" problem. Also, some terminology is confusing, long-acting insulin and a "pump" Greek to me. 18 months to 2 years to reverse T2D?? Surely with aggressive treatment 6 months is achievable?
Definitely worth rewatching...but im a little biased🙂
Can an obesogenic non diabetic heal this insulin anomaly and chronic gluconeogenesis with just a carnivore diet or is medical intervention necessary?
If you aren't on insulin and are looking to keep getting your sugars down but even with low carb/keto/carnivore for years could you potentially spike your insulin yourself with things like cauliflower which are a bit higher on the insulin index to bring the sugars down?
Insulin index?
@@pittsburgh-gal Rather than GI there is an insulin index of how foods affect insulin. From memory it may have been an Australian paper? I know Marty Kendall has covered it a couple of years ago.
@@katecollins3894 thanks, I had never heard of it🌹
I was wondering how my friend's dad can be severely overweight, 300+lbs isn't a diabetic!
💪 excellent video
Why aren’t you suggesting the use of Metformin?
carnivore is cap. when i went carnivore the animal proteins were giving me as many diabetic rushes as if I were eating chocolate cakes and caramelized nuts all day!!!
same same
@@durango4624 sure our digestion might be compromised a bit, but still that doesn't make the diet safe for everyone. Especially for histamine intolerant people
Dr Bart Kay says insulin resistance doesn't exist. it's just a perturbation of the randle cycle
My mom is not statistically significant or peer reviewed but her experience has had real significance among her circle of friends and family.
2 years ago, my 80 year old mother finally had a follow up appointment with her physician which was delayed for months because her doctor has been in charge of treating Covid patients in the hospital and in nursing homes and was not able to meet with her.
She had a full blood panel taken for this visit and her doctor was astounded at the progress she had made during the last year. She is now no longer diabetic and she was instructed to stop taking insulin after having been on it for 12 years. Her doctor also praised her kidney function which has never looked better. Also, she couldn't believe that her total cholesterol was only 139, with LDL of 67, HDL of 60, and triglycerides of 82 which is a big improvement for her. According to the Framingham Heart Study, these numbers mean that she is virtually "heart attack proof" as many plant based doctors have noted.
Her physician mentioned that she is reconsidering the diet for her family based on this experience. She also asked my mom to share her experience with our community after the pandemic. All of these results are exactly what I had hoped would occur. Here is the menu that I had developed for her to try to mimic what she was used to eating -> "GSP Mother's Menu" - While this menu is not a pure whole foods plant based diet, it appears to be health promoting enough to work for her. I plugged her bloodwork test values into the Levine Biological Age Calculator (free online) and she has aged minus 15 years during the last 3 years. I joke with her that she may be required to give up her Social Security benefits if she keeps going like that.
My understanding is that low carb diets are a workaround that do not address the root cause of diabetes which is excess intramyocellular lipids (also fatty liver/pancreas) and the resulting insulin resistance (excess saturated fats and refined sugar/flour are the most common cause of this metabolic system failure). Cheers!
Congratulations to your mom for having such a caring child and for working to get herself so well!
Fascinating...
Cywes are adoptivfar to Bart Kay and his promotion of The Randall Cycle.
So the Randle Cycle.
Why do diabetics “need” statins?
What is the role of quantitative lipoprotein analysis?
Deep.
Nobody is taking away the diabetes medication without measuring blood sugar. So there is no issue here.
I still thing Fungs method is superior.
I'd love to hear your thoughts on histamine accumulation through consumption of slow-cooked keto/carnivore foods (bone broth, collagen peptides, braised meats, etc), and the resulting reflux, nausea, etc. Perhaps a pressure cooker is the better option to slow cooking (less histidine-histamine conversion).
Some strict Ketos avoid Collagen (Oxalates) and Bone Broth (Glutamate) Need very high quality sat and poly fats - don't follow the meat heads 70 grams protien / day max women
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The problem is not the carbs or fat or protein. The problem is overeating. The modern society population eat a lot more than our grandparents ate. That is the problem. Eat less , people. The 2000 calories needed is overestimated. You don't need 2000 cal especially when sitting on your ass all day .