I'm a 44 y.o. male, pretty good shape and health otherwise. Probably around 16% bodyfat. I work out regularly (gym 3x perweek), and I do weights and high intensity interval cardio, and maybe monthly5-10 mile hikes. I don't eat a lot of carbs - no soda, no juice, easy onthe grains, moderate protein. I have the occasional glass of wine or 2 ora cocktail (using Stevia), 3 if it's a big happy event. Non smoker. Sleep pretty well. No chronic meds. Job not too stressful. Happy marriage. I supplement withKrill oil, Astaxanthin, Vit C, and Vit D3 + K2 in winter. Juicevegetables occasionally.
I've always known I was sensitive to starch and sugar (high,then crash), and also get hypoglycemic if I wait too long between meals. So in 2006 I got a glucose challenge test:
1 hour: 91
2 hours: 50
So there, reactive hypoglycemia. The BG peak wasn’t recorded. Unfortunately insulin wasn’t measured.
After getting the results, I decided to follow the “Leptineating guidelines”:
- Cut sugarand starch, especially for breakfast
- 4-6hours between meals, no snacks
- 12hours between dinner and breakfast (no midnight snacks)
I quickly lost 15 lbs, and stayed at my current weight. I also stopped getting “the shakes” between meals,and can tolerate delayed meals. This was2006. I thought my reactive hypoglycemia was cured.
Over the years my fasting blood sugar has always stayed in thehigh 90s, and my A1c has crept up from 5.3 to 5.6. So I decided to buy a glucometer, an AbbottLifestyle.
It’s not pretty.
Fasting sugar: 99-104
Before meals: 90-95
Now here’s the kicker – the post meal BG spikes.
One lunch was a largish sandwich that I wolfed down (normally I’deat one and not both buns):
before meal: 90
45 minutes: 157, 152(repeated)
60 minutes: 175 (!)
1.5 hours: 134
2 hours: 129
felt sleepy so I did 20 minute of interval cardio then at 3:20 after meal: 84 <-didn’t feel hungry or weak
I then did my version of a glucose challenge test: an 8-oz sweet potato, steamed, for lunch
40 mins: 176 (!)
50 mins: 166
60 mins: 147
2 hours: 85 <- felt famished at this point, so I ate anice fatty tuna salad
I then repeated the sweet potato test, but had 2 plums 30 minutes before … noimprovement in the peak reading
I tried it again, but I drank 2 tbsp apple cider vinegar inwater plus stevia just before the sweet potato … no improvement
This morning I had my usual workout, 45 minutes, today was squats,deads, and bench. At lunch, I had a Mexicanmeal of meat, a cup of salsa / pico de gallo (chopped onions and tomatoes), andguacamole (avocado), and no rice, beans, or tortilla (normally I'd have some of it):
before: no measurement
45 mins: 111
65 mins: 104
2 hours: 101
3 hours: 103
Dramatic difference, so the obvious thing is, *avoid starch*. OK.
I went to a new doc, a generalist, and her suggestions were:
<!--Avoid starch,learn which foods cause spiking
<!--Considerlow dose metformin, so I got a prescription for 2x daily 500 mg
Now for my questions.
<!--Can metformin dependence appear? i.e. Istart taking it, it helps, then if I stop, I’m worse off than before I started taking it (assuming I continue to avoid starch)
<!--Should I have asked for the slow release metformin?
<!--Will there be important new information if I get insulin measured during a glucose challenge test? Or will the effects ofmetformin tell me the same thing?
<!--Whydoes my BG spike so high then plummet so quickly? Does it suggest an insulin secretion problem? (e.g. delayed release, then too much is released)
<!--Why is my fasting BG highish? Why is it higher in the morning than it is before lunch or dinner? Liver doing too much gluconeogenesis only while I sleep? Is this always due toliver insulin resistance?