Gluconeogenesis VS glycogenolysis and adaptive glucose sparing

[Skeptic]

Wanted to start a dedicated thread on this, as I am still learning, and have more questions than answers, but a bit of experience to bring to the table.  Sorry in advance if this gets long.

I am two years in on the carnivore diet, and (to my knowledge) properly fat adapted.  I can consume fats with relative abandon with no restroom related "side effects" shall we say.

As a type1 diabetic, I can definitely spend a good portion of anyone's time singing the praises of what I have been informed is something called gluconeogenesis, as it keeps me from having to carry sweet snacks always at the ready.  I can work along, and not worry about low blood glucose most of the time, even as a type1.  I have proven to myself that a zero carb diet is the way to health, especially with type1 in the mix, but I dont wish this thread to be isolated to those with a specific knowledge of diabetic physiology.  As an additional thought, wearing a CGM (continuous glucose monitor) allows me to get a different perspective on what is happening as my body processes different foods and situations.  Its my hope that some of this may be a help to others (as well as yours truly!)

 Many folks here speak about being kicked out of ketosis if they consume carbs or sugars, and while I notice this myself, I ALSO notice that if I eat anything that contains sugar or carbohydrates, it will seemingly hamper my gluconeogenesis abilities, and I will drop terribly low in the hours following the compromised meal.  This is as opposed to the normal days  where I have eaten "clean" and my glucose level will drop to say, 70 and then self correct and I can go right on working (or sleeping) like its nothing.

I have been trying to get a straight story from all my internet searches (heh, get in line, right?!) ...so wanted to poll the community here for everyone's thoughts.

In another thread (that I didnt want to hijack) Bob spoke about "adaptive glucose sparing" and some of it's effects.  

Here are my observations, please critique, or add to these with your thoughts!

- When I have been able to keep my diet SPOTLESSLY clean for many days in a row (no cheats, ever) my sugar levels seem to stay right on target and I feel simply amazing!  I have been under the assumption that me being properly fat adapted, I am in these times reaping the benefits of adaptive glucose sparing.

Something that I am beginning to suspect, is that adaptive glucose sparing is akin to ketosis in that a dietary change can "kick us out" for a while.  Is this at all correct?

I further notice that *sometimes * when I fast for any longer than one meal, my glucose levels can sometimes rise and stay elevated as if I just ate an oreo cookie!  This happened most recently at a dr visit, and I was amazed at how high my glucose level was (145) even though I had not eaten anything for nearly 24 hours! ( @Geezy has made a comment in a recent post suggesting that I may have fasted too long before the appointment, which can throw your numbers off?) Anyway, I say *sometimes, because it doesnt seem to be a hard and fast rule, and on other occasions I can go for days and not have my sugar level rise at ALL, even with fasting!

There are also many regular days when no fasting is going on, and my diet has been a proper balance of meats and fats, but I throw some cheese in, I notice that after my midday meal, my sugar level goes up considerably as if I was back on the cookies again!  Ill be sitting there later on thinking to myself "what the heck did I EAT??!!" as my blood sugar level is going up past 175!  I have so far attributed this discrepancy to diet (perhaps as a result of eating things like cheese maybe?) and that in these times I am experiencing gluconeogenesis without the benefit of adaptive glucose sparing? Am I on the right track here?

Is the cheese (or even a small amount of dairy) enough to shut down adaptive glucose sparing to the point that my body begins creating a sizeable amount of glucose from the protein I just ate?  Does it work like this?  It certainly seems like it, but these are the questions I have in my head day to day.

Lastly, I hear just a bit about a process from time to time called glycogenolysis, that is similar to gluconeogenesis, but is instead the body's conversion of glycogen to glucose.

Is glycogenolysis actually what is saving me during the times I would drop "low"?  

According to the internet at large, a high fat diet increases insulin resistance, but I have experienced my insulin resistance going DOWN as a result of carnivore, as well as my A1C.

Okay, Im done for a minute.  Please let me know your thoughts!


 

[Geezy]

I’m far from being any kind of expert on this. In fact glycogenolysis is a new one on me. 
 

But here’s what I do know (or think I know) 

1 hour ago, Skeptic said:

I am two years in on the carnivore diet, and (to my knowledge) properly fat adapted.  I can consume fats with relative abandon with no restroom related "side effects" shall we say.

Fat adapted isn’t about whether you get the runs or not. That just means that your gut biome has adapted to digesting fats and proteins instead of carbs. 
 

 

1 hour ago, Skeptic said:

As a type1 diabetic, I can definitely spend a good portion of anyone's time singing the praises of what I have been informed is something called gluconeogenesis, as it keeps me from having to carry sweet snacks always at the ready.  I can work along, and not worry about low blood glucose most of the time, even as a type 1

Gluconeogenesis can be a good thing or a bad thing. 
Gluconeogenesis which is a conversion of amino acids or the glycerol from triglycerides from fat. We can turn that into glucose and get all we need. The body makes exactly what you need. That is what you are experiencing and that’s a good thing. Especially for a T1. 
But it is said that too much protein and not enough fat in the diet can also cause Gluconeogenesis which would kick us out of ketosis and in the case of a diabetic could be bad if the glucose gets to high. 
It’s my understanding though that it would take a very large amount of protein to do that. 
Gluconeogenesis is supply driven. This means that your body only creates glucose from protein when it’s needed not simply because you ate protein. In fact, adequate protein intake is essential for muscle maintenance, hormone production and overall health. So moderation protein intake will not knock you out of ketosis or spike your blood sugar in a significant way and never forget that low carb diets are moderate protein diets not high protein diets. 
 

 

2 hours ago, Skeptic said:

Many folks here speak about being kicked out of ketosis if they consume carbs or sugars,

Yes this happens but from my understanding, those of use who pretty much stay in a ketogenic state snap back quickly into ketosis within a day or two. I don’t know if diabetics do or not. 
 

 

2 hours ago, Skeptic said:

I ALSO notice that if I eat anything that contains sugar or carbohydrates, it will seemingly hamper my gluconeogenesis abilities,

So I’m not trying to be mean or sound condescending and forgive me if I come across that way but why would you eat anything like sugar or carbs knowing full well that they do nothing but harm you? You’ve got more to lose than the rest of us. Come on man, eat right and maintain your health not only for yourself but those who love you. You have value to those around you and to us as well. Ok, off my soapbox now. 
 

 

2 hours ago, Skeptic said:

When I have been able to keep my diet SPOTLESSLY clean for many days in a row (no cheats, ever) my sugar levels seem to stay right on target and I feel simply amazing! 

Well that aught to help keep you on the straight and narrow.  “Nothing tastes as good as how I feel” should be your motto.

2 hours ago, Skeptic said:

According to the internet at large, a high fat diet increases insulin resistance, but I have experienced my insulin resistance going DOWN as a result of carnivore, as well as my A1C.

Negative ghost rider. Insulin resistance is what happens when you are diabetic. Your cells close the door to insulin and won’t allow anymore in. As non-diabetic carnivores we are insulin sensitive. At least that is how I understand it. Now exactly how that works with a T1 I don’t know but I would think that you are in a permanent state of insulin resistance. Yes everything should go down because you are not shoving carbs down your throat and there is less glucose running around in your body. 
I was listening to a podcast where Prof Bart Kay was interviewing a doctor who was a T1. The doctor said that he was on a high amount of insulin every day, I don’t remember the number, maybe 300? I don’t know, does that sound right? But after being carnivore he only takes 100 and that’s good for him all day. I don’t understand the numbers and how all of that works but it sounds pretty good to me. 
 

I’ll have to study up on that glycogenolysis. 
 

[Skeptic]

21 hours ago, Geezy said:

Come on man, eat right and maintain your health not only for yourself but those who love you. You have value to those around you and to us as well. Ok, off my soapbox now. 
 

Now I should preface by saying that this was not my only takeaway from your fantastic response, but I have to sat that I really appreciate the reply, and GREATLY appreciate the sentiment behind what you have said here!

My diet is pretty darn strict, Ill tell ya.  Morning time I eat eggs and some type of breakfast meat, then lunch and supper are always some variety of beef with butter or beef with actual beef fat.  I eat about 3/4 lb of beef midday, and a bit less at supper time.  Other times I am simply not hungry at supper, and can easily fast until the following morning without batting an eye.  I should have specified when speaking about the carbohydrates and sugars, that it is not a regular thing by any means, but more of an observation that I have made during the times I have unknowingly ingested something sugary that was not supposed to be.  I myself hate to hear about folks who are battling type1 and eat all kinds of crap anyway.  They rationalize it by saying they will take sufficient insulin to "cover" what they ate, but in reality, excessive insulin has extremely negative effects on our tissues as well!  The only way I know of is to minimize. 

I have a lot more reading and research to do before I am even slightly confident in what I know for sure, but I feel I have come leaps and bounds ahead of where I was when the medical profession was telling me next to nothing about my condition and scheduling dietician meetings for me where they would harp on the carb based food pyramid.

 

Edited March 4 by Skeptic

[Skeptic]

22 hours ago, Geezy said:

The doctor said that he was on a high amount of insulin every day, I don’t remember the number, maybe 300?
 

I had to go look up what my average daily insulin is.  Im on a pump, which has a total capacity of 300 units.  

Before carnivore, I used to have to fill it back up every other day.

Currently I am averaging less than 60 units a day.  I know I can do even better, but I think I might need to do a food diary to get there.

[Geezy]

2 hours ago, Skeptic said:

and GREATLY appreciate the sentiment behind what you have said here!

You are welcome. I see it so often where people only think about themselves and don’t think about how their actions affect those around them. I know I’ve enjoyed your posts and you bring value to us. You should consider joining us on our weekly zoom call. We need some fresh blood in there. 
 

 

2 hours ago, Skeptic said:

My diet is pretty darn strict, Ill tell ya.

Thats good to know and what you are eating sounds great. The only thing I’d change, and this is just me, is I wouldn’t eat unless I’m hungry. That’s just how I like to do carnivore and it’s how I feel best. In the beginning I ate by the clock and one day it just hit me, why am I eating if I’m not hungry. True hunger is your body telling you that it needs fuel. No hunger? No fuel needed. 
But I have no idea how that would work for a diabetic. 
 

 

2 hours ago, Skeptic said:

I should have specified when speaking about the carbohydrates and sugars, that it is not a regular thing by any means, but more of an observation that I have made during the times I have unknowingly ingested something sugary that was not supposed to be. 

That’s good. Well those times are a good thing in that they teach you. Forget the mistake but remember the lesson or, nothing tastes as good as how I feel. 
 

[Scott F.]

Great thread. I have been reading some on the very subject. I will look back and tag the video I watched the other night about protein, protein synthesis and there was a conversation about glucose sparing.

Just like anything when you bring in an autoimmune disease it really brings out the individual in individual concerns. I have Type I and Type II throughout my mom's side of the family. I have never had an issue but have always kept tabs on my glucose. Even had doctors tell me, "It's coming". 

I fasted a couple weeks ago and found my blood sugar was super responsive to the meals just after the fast. I have always had relatively low blood sugar and never seen a 100 til Carnivore. I have done two longer fasts, one 71 hours and one a full 72. Both took my blood sugar from the very low 80's to 113-115 (first and second meal breaking the fast). Both were fatty red meats on the first meal and the next meal was pork/chicken. Then after a couple three meals after the fast my blood sugar dropped into the 80's and after eating I would see the upper 90's and maybe once a 100.

The week after the second fast I had energy out the ying yang. Like, worked 40 some hours in three days and on the fourth day was up and in the gym at 4AM. I completed a hard workout followed by a 12-13 hour shift, a very hectic shift at that. I came home where I usually plop, but still had gas in the tank.

I am a strict eater myself and other and a bi-weekly glass of milk, very strict. The milk does not seem to affect my blood sugar although it is sugar packed. I believe I am fat adaptive, and I think the fast drove my sugar down and my ketones up. And by the energy levels I experienced, I think they were way up, maybe really deep into ketosis. 

My next fast I will have a meter to measure ketones vs. the strips. They only showed I had some excess in my urine but nothing definite about what I had in my blood stream.

I think our numbers would more than likely track the same based on what we eat just maybe with Type I your swings would be further up and further down than mine as a non-diabetic. 

One of the things I have seen is my sugar makes a slightly larger push up if my fat content is down. In my journal I track my stools/stool situation. On the days I have been constipated I feel like my fat content has been lower than I need it to be for that period in time. During the constipation my sugar will be a couple point higher. Like pushing 100 or slightly over. I think this is gluconeogenesis as I am higher in protein and lesser in fat that I need to be during a period of time. 

I think our bodies yearn for sugar/glucose and if we let the fat content drop it will revert to what is easy for energy, sugar, and when that happens the need le moves. For you, bigger moves than for me as you have more to deal with and factor than I do as far as diabetes/sugar count is concerned. 

Great thread. I will look back and try to find that video. I think it was by the personal trainer LaFleur?? I will look.

Thanks for the insight. I'm learning too.

Scott

[Skeptic]

10 hours ago, Scott F. said:

My next fast I will have a meter to measure ketones vs. the strips. They only showed I had some excess in my urine but nothing definite about what I had in my blood stream.

Great post!  I honestly never thought about a ketone METER!  Gosh, and they're honestly comparable in price to a glucose meter!  What brand are you getting?  Anybody else have one they would recommend?

[Skeptic]

21 hours ago, Geezy said:

You should consider joining us on our weekly zoom call. 

...

No hunger? No fuel needed. 
But I have no idea how that would work for a diabetic. 
 

I may have to pop in on future zoom calls. I appreciate the invite!

Back when I first started carnivore I was a mess (weren't we all?) and would bottom out whenever I was even a little late on a meal, and we all know why.  These days I can easily and randomly skip a meal or two and not even think about it.  I can randomly initiate a fast and go for many days with no ill effects.  My wife has gotten pretty used to me having a bunch of food at 6 am, 10am and then nothing for midday or supper at all.  I missed "Fasting February" but I am determined to pull off a multi day dry fast before spring.  Ill definitely be journaling that one.

[Geezy]

So being a T1 what does fasting do to your numbers?


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[Skeptic]

24 minutes ago, Geezy said:

So being a T1 what does fasting do to your numbers?
 

Well, honestly the glucose numbers vary considerably, which is why I have been doing more research.  Theres another piece to this puzzle yet.  One would assume that when not eating and having reached a fasted state, that glucose numbers would level out and stay steady (provided you arent trapped in a glucose metabolism of course) ...but I see something different from time to time, which is puzzling.
SOMEtimes, I will level out and stay around 80 to 90 for as long as I want to fast, but other times (and I dont yet know why) I will see spikes up into the 140-150 range as much as 15 hours after my last meal!   Surely there is something else at play here.  The next fast I do, I am journaling what I eat for the week prior, and then tracking my glucose levels very closely.  I wear a continuous glucose monitor, so that last part should be pretty easy haha.  Im also hunting through reviews and doing a little sniffing around tonight for a finger stick ketone tester.  The strips are expensive no matter which way I look it seems, but to be able to track ketosis with real numbers should paint a little better picture I hope.

You know, this board is REALLY great.  The opportunity to post all these thoughts and questions, coupled with shared interest and accountability is a greater encouragement than I ever imagined it would be!  

 

[Scott F.]

I seen some of the same with glucose numbers shifting up 12-16 hours into the fast. The first thing I thought was the 'dawn phenomenon' but a couple of the fasts I started in the morning so 12-16 hours was later in the night. 

I don't know but I will throw out a thought and it can be chopped up from any number of ways. 

I think it is the changing of energy states. For me, I was more than likely fat adaptive and was using fat for energy with ketone levels moderate to moderately high. The body is looking for the first available. If I had eaten fat, it would have used that and metabolic numbers stay on that even keel, and if in need of more, it naturally goes from the fat I have eaten to the fats I have in reserve. (weight loss/body composition change) 

Most who advocate fasting recommend intermittent fasting. 16-20 hours of fasting puts us in a really good metabolic window (hint, so much success stories teeter around OMAD). At this point the body is starting to look for its next energy source and since I have not eaten fat to bridge to the use of fat and there are no carbs/sugars available, protein becomes the next source of fuel. I think that shift is a form of gluconeogenesis. It is the conversion of proteins to sugars. 

I think this is the spike or shift upward around the 16 hour mark, give or take. 

On my next fast I built a chart to track glucose and ketones along the way. I'm sort of interested in the first 24 hours, maybe every couple to four hours during that first 24 hour span. 

I'm also going to track/wondering about energy levels during that first 24 hours. I have not thought of it before but I wondering if I will feel a lull around 10-12-14 hours and then a boost around 16 when the glucose levels tend to jump, and the how long does that last? or how long does it take to fade?

Or maybe I am just way out in left field and my ignorance is bliss? 

Scott

 

[Geezy]

12 hours ago, Skeptic said:

I will see spikes up into the 140-150 range as much as 15 hours after my last meal!   Surely there is something else at play here. 

 

1 hour ago, Scott F. said:

I think it is the changing of energy states.

I got this from Dr. Jason Fung

This is a normal process. When you fast, insulin levels start to drop and this triggers a surge of counter-regulatory hormones, including noradrenalin and growth hormone. This is normal, and meant to pull some of the stored sugar from the liver into the blood. If your liver is full of sugar, it may release lots of sugar into the blood, causing the blood sugar to rise.

So, yes, blood sugar may rise during fasting. The most important question to consider, though, is where this sugar came from. If you are not eating, the rise in blood sugar may only come from your own body. You are simply moving sugar from the liver to the blood. It means that there is too much sugar stored inside your body and you need to empty it out, either with LCHF diet or intermittent fasting

Dr. Jason Fung