Interrupting the CGM Data for Breaking News

I learned so much from my continuous glucose monitor (CGM) study and I will continue sharing my data from my Standard American Diet (SAD) experiment, but first, I want to share what happened to me yesterday and a very timely email I received.

I’ve been strict low carb for two-weeks, increasing my amount of intermittent fasting. Last week was very carb restricted (I’m not counting for time reasons, but I’ve done this enough to know) and I did 18/6 intermittent fasting with a 40-hour and a 44-hour fast.

The day I started the 40-hour fast, my glucose/ketone readings were 80mg/dL and 0.9mM (respectively) and then the next day 75mg/dL and 1.8mM.  That was typical for me.  Friday, they were 85mg/dL and 1.0mM, and Saturday morning, a surprising 62mg/dL and 3.9mM!  I had reservations for a four-course swanky dinner Saturday night, which would involve a lot of carbs, so I knew I needed to do some damage control.

I broke my fast after exercising with a low-carb meal, as I didn’t want to send my glucose levels surging.  Everything was going well, so I moved on to phase 2.  I had some tortilla chips and salsa, while sampling three beers.  I tested my blood glucose an hour after starting and finishing the snack, and both times, measured 99mg/dL.  I was definitely starting to miss the convenience of having a CGM, but I was feeling positive about where I was.

Two hours later, right before dinner, I measured my glucose and my ketones to be 144mg/dL and 0.5mM.  The glucose surprised me because all I had eaten after the beer and chips was a bite of carrot and potato (to determine if they were done) and I had a mixed drink containing only tequila and sparkling water.  Without having a CGM, I can only assume that my glucose response to the chips and beer was delayed.  I was glad, however, to see that my ketones were under control.

Dinner was delicious, but way more carbs than I usually eat and I didn’t even finish half of my dessert.  I then started to feel nauseated and was burping nonstop.  It’s funny, I used to think the burping was a problem with dairy, but now I know that it’s caused by carbs of all varieties!!

I took my blood glucose twice, an hour after the middle of the meal and then an hour after we finished.  My values weren’t terrible, measuring 123mg/dL and 138mg/dL, respectively.

I felt horrible and went to bed.  During the night, I experienced hot flashes and my heart rate increased during the first half of my sleeping, which I’ve learned means my blood glucose is high and crazy.

I woke up, still nauseated, with a blood glucose of 99mg/dL and ketones at 0.2mM.  It’s pretty typical for my morning glucose to be elevated after high carbohydrate consumption the previous evening; I actually expected it to be higher.

I read my email and had the most timely email from Peter Attia (Peter Attia is one of my favorite doctors to read/listen to) discussing a Japanese paper that is available full text. The paper is Kanamori, et al. “Postprandial Glucose Spikes after Extremely Low Carbohydrate Diet in Healthy Adults”.

In Attia’s email, he mentioned that he was surprised that one day of carb restriction could cause this, but after all of the crazy carbohydrate responses I have seen personally, it doesn’t surprise me in the least!  I would love to be able to work with Dr. Attia to better understand what’s going on in my crazy body!!

I read the study and found it fascinating.  I could have done this study (and others like it) based on what I’ve seen with my body!  In fact, if I had a CGM long-term, it would be great to do more well-controlled n=1 studies, like this, on myself.  I agree that the other blood markers would have helped the study, but I wouldn’t have that ability either, even if I had a CGM.

I do know that low-carb eating caused me to fail the oral glucose tolerance test (OGTT), that increasing carbohydrates improved my performance on the OGTT (although I still didn’t pass the second time), and 10-days of eating the SAD allowed me to finally pass the OGTT.  That’s covered in The Dreaded Oral Glucose Tolerance Test and Third Time’s A Charm.

I also know that during low-carb eating, I have stable blood glucose levels, a large glucose response to carbs initially, but that response gets blunted over time, as I consume large amounts of carbohydrates.  All of my data is available in CGM Study Results – Low-Carb Eating, CGM Study Results – Controlled Carb Eating, SAD Effect on Blood Glucose (Part 1), SAD Effect on Blood Glucose (Part 2), and SAD Effect on Blood Glucose (Part 3).  The rest of the data will be shared (hopefully) this week.

Yesterday, I was set up for (and probably experienced) a huge carbohydrate swing in my sleep.  I felt the physical effects, I just wish I had the CGM to see what happened….  I thought it was perfect timing that Peter Attia sent out his thoughts on a paper about that very topic, as I was in bed recovering from the damage I had done and had plenty of opportunity to read it and compose this blog!

Today, it’s back to the straight and narrow nutritionally.  I planned to do 18/6, but my body is not ready to have food right now, so I am more likely to only have dinner (OMAD), or jump back into a 40-hour fast, depending on how I feel after exercise.  I’m thankful that I have yoga to help me recover physically.  My goal for today is to make it through both my aerial class (the fascial release will likely be intense after all of those carbs) and some mat training to remedy my digestive issues.

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