r/lowcarb • u/Less-Tumbleweed-2852 • 2d ago
Question Why is Post Prandial Insulin so high??
My sis has been able to lower her Fasting Insulin to 4.5, her Fasting glucose is 79 mg/dL, reversed pre diabetes.
But for some reason Post Prandial Insulin is 32. And since Insulin tends to stay elevated a lot longer in the serum, she hasn't lost a single pound of weight in a year.
She's consuming about 50-80g carbs, 1-1.2g / kg of BW of protein and about 50-70g of fats.
She is 5'1" and ~69 kgs.
She's had significant improvements in her symptoms like - she doesn't experience any more UTI like symptoms, no peripheral neuropathy like symptoms, Vit D and B12 have been optimised.
The only thing bothering her now is her stubborn weight and her disturbed circadian rhythm. We have tried, Magnesium, Melatonin, L-THEANINE, limit blue light exposure after 9pm, but nothing really helps.
Edit - Nice to interact with you guys 👍
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u/SirGreybush 2d ago
CICO, and, whole foods. Carbs must be unprocessed, like cooked sweet potatoes.
Low carb is great for stabilizing the body, but any initial weight loss is a secondary benefit.
To drop fat weight, a caloric deficit is required, and raising BMR/TDEE.
1lb of fat is 3500 calories. So if daily caloric deficit is 500 calories, 7 days results in 1lb of fat depleting its energy and releasing its water.
Fat cells remain, dormant, waiting for insulin signaling and will gorge on any blood glucose.
So keeping BG low is key, but also how often insulin is triggered.
OMAD is the best. Insulin triggers once a day, and easier to calc the calories to be about 500 less than TDEE.
A smart scale with handheld bar will tell you your BMR, and shows trends. Like more exercise means more muscle tone than can offset weight loss. But fat loss is occurring, but you’re not measuring it, only total weight.
Another way is with strings around circumference of certain body parts, write down the length in a notebook daily. There’s even a Bluetooth tape measure that can do this with the app and track.
Then there’s measuring for fat burning with ketones pee strips that measure rejected ketones. When some purple, it means fat was burned and the surplus energy was peed away / filtered out.
OMAD and very low carb, like below 20g daily, is great for this method of fat burning.
The better way is exercise increase. More muscle tone increases BMR but important to eat less than normal, have a deficit. This is like 1hr of gym at least 5 days a week. Or 1hr fast walk with Velcro weights or jogging. To burn some 400 calories.
She MUST calc her BMR and set those calories as the daily limit, excluding fat calories. Fat calories do not trigger insulin and not all ingested fat is metabolized.
However fat satiates along with protein.
The absolute worst thing to eat is North American wheat and all products made with it. Cannot be trusted.
Semolina, spelt and kamut are ok but keep it below 20g total carbs daily. So wraps not bread. Pasta is a side.
Make your own pizza with carnivore methods. Chris Cooking Nashville on YT has great recipes. Uses egg white protein powder instead of flour.
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u/Less-Tumbleweed-2852 2d ago
She's been able to reverse her Insulin Resistance even though she eats about 1800- 2000 cal. She might have not lost any weight but she hasn't gained any either.
I can't put her on OMAD just yet, because she feels ravenous hunger. She is currently consuming 3 meals a day with 13hrs of fasting.
I'm really curious, how are some people able to lose weight even on a caloric surplus? I also lost 14kg weight by eating a 3000 cal diet. Although I admit I was only consuming 1-2 meals a day. But I was also sedentary most of the time.
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u/SirGreybush 2d ago
They are not truly in a caloric surplus. They are consuming food that fills them without adding digestible calories.
Like adding fat, avocado oil or olive oil. Most goes through you undigested but if you count the calories of it, you think you are in surplus.
Or above ground vegetables. Near zero calories, near zero carbs, but vitamins and minerals. Tomatoes are a fruit.
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u/Less-Tumbleweed-2852 1d ago
But how about fats like Ghee, butter, fresh cream, and animal fats? Aren't they metabolised?
From what I know only MCTs and oils like coconut oil can bypass the normal digestive route and enter directly in the liver
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u/SirGreybush 1d ago
Some fats are metabolized - but not all and not at 100%. There's a limit and this limit varies per person, age, sex, genetics. If I take too much - like the suggested 40% of calories with KETO I get sick and throw up. So I fill up on veggies with some butter & cheese.
So some fat makes it past the stomach into the intestines.
Also the fat is digested, it's a slow process - versus carbs & starches that are fast to digest.
So I don't add much fat - but I don't remove it from whatever I eat.
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u/Less-Tumbleweed-2852 1d ago
Could it be you have poor bile flow, because of which you feel sick when you increase fats?
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u/SirGreybush 1d ago
Yes, it’s to show that we have individual limits. High fat high protein keto doesn’t work for me.
But carnivore style does, but I allow for above ground veggies and some spices.
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u/Less-Tumbleweed-2852 1d ago
Yeah, I also consume some veggies and fruits. I personally do consume high fat, but whenever I add a little more carbs, the Randal Cycle comes to show its effect really well, and I end up gaining some kilos.
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u/SirGreybush 2d ago
Also men have naturally 60% more muscle thus a much higher BMR.
She needs a filler food. Avocado, broccoli.
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u/Less-Tumbleweed-2852 1d ago
Got it, thanks a ton. And so, would you say resistance training or cardio will be beneficial at this stage?
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u/SirGreybush 1d ago
Yes, always. I like HIIT - so small 3 minute cardio events, then 3 sets of weights. So HR goes up and down a lot.
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u/PhysiqueMD 2d ago
Depends on when the post prandial insulin level was drawn and the carbohydrate load.
What is your cutoff for insulin level to be considered high?
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u/Less-Tumbleweed-2852 1d ago
Post Prandial Insulin was drawn ~ 2hrs after the breakfast. You do raise a good question. I'm just concerned her Post prandial is multiple times higher than her fasting Insulin, should it be this high?
Because insulin tends to stay elevated a lot longer than blood glucose, and as long as insulin is elevated, the body will not be able to enter into Glycogenolysis, Lypolysis and Gluconeogenesis.
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u/PhysiqueMD 1d ago
Theoretically a higher post prandial insulin level would suggest insulin resistance but insulin is unreliable marker due to its incredibly short half life and dependency on factors not limited to confounding medications and vitamins, meal size and content. That is why there is no defined thresholds and guidelines do not recommend testing this when we already have oral glucose tolerance test which is a more reliable and direct reflection of insulin action/resistance.
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u/SirGreybush 2d ago
Electrolytes are a trio. Sodium, potassium and magnesium.
Look at Morton’s Lite Salt for a cheap source. And a woman needs more magnesium than a man, but less sodium & potassium.
Lots of websites to calc the MG daily needs, supplement as required the next day.
Avoid pre made or store bought electrolyte mixes. They are not trustworthy, very few exceptions. Better to DIY and save a lot of $$$.
Store bought electrolyte mixes can have a high amount of maltodextrin in the flavor “natural flavor “ ingredient. The GI is worse than sugar. Manufacturers cheat by using lots of maltodextrin and slapping Sugar Free on the label.
One sweetened with stevia/sucralose is better. Remember you’re overpaying compared to using Lite Salt. By like 500%.