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Keto Diets and Glucogenesis

keto diet was the first diet i tried when I first started trying to lose weight. It worked really well for a while. Fast forward 8 years, I cannot get into ketosis anymore. I am currently on metformin which keeps my blood sugar level in the 80’s, but in its absence it is over 100.

i am just curious if this approach was a mistake in retrospect ( I am not trying to do a very low carb diet now - probably wont in the future either). Glucogenesis is inevitable from what I understand. So will very low carb diets always result in glucogenesis to the point where high levels of sugar are produced in the liver despite the diet - given enough time on the diet.

Once this cycle of glucogenesis starts, how do you improve insulin sensitivity to start repairing this mess? Seems like it would be impossible without the aid of a drug like metformin.

[quote]koffea wrote:
Glucogenesis is inevitable from what I understand.[/quote]

Yes.

[quote]koffea wrote:
So will very low carb diets always result in glucogenesis to the point where high levels of sugar are produced in the liver despite the diet - given enough time on the diet.[/quote]

Depends on your definition of what “high” levels are.

[quote]koffea wrote:
Once this cycle of glucogenesis starts, how do you improve insulin sensitivity to start repairing this mess? Seems like it would be impossible without the aid of a drug like metformin. [/quote]

Lose weight.

[quote]koffea wrote:
keto diet was the first diet i tried when I first started trying to lose weight. It worked really well for a while. Fast forward 8 years, I cannot get into ketosis anymore. I am currently on metformin which keeps my blood sugar level in the 80’s, but in its absence it is over 100.

i am just curious if this approach was a mistake in retrospect ( I am not trying to do a very low carb diet now - probably wont in the future either). Glucogenesis is inevitable from what I understand. So will very low carb diets always result in glucogenesis to the point where high levels of sugar are produced in the liver despite the diet - given enough time on the diet.

Once this cycle of glucogenesis starts, how do you improve insulin sensitivity to start repairing this mess? Seems like it would be impossible without the aid of a drug like metformin.
[/quote]

Your whole post was a little confusing, but I will try and decipher it. I am assuming you were talking about gluconeogenesis? Formation of glucose from other non-glucose counterparts (usually speaking of amino acids). I am sure a small amount of gluconeogenesis takes part in normal individuals on daily basis. The point you mentioned of it being absolutely inevitable though I am not sure is true.

As far as ketogenic diets increasing gluconeogenesis, perhaps temproraily until the body adapts to using ketones for energy sufficiently. Once your body is adapted to ketones as a primary fuel source, and assuming you are consuming adequate levels of dietary fats to fuel your body, there should be no increase in gluconeogenesis.

As pertaining to insulin sensitivity, being in a ketogenic state your body won’t be subjected to blood sugar and insulin swings, so the lack of contact from insulin to insulin receptors should actually increase insulin sensitivity in the long run.

[quote]koffea wrote:
keto diet was the first diet i tried when I first started trying to lose weight. It worked really well for a while. Fast forward 8 years, I cannot get into ketosis anymore. I am currently on metformin which keeps my blood sugar level in the 80’s, but in its absence it is over 100.

i am just curious if this approach was a mistake in retrospect ( I am not trying to do a very low carb diet now - probably wont in the future either). Glucogenesis is inevitable from what I understand. So will very low carb diets always result in glucogenesis to the point where high levels of sugar are produced in the liver despite the diet - given enough time on the diet.

Once this cycle of glucogenesis starts, how do you improve insulin sensitivity to start repairing this mess? Seems like it would be impossible without the aid of a drug like metformin.
[/quote]

Have you tried starvation?

Seriously though, how do you qualify that you cannot get into ketosis anymore?

I do IF and I can have bloodsugar readings well over 100 mg/dl after an intense workout even after fasting more than 12 hours (average: 107 mg/dl). In this state I am also measuring moderate ketone body production from urine (approx 15 - 40 mg/dl AcetoAcetate).

[quote]schanz_05 wrote:
The point you mentioned of it being absolutely inevitable though I am not sure is true. [/quote]

If it wasn’t, your RBCs would certainly die in ketosis.

As far as I am aware, the brain never becomes 100% adapted to such a diet, either.

[quote]anonym wrote:

[quote]schanz_05 wrote:
The point you mentioned of it being absolutely inevitable though I am not sure is true. [/quote]

If it wasn’t, your RBCs would certainly die in ketosis.

As far as I am aware, the brain never becomes 100% adapted to such a diet, either.[/quote]

Yep you are correct, apparently the majority of the brain’s fuel can come from ketones but there are still certain parts that rely solely on glucose.

sorry if my post is confusing, I am trying to make sense of the verbal info I was given by a bariatric doc a while back. He basically said I had high insulin and sugar levels despite a low carb diet. High insulin spikes would cause blood sugar crashes, that in turn told my liver to produce more sugar and then more insulin etc. it was his explanation as to why i had seen my blood sugar go slowly up over the years. its possible though, that i really did not understand what he was saying at all.

in the past 8 years i have lost 110 lbs total, but the last 40-ish lbs have been the most difficult to take off and maintain. I have yo-yo ed from 190 to 240 several times. I am on Metformin now and sit comfortably at abt 200 putting my current body fat at around 15 - 17% according to the last measurement i got.

I stopped pursuing ketogenics diets a while back because I could never get anything to register on the ketostix. During this last attempt i kept my carbs around 15 - 20 gms a day and cut calories as well (sorry dont remember the exact calories). I then tried the so called 5 day fat fast to no avail. perhaps thats not a good measure of ketosis? at any rate, i did not lose weight and still had a lot of craving issues.

I got the aid of metformin to help me end the sugar insulin cycle and this has absolutely worked. I still have to eat healthy and work out. As long as I do that, I can lose weight. Before metformin, it took monumental will power to control cravings.

just trying to understand if a ketogenic diet in my case was a flawed approach.

[quote]koffea wrote:
sorry if my post is confusing, I am trying to make sense of the verbal info I was given by a bariatric doc a while back. He basically said I had high insulin and sugar levels despite a low carb diet. High insulin spikes would cause blood sugar crashes, that in turn told my liver to produce more sugar and then more insulin etc. it was his explanation as to why i had seen my blood sugar go slowly up over the years. its possible though, that i really did not understand what he was saying at all.[/quote]

This is more or less the case. What is seen is that insulin resistance leads to elevated fasting glucose levels not so much because of glucose peaks and crashes, but because of impaired feedback mechanisms to elevated blood sugar (basically, your liver doesn’t get the message that enough is enough so it keeps breaking down glycogen and producing glucose). This inhibition is the result of various direct and indirect influences, such as modulation of glucagon and adipokine levels, regulation of lipolysis and even activity within the hypothalamus. I’m not sure how much detail you really want as far as that crap goes.

BUT… the good news is that you do not need to hit ketosis in order to normalize your blood sugar and insulin sensitivity. Not by any stretch.