Part 8: Wearing a Continuous Glucose Monitor as a non-diabetic Physician: more testing of carbohydrate responses in a fat-adapted human

Low Carbon and Low Carbohydrate 582
Low Carbon and Low Carbohydrate 582 (View on

As I mentioned in part 7 of this series, for a person without known diabetes/prediabetes who is fat adapted (via a low-carbohydrate, healthy fat, or #LCHF diet), the response to a carbohydrate load may be different than a person who is carbohydrate adapted or continually seeing a massive deluge of carbohydrates and/or processed foods.

This time, low carbohydrate chocolate chip cookies, with distilled spirits

The chart above shows the impact on glucose using a continuous glucose monitor after ingestion of low carbohydrate chocolate chip cookies, combined with distilled spirits (no added sugar) and healthy fat meal, in a fat adapted, #LMHR (Lean Mass Hyperresponder) individual. As the chart shows, there is a more profound hygoglycemic excursion, likely due to reduced liver gluconeogenesis competing with alcohol processing. Interstitial glucose excursion is also more pronounced in probably insulin sensitive person on an low-carbohydrate, healthy-fat diet. The hypoglycemia was asymptomatic.

There are no added sugars (with perhaps a small impact from the low-carbohydrate chocolate chips) and no industrial vegetable oils used in the cookies themselves.

It’s known that people on on low-carbohydrate diets do not have trouble manufacturing the glucose they need. In the above, it’s possible that the liver is occupied processing alcohol, which diverts its ability to manufacture glucose. Interestingly, there were no symptoms associated with this hypoglycemia.

As always, feel free to check my work.

In a person who is not diabetic and specifically not type 1 diabetic and therefore produces insulin, this is not as dangerous as it would be for someone who does not produce insulin.

This is not a promotion of CGM-for-all

I’ve been asked directly or indirectly recently if I am advocating CGM-for-all. I am not, and definitely not with the current profile of devices available. This could change dramatically if CGM is more universally available. The manufacturer recently made CGM more available by allowing direct scanning of sensors via iPhone. I’ll post on this next.

Reminder of my statement of independence and no conflict-of-interest:

I’ve created a page specifically addressing any conflicts (I have none).

Recipes coming to this blog

I’ve been asked to post the recipes I’m using in these tests. I’ll be doing that soon.

Ted Eytan, MD