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Keto and Fasting vs. Blood Sugar | Ketone Production | Glucose- Thomas DeLauer

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Keto and Fasting vs. Blood Sugar | Ketone Production | Glucose- Thomas DeLauer…
Prior to converting to the keto diet, your muscles were the major sites to soak up and use glucose in the blood for energy.

On the long-term keto diet, however, they now prefer fat as fuel – so the muscles are resisting the action of insulin to bring sugar into cells for energy as they don’t want or need sugar anymore, so they don’t get absorbed.

Hence, the slightly elevated, but generally stable, glucose circulating in the blood – the glucose coming from when you consume no sugar is due to gluconeogenesis.

Why Does This Occur?

There is no essential requirement for dietary carbs because humans possess the ability to adapt to low-carb availability.

In the liver of a keto-adapted person, ketone production increases dramatically to displace glucose as the brain’s primary energy source, while fatty acids supply the majority of energy for skeletal muscle.

Glucose production from non-carb sources via gluconeogenesis supplies carbons for the few cells dependent on glycolysis.

The majority of glucose is spared for tissues with an absolute requirement for it, such as the brain.

So with muscle tissue “refusing” the glucose in order to keep it available for the brain, the blood glucose rises, especially first thing in the morning – due to the dawn phenomenon.

When you are sleeping your body is very active cleaning out the brain and rebalancing hormones to prepare you for the next day.

Early in the morning, the body releases cortisol, epinephrine, growth hormone, and glucagon – these hormones all have the effect of increasing blood sugar to wake you up.

The difference in those who are following a ketogenic lifestyle is that if they are well keto-adapted, then their cells may refuse to burn that sugar for energy, which can make fasting blood sugar levels be more elevated than usual.

Simply, dawn phenomenon is a natural rise in blood sugar because of a surge of hormones secreted at night which trigger your liver to dump sugar into your blood to help prepare you for the day.

In Depth:

So physiological insulin resistance is actually quite logical as muscle runs well on lipids and so glucose can be left for tissues such as brain, which really need it.

Neuronal tissue varies in its use of insulin to uptake glucose but doesn’t accumulate lipid in the way muscle does, so physiological insulin resistance is not an issue for brain cells.

However, while muscles are in “refusal mode” for glucose the least input, from food or gluconeogenesis, will rapidly spike blood glucose.

Instead of sugar not being able to get into the cells due to insulin resistance, the cells are simply refusing to burn sugar because they would prefer the ketones already being used.

So after going low carb, your muscle tissue becomes insulin resistant in order to preserve serum glucose availability for the brain.

If your muscle tissue did not do this, reduced availability of glucose in the serum could (theoretically) put you in dire straights if your brain can’t meet minimal demand for glucose.

In other words, physiological insulin resistance is a protective response of the body that ensures that the brain gets the benefit of a limited supply of glucose.

Because the rest of the body is refusing to take up glucose, and the liver takes it up slowly, a meal of carbohydrates is followed by higher blood glucose levels in someone on a low carbohydrate diet.


1) physiology.org | Error. (n.d.). Retrieved from https://www.physiology.org/doi/full/10.1152/ajpendo.00580.2013
2) Distinct Effects of Ketone Bodies on Down-Regulation of Cell Surface Insulin Receptor and Insulin Receptor Substrate-1 Phosphorylation in Adrenal Chromaffin Cells. (2003, March 1). Retrieved from http://jpet.aspetjournals.org/content/304/3/994.long
3) Why High Fasting Blood Glucose on Low Carb or Keto? ? Diet Doctor. (n.d.). Retrieved from https://www.dietdoctor.com/low-carb/fasting-blood-glucose-higher
4) Higher Fasting Glucose on Ketogenic Diets: Reason to Worry? (2018, October 10). Retrieved from https://blog.designsforhealth.com/node/835
5) Physiological Insulin Resistance – Ketopia. (2015, September 2). Retrieved from http://ketopia.com/physiological-insulin-resistance/
6) Ketogenic Diet and Physiological Insulin Resistance | Low Carb Diet and Dawn Phenomenon. (2018, March 4). Retrieved from https://www.ketoshop.com/blogs/news/ketogenic-diet-and-physiological-insulin-resistance-low-carb-diet-and-dawn-phenomenon

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