Any idea what is going on here?

[Callista]

Hi, since my DX as pre-T2, and me going on as near keto as I can bear (!), and as low cal as I can bear (!!), I have increasingly noticed that 'first exercise' is getting much tougher. And by 'exercise' I mean 'heading upstairs briskly' and 'setting off to the shops on foot'. I am finding myself very 'weak', and have to lean on a lampost, or sit on the bed for a moment before getting going again.

Yet, after a short while (maybe five mins) when I'm walking, I do seem to 'pick up' and then can keep going, not very fast, but not feeling I just want to stop and lean on the nearest lamppost again.

Does this look to be my heart (I am on bp meds, but pre-DX re pre-T2 I never had this phenomenon)? Or is it that I am 'low energy' (because of low cal) or 'low glucose' (because of near keto)?

I'm wondering whether what is going on, expressed by my 'low energy' or 'weakness' (fatigue), is that when I start to use my muscles (to head upstairs, set off on a walk), I use up whatever glucose I've got 'sitting' in my blood, but it is insufficient, and so I get fast fatigue, but, if I just keep walking, my glycogon kicks in, and flushes some glycogen-to-glucose into my blood to 'refuel' my muscles, and then I can settle down into 'normal' walking pace?? (Who knows, maybe I'm even starting to draw the fat out of my adipose tissue and get that out into my blood as glucose??!) (though I suspect the pathway for that takes longer, and I wouldn't feel it that fast??)

 

[harbottle]

Sounds like it could ‘keto’ fatique or you are not getting calories and this is causing fatique.

The body will produce glucose as it needs it, whether it’s from the release of glycogen or gluconeogenesis. It will also start to make ketones to power muscles.

 

[Leadinglights]

Hi, since my DX as pre-T2, and me going on as near keto as I can bear (!), and as low cal as I can bear (!!), I have increasingly noticed that 'first exercise' is getting much tougher. And by 'exercise' I mean 'heading upstairs briskly' and 'setting off to the shops on foot'. I am finding myself very 'weak', and have to lean on a lampost, or sit on the bed for a moment before getting going again.

Yet, after a short while (maybe five mins) when I'm walking, I do seem to 'pick up' and then can keep going, not very fast, but not feeling I just want to stop and lean on the nearest lamppost again.

Does this look to be my heart (I am on bp meds, but pre-DX re pre-T2 I never had this phenomenon)? Or is it that I am 'low energy' (because of low cal) or 'low glucose' (because of near keto)?

I'm wondering whether what is going on, expressed by my 'low energy' or 'weakness' (fatigue), is that when I start to use my muscles (to head upstairs, set off on a walk), I use up whatever glucose I've got 'sitting' in my blood, but it is insufficient, and so I get fast fatigue, but, if I just keep walking, my glycogon kicks in, and flushes some glycogen-to-glucose into my blood to 'refuel' my muscles, and then I can settle down into 'normal' walking pace?? (Who knows, maybe I'm even starting to draw the fat out of my adipose tissue and get that out into my blood as glucose??!) (though I suspect the pathway for that takes longer, and I wouldn't feel it that fast??)

As you have only got a pre diabetes diagnosis you have over done your reduction in carbs and calories too quickly, your body need time to adjust and you are putting yourself at risk of getting issues with your eyes and nerves from such a drastic change.

 

[Callista]

Yes, I'm hoping it's some form of keto fatigue, and/or low-cal fatigue. As I say, my 'game plan' is to reduce my fat content and eat my spare tyres, lowering my overall weight, and helping to head me out of pre-DM if possible

LL - I probably was a bit drastic, though I did take a good couple of weeks to finally ditch most of the carbs I was merrily stuffing away pre-X. I wonder why being too drastic imperils eyes and nerves, which I thought came from too much BG? Or is it that if one goes too low cal, and too low keto, too fast, the body goes into overdrive flushing fat into BG?

 

[Inka]

A sudden drop in blood glucose level can sometimes cause retinopathy @Callista and neuropathy (nerve pain). Better to bring it down gradually.

 

[Leadinglights]

I thought that as my HbA1C was not very high that reducing carbs all at once wouldn't be the wrong thing to do. I only learnt afterwards by reading on here that the reason my eyesight had gone to pot that it is because the environment in the eye will change from 'sugary' back to the normal 'salty' which changes the shape of the eye and thus the focal length changes. My distance vision was OK but near vision was awful, my eyes felt as if they were in different heads, no co-ordination.

 

[Spathiphyllum]

Hi, since my DX as pre-T2, and me going on as near keto as I can bear (!), and as low cal as I can bear (!!), I have increasingly noticed that 'first exercise' is getting much tougher. And by 'exercise' I mean 'heading upstairs briskly' and 'setting off to the shops on foot'. I am finding myself very 'weak', and have to lean on a lampost, or sit on the bed for a moment before getting going again.

Yet, after a short while (maybe five mins) when I'm walking, I do seem to 'pick up' and then can keep going, not very fast, but not feeling I just want to stop and lean on the nearest lamppost again.

Does this look to be my heart (I am on bp meds, but pre-DX re pre-T2 I never had this phenomenon)? Or is it that I am 'low energy' (because of low cal) or 'low glucose' (because of near keto)?

I'm wondering whether what is going on, expressed by my 'low energy' or 'weakness' (fatigue), is that when I start to use my muscles (to head upstairs, set off on a walk), I use up whatever glucose I've got 'sitting' in my blood, but it is insufficient, and so I get fast fatigue, but, if I just keep walking, my glycogon kicks in, and flushes some glycogen-to-glucose into my blood to 'refuel' my muscles, and then I can settle down into 'normal' walking pace?? (Who knows, maybe I'm even starting to draw the fat out of my adipose tissue and get that out into my blood as glucose??!) (though I suspect the pathway for that takes longer, and I wouldn't feel it that fast??)

Firstly: If you 'pick up' after five minutes or so, that's great!

I've always-- long before I developed Type 1-- found that, if I started to exercise when I hadn't eaten for a while, I would feel terrible for the first ten mins or so; and then something would kick in and it would be ok. I wouldn't worry too much about the precise mechanism. ; )

Also: how many calories a day are you consuming? ... I gather that, on the NHS very low calorie diet (VLCD) plan, which is only 800 kcal a day, they do not advise exercise during this phase because you can expect to feel a bit weak! Similarly with the Newcastle diet (600 kcal/day): they advise that you may have some dizziness and weakness, especially in the first two weeks. (https://www.ncl.ac.uk/media/wwwncla.../files/201809 Sample Recipes & meal plans.pdf )

 

[Callista]

thank you all for your answers. Luckily, my eyes are fine (had a good eye test this last week, and nothing 'nasty' reported, so VERY grateful for that)(I have poor vision anyway, so get lots of care and attention), but it might account for my sudden onset peripheral neuropathy in my foot/lower leg (if that's what it is, and I guess DM is the most likely culprit)

Reassuring re exercise. As for daily calories, I'm definitely not under 1000!! (I looked up the Newcastle diet and I dont' think I could do it for five days, let alone five months!!!!). At a guess I'm probably between 1000-12000, but most of that will be coming from protein and fat, and my limited fruit and museli and milk carbs.


As I've lost over a stone, and want to just lose a few pounds more (my 'margin') I feel I can soon look to both up my calories a bit, and up my exercise a bit. I've been holding back on the latter while I lose weight, as I want to maximise my fat-weight-loss before I start building up muscle. Then, with more exercise (and more muscle mass) (and the increase in weight that goes with it, but it will be 'healthy weight' not the unhealthy fat-weight) I can aim for what I hope will be my 'maintenance' regime, which is me both fitter, less fat, overall lower but sustainable calorie intake, and lower/tolerable (ideally 'out' of pre-DM) BG levels. Well, that's my hope anyway!

 

[Inka]

I thought that as my HbA1C was not very high that reducing carbs all at once wouldn't be the wrong thing to do. I only learnt afterwards by reading on here that the reason my eyesight had gone to pot that it is because the environment in the eye will change from 'sugary' back to the normal 'salty' which changes the shape of the eye and thus the focal length changes. My distance vision was OK but near vision was awful, my eyes felt as if they were in different heads, no co-ordination.

That’s true but I was referring to the risk of retinopathy, which others have experienced after a sudden reduction in HbA1C eg here:

https://forum.diabetes.org.uk/boards/threads/lowering-hba1c-too-quickly.85552/#post-956193



.

 

[ShaunM]

Hi, since my DX as pre-T2, and me going on as near keto as I can bear (!), and as low cal as I can bear (!!), I have increasingly noticed that 'first exercise' is getting much tougher. And by 'exercise' I mean 'heading upstairs briskly' and 'setting off to the shops on foot'. I am finding myself very 'weak', and have to lean on a lampost, or sit on the bed for a moment before getting going again.

Yet, after a short while (maybe five mins) when I'm walking, I do seem to 'pick up' and then can keep going, not very fast, but not feeling I just want to stop and lean on the nearest lamppost again.

Does this look to be my heart (I am on bp meds, but pre-DX re pre-T2 I never had this phenomenon)? Or is it that I am 'low energy' (because of low cal) or 'low glucose' (because of near keto)?

I'm wondering whether what is going on, expressed by my 'low energy' or 'weakness' (fatigue), is that when I start to use my muscles (to head upstairs, set off on a walk), I use up whatever glucose I've got 'sitting' in my blood, but it is insufficient, and so I get fast fatigue, but, if I just keep walking, my glycogon kicks in, and flushes some glycogen-to-glucose into my blood to 'refuel' my muscles, and then I can settle down into 'normal' walking pace?? (Who knows, maybe I'm even starting to draw the fat out of my adipose tissue and get that out into my blood as glucose??!) (though I suspect the pathway for that takes longer, and I wouldn't feel it that fast??)

Hi it sounds like you have gone extreme I’m type 2 diagnosed November last year and even I didn’t cut out as much carbs as you have you need carbs for energy I don’t know how that works with your BP but I have carbs just not bad ones and not huge amounts I stick to about 50 gr of carbs a day such as from oats fruit rice sweet potatoe and my blood glucose’levels have dropped into an almost Pre Type 2 level

 

[Callista]

I'm letting carbs creep back in now, and seeing what that does to BG levels. There's such a lot to explore!

 

[Drummer]

When I am going out with the morris dancers I eat either scrambled eggs with cheese and a bit of salad, or steak and mushrooms for breakfast, followed by a cup of coffee with cream - and I then have 12 hours of energy no problem.
It is just a case of being adapted to the diet, eating freely - my appetite is small anyway, so I have to encourage myself to ignore a half century of being told I am a greedy glutton and that is why I put on weight so easily.
If I do eat anything high carb a few hours later I am so very tired I am unable to concentrate.

 

[Dragonheart]

you need carbs for energy

You need fuel for energy for sure. But to say you need carbs for energy isn’t strictly accurate.

Energy is typically from glucose in most people which is mostly obtained from carbs.

However glucose can be obtained via gluconeogenisis from proteins and fats in sufficient amounts that zero carbs are actually required to sustain life so long as those fats and proteins are available. Other than eating these can come from the body itself. Obviously the body’s fat is a great source if weight loss is desired, but it’s protein (muscle) isn’t a great option as can be seen in undiagnosed type 1 losing weight. Hence the need to eat enough protein that muscles aren’t scavenged.

It’s also possible to utilise ketones and fats for energy in nutritional ketosis when carbs are sufficiently low enough, though becoming properly and flexibly fat adapted takes longer than just reaching ketosis

 

[Callista]

I then have 12 hours of energy no problem.
**

That's impressive! But depressing for folk like me who are still stuck, alas, in the 'greedy glutton' phase. (As in, I just love scoffing food!!!!!)

(As Susie Orbach grimly pointed out decades ago, so few of us actually eat only 'for hunger' - there are so, so, so many other reasons as well, and none of them healthy, sigh.)

 

[Callista]

However glucose can be obtained via gluconeogenisis
**

What I guess I worry about a bit now is that, on a pretty low carb (but still not sure, as in, I haven't rigorously measured, just how low carb)(I may be fooling myself of course!) diet I 'should' be, I assume, getting more glucose from both gluconeogenisis making new/novel glucose from fats/proteins etc, and also replenishing by breaking down glycogen, I worry that my body is used to higher-than-healthy levels of circulating (or even cell level) glucose, and so is making and releasing more glucose than I need. ie, that my body, thanks to my previous indolent and carb-stuffing lifestyle (!) has 're-set' so to speak what it considers 'normal'. And, of course, my self-incapacitated insulin is not capable of soaking it away into glycogen.....

I keep feeling I've got a refractory 'sump' or 'residue' of glucose in my blood, that just won't get used up by my cells to fuel them, or mopped up into glycogen (and eventually fat).

My BG levels never go up much - I've had my usual highest-carb-of-the-day meal (museli) and an hour after eating BG was 7.2 which I think is well within normal range (if I'm understanding that properly - my monitor handbook says shouldn't be above 7.8 after a couple of hours).

But I rarely get my 'fasting' or 'empty stomach' levels below 6.

I'm still exploring what exercise does to all of this!! (And what kind - cv/weights - and when, and how long etc etc etc) As I say, so, so, so much to explore and explain.

 

[harbottle]

If you're pre-diabetic and fasting levels are > 6.0 this can indicate insulin resistance in the liver, which means the signal to stop producing glucose isn't getting through, or is struggling to get through, which is causing BG to rise. Ideally, fasting should be < 6.0

Exercise uses a different mechanism to get glucose from blood, and I always find it brings mine down pretty quickly. Sometimes to < 4.0

 

[Callista]

Thank you - that does make sense, even if unwelcome sense alas!

Everything points to me facing up to taking more exercise!!! (And yes, also has such good 'side effects' as well as BG regulation!) (thinner, trimmer, sleeker, slimmer - all to run for!!!!) (Not that I can run at all - just brisk walking, and hefting weights around!)

 

[Drummer]

I then have 12 hours of energy no problem.
**

That's impressive! But depressing for folk like me who are still stuck, alas, in the 'greedy glutton' phase. (As in, I just love scoffing food!!!!!)

(As Susie Orbach grimly pointed out decades ago, so few of us actually eat only 'for hunger' - there are so, so, so many other reasons as well, and none of them healthy, sigh.)

Oh it never added up as I have never been a big eater, and feel really tired if I have carb heavy meals.
Whenever I escaped from the tyranny of low fat and high carbs I could lose a stone in a week just by cutting out the carb laden 'healthy' foods.
I don't eat because I am hungry - on my present diet I am never hungry. I just noticed that it is almost 4pm and I have not eaten anything today. If I don't go to get a cup of coffee first thing then I can just forget about eating - also if I don't stop to pick up things from one of the fridges before getting coffee I can find myself with a half mug of cold coffee by the time noon strikes.
I don't really do exercise for no reason - heaving knitting machines around as part of my part time job servicing repairing and teaching, a bit of housework or gardening, or going out with the morris teams, though these days I use an electric buggy to move the instruments and kit from place to place.
A Human metabolism working in ketosis seems to have its correct fuel.

 

[Dragonheart]

However glucose can be obtained via gluconeogenisis
**

What I guess I worry about a bit now is that, on a pretty low carb (but still not sure, as in, I haven't rigorously measured, just how low carb)(I may be fooling myself of course!) diet I 'should' be, I assume, getting more glucose from both gluconeogenisis making new/novel glucose from fats/proteins etc, and also replenishing by breaking down glycogen, I worry that my body is used to higher-than-healthy levels of circulating (or even cell level) glucose, and so is making and releasing more glucose than I need. ie, that my body, thanks to my previous indolent and carb-stuffing lifestyle (!) has 're-set' so to speak what it considers 'normal'. And, of course, my self-incapacitated insulin is not capable of soaking it away into glycogen.....

I keep feeling I've got a refractory 'sump' or 'residue' of glucose in my blood, that just won't get used up by my cells to fuel them, or mopped up into glycogen (and eventually fat).

My BG levels never go up much - I've had my usual highest-carb-of-the-day meal (museli) and an hour after eating BG was 7.2 which I think is well within normal range (if I'm understanding that properly - my monitor handbook says shouldn't be above 7.8 after a couple of hours).

But I rarely get my 'fasting' or 'empty stomach' levels below 6.

I'm still exploring what exercise does to all of this!! (And what kind - cv/weights - and when, and how long etc etc etc) As I say, so, so, so much to explore and explain.

If the liver readjusts “normal” to higher levels with gluttony it can do the same in reverse with more appropriate eating.

And if the glucose is in the blood regardless of if it gets their via food or the liver and assuming you have insulin production, then you will utilise your insulin to deal with it. You are not incapacitating your insulin, I assume you mean by low carbing. You are simply making less demands, by food driven glucose, on it.

Exercise is variable looking at many people experiments over the years. In general it seems steady exercise like walking or mire gentle swimming will get a lowering of levels pretty much instantly. More intense exercise can often get a brief raising of levels (that liver dump again to help with the energy required) but if you keep checking a longer lasting reduction often follows and it’s good for building glucose mopping muscles and general well-being.

 

[Callista]

Definitely like the idea of glucose-mopping muscles!!