Disclaimer - I'm no expert in anything and nothing I say should be taken seriously by anyone.
Fasting blood glucose levels, your readings taken first thing in the morning, are entirely set by the liver and the hormones that regulate it. While it is often stated on this forum and elsewhere that lowering your carb intake can bring down fasting BG levels directly there is actually no science to back that up. The opposite in fact - the science says it's all about the liver and the hormones. The carbs you ate yesterday had no effect on your BG when you woke up this morning - they were all digested and metabolised hours before, and practically all the glucose in your blood on waking came from the liver. The liver doesn't remember what you ate yesterday.
In the fasted state a healthy person's blood glucose is regulated as follows:
1: If blood glucose drops too low the pancreas secretes glucagon
2: The liver responds to glucagon by releasing much more glucose into the blood
3: When blood glucose rises a smidge too high the pancreas stops secreting glucagon and secretes insulin
4: Insulin antagonises glucagon - it cancels out its effects
5: The liver responds to insulin by releasing much less glucose into the blood
This cycle repeats over and over, keeping blood glucose levels quite stable, until you eat something. Other hormones also have an effect on the action of insulin or on the liver such as stress hormones, growth hormone, adrenaline etc. which are perhaps responsible for effects like Foot on Floor and Dawn Phenomenon.
In susceptible people, if they have excess fat in their liver that organ can become insulin resistant. That compromises step 5 in the cycle - the liver doesn't switch-off glucose output quickly in response to insulin as it's less sensitive to its effects. This leads to higher fasting blood glucose levels. Reducing fat levels in the liver may improve its insulin sensitivity and resolve the problem. If a low-carb diet or any other diet leads to weight loss and a reduction in liver fat that may do the trick. While a low-carb diet can be highly effective for controlling blood glucose levels after eating it cannot directly lower a person's BG levels below the 'floor' set by the action of the liver, the hormones that govern it, and the liver's sensitivity to those hormones. A low-carb diet only has an effect on fasting BG if it leads to weight loss (which it very often does).
The concept that weight loss leads to a reduction in liver fat which leads to lowered fasting BG levels is well proven at this point - this long interview with Prof Roy Taylor explains the concepts:
Link I should mention that I don't trust his Personal Fat Threshold theory but this ideas on weight loss, liver fat and insulin resistance seem sound and well-proven.
The liver pumps out fat constantly into the blood in the form of triglycerides. If rising levels of fat in your liver are the culprit for your rising fasted BG levels then possible solutions are all about making sure less fat enters the liver than exits it over an extended period of time. Significant weight loss will do this if you have the weight to lose. I see from your previous posts that you were diagnosed with a fatty liver and that you have lost weight since diagnosis. Is further significant weight loss possible for you without becoming unhealthily underweight?
Stopping alcohol will help greatly if you drink, as alcohol is converted to fat in the liver. Non Alcoholic Fatty Liver Disease (NAFLD) is strongly associated with low levels of exercise and low skeletal muscle mass, and addressing this further may help. As far as I can make out, extended exercise burns up fat stored in muscle tissue. As the 'fat tank' in muscle tissue empties it soaks more fat up from the bloodstream. Increasing muscle mass increases the size of the 'tank', and exercising as much of that muscle mass as possible regularly and for an extended period of time empties the tank regularly. The effect of doing this might be that muscle tissue will be able to soak up more of the fat you eat, leading to less of it accumulating in the liver. There are numerous studies linking NAFLD with low skeletal muscle mass, and one I found seems to suggest that muscle mass might be at least as important a factor as exercise or obesity:
Study Link
Taylor's Personal Fat Threshold theory suggests that if you get below a certain weight and stay there fat will not re-accumulate in the liver - it will stay largely in adipose tissue (fat cells) instead. As I don't trust this theory myself my plan is to lift weights (tiny ones admittedly) and, hopefully, get fit enough to use a rowing machine regularly, as that exercise works a lot of muscle groups. My thinking is that if I address all the risk factors for NAFLD as much as I possibly can then I can maximise the chances that fat won't re-accumulate in my liver and that may keep my fasting BG levels low for as long as I am able to keep exercising. That's the theory, though there's no hard evidence that it will work. I believe it worth the effort though as there are only so many times I can empty out my liver through weight loss before I lose too much weight for that to remain an option.
I hope all that helps. Very best of luck!
