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Blood Sugar Disorders

Once you do it and blood sugar and lipid levels are better, does that somehow reset the metabolic parameters for individuals such that they can safely resume normal eating?

Chris Kresser: In some cases yes and in other cases no.

I really don’t get how that works to normalize things once the diet is completed.

Chris Kresser: Well, you can refer to studies like I’m sure you saw a few years ago a study on...

Elevated fasting blood sugar and pregnancy often occurs fairly early on in gestational diabetes, likely related to human placental oxygen enhancing insulin resistance. We often have to resort to insulin at bedtime to control the morning insulin. Is there anything specific you believe would work in pregnancy to avoid the use of insulin when diet fails?

Chris Kresser: That’s a really good question. Nothing comes to mind right off the top of my head because a...

In cases of hyperglycemia, how do you make an assessment that the second insulin response is impaired or if there is beta cell damage?

Chris Kresser: You can’t really do that from the basic markers that we have on a case review panel. You...

Not sure if you’re covering this in future sections, but interested in how you approach patients producing insulin antibodies and have some evidence of mild blood sugar dysregulation. HPA-D may be coming into play, so plan to address other than referring out to an endocrinologist, how do you advise these patients?

Chris Kresser:  First of all, I should go back and apologize. I don’t think you guys have seen the  hyperglycemia...

You mentioned several genetic polymorphisms that have been identified that can predispose certain people to having high blood sugar. Do you remember what these are?

Chris Kresser: There are numerous ones that I’ve come across in various papers and I’ve never actually bothered to collect...

I have a patient with normal A1c and lipids, diabetes in family, started monitoring blood sugar because she’s having easy weight gain, especially with starchy carbs and difficult weight loss. Blood sugar throughout the day pre- and post-prandial is okay on a low-moderate-carb diet. However, she’s fasting for 14 hours at night, and morning readings are high, in the 108 range, and can rise before eating. She had black coffee, and blood sugar rose from 108 to 114 an hour later, no food yet. Comments on the high a.m. readings and if coffee can raise levels significantly.

Chris Kresser:  First of all, an increase of 108 to 114 is not statistically significant interindividually, especially if that’s being...

Can you explain the mechanism behind how insulin resistance can influence both of these in opposite directions?

Dr. Amy Nett:  Okay, these aren’t really opposite directions. In case three, we’re saying that high insulin favors cortisol over...

Do you think a shorter-term calorie restricted diet is okay for patients with type 2 diabetes? I think you referred to a very-low-carb diet, which has been shown to reverse diabetes, or a very-low-calorie diet. I think in one of the studies, the subjects were on a very-low-calorie diet for eight weeks.

Chris Kresser:  Yeah, I think it can have short-term benefits. Generally I prefer dietary approaches that favor spontaneous calorie reduction,...

Regarding the supplements for glycemic dysregulation, are they for both high blood sugar and low blood sugar (reactive hypoglycemia-type symptoms)?

Dr. Amy Nett:  So, the symptoms we talked about for glycemic dysregulation, primarily GlucoSupreme, I think you’re mentioning, GlucoSupreme and...