[noctuid]

This is not pathological insulin resistance and is an expected adaptation. OGTT is useless for someone on a low carb diet. A normal person can go from failing to passing in ~72 hours by reintroducing higher levels of carbohydrates. Good luck reversing diabetes in 72 hours...

[876978095789789]

The "physiological insulin resistance" meme only started because so many people going on low-carb (and especially high-fat keto) diets saw worse fasting BG and A1C numbers, which flied directly in the face of the common-sense (but completely wrong) assumption that excess carbohydrate consumption is the primary cause of insulin resistance:

>Wait, I cut carbs out almost completely, why are my numbers getting worse?

Because you're eating more fat, and probably more saturated fat in particular, which means more intramyocellular lipids, and hence, you're becoming more insulin resistant. Cutting the carbohydrate consumption only masks the IR, at best. The simplest explanation is that "phsiological IR" is just plain-old insulin resistance: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6602127/

> OGTT is useless

It's probably the best cheap test for clinically diagnosing insulin resistance: https://pubmed.ncbi.nlm.nih.gov/23327814/

Fasting BG, fasting insulin, and HbA1C only measure blood sugar control, which severe carbohydrate restriction can sometimes obtain, but without actually reversing the underlying pathology of IR. An OGTT, by contrast, measures your insulin response to a bolus of glucose in real time.

[BigCryo]

You're saying something that the low carb advocates already know.. but let's be clear it's not this underlying pathology that causes the damage.. it's the high blood sugar that causes the damage.. the high blood sugar is basically reversed by keto diets.. problem is that keto can put weight on you very easy because it's high fat and you can eat a lot of fat very quickly and get a lot of calories that way.. also keto is very hard to stay on for a long periods of time.. now lots of people will reply to me and say oh look at me my personal example look at my brother or whatever.... this is basically worthless data that you're giving me about your brother about you or whatever

[876978095789789]

> high fat and you can eat a lot of fat very quickly and get a lot of calories that way

Fat also has the lowest thermic effect, a paltry 2-3%. Besides having the most calories per gram (9 vs 4 for protein or carb), it provides by far the cheapest, easiest calories for your body to digest.

[BigCryo]

Well I am not too sure about that cheap easy calories as far as fat goes.. as far as the price yeah oils not too expensive but Meat is not cheap and meat is really the way you have to get most of the calories in fat... Easy to digest? Starchy carbs far and away the easiest

[876978095789789]

By

>provides by far the cheapest, easiest calories for your body to digest

I mean metabolically cheap and easy. Your body expends the least energy digesting fat (2-3%, or 2-3 calories worth of energy for every 100 fat calories you consume), and the most digesting protein (>20%). Add to that the fact that fat has more than twice the calories per gram that carbohydrate and protein do, and it's little wonder why so many people fail with keto.

[sheepscreek]

This. From my experience doing Keto and based on what I’ve read, your body enters ketosis after blood glucose drops very low. When that happens, it switches to ketones for fuel. It doesn’t need glucose anymore (although glycogen plays a role).

The assumption here is that this is a temporary/reversible condition. At least it was in my case.

For the record, I did a low carb diet for 6 months. I was in ketosis for much of it, with temporary periods of break when it was unavoidable (during travel, lack of food options, social setting). I feel exogenous ketones helped me with the process of getting back in ketosis.