A Fifty Percent Chance
July 2017 — day 34
I didn't start keto to lose weight. Weight loss was a goal, sure, but keto wasn't the tool I picked for it. Keto is where I ended up after I tested my blood sugar and didn't like what I saw.
How I got here, in order
On a live that July I laid it out as a list, so here's the list (live 10000000_637424646467238_6646023133880909824_n):
- Lose some weight. I'd taken up kickboxing because I wanted to look better naked. Honest answer.
- Try intermittent fasting, as a tool for that.
- Test my blood sugar, to see if the fasting was doing what it was supposed to.
- It wasn't.
The idea behind intermittent fasting, as I understood it, is that your blood glucose drops overnight and that lets a bunch of good metabolic stuff happen. So I checked. My numbers after meals looked fine, good even. But during the fast my glucose just kept climbing. 122 when I woke up to test at 3am. 126 or 127 when I got up in the morning. And if I didn't eat until noon, by 11am I was at 135, still fasted (live 10000000_637424646467238_6646023133880909824_n).
The way I understood the cutoffs then, over 126 fasted is the diabetic range, and 100 to 126 is prediabetes (live 10000000_637424646467238_6646023133880909824_n). So fasting wasn't doing what I needed. It looked like I had an insulin resistance problem.
The fifty percent
The name for what I had is impaired fasting glucose. As I read it at the time, about half the people who have it go on to type 2 diabetes, and it takes about three years on average. So I put my own odds at 50% of being diabetic within roughly three years if I didn't change how I ate (live 10000000_637424646467238_6646023133880909824_n).
That's not immediate. But it's not really far away either. I'm talking about the same decade of my life (live 10000000_637424646467238_6646023133880909824_n).
So I read about how people treat impaired fasting glucose. The number one suggestion seemed to be controlling and limiting carbs. That sent me to research on very low carb and low carb diets, and that's how I found ketosis. Most of what I read was about low carb in general, not keto specifically (live 10000000_637424646467238_6646023133880909824_n).
I didn't learn it from books. Somebody on the live asked what the best keto book was, and I said I hadn't read many. I did most of my reading on PubMed and through NIH studies. Books make me a little nervous because the author is selling something, the book, the tour. And keto is a funny one, because unlike fasting, there actually is stuff to sell: exogenous ketones, the MCT oil everybody supposedly needs (live 10000000_637424646467238_6646023133880909824_n).
Small detail, since people ask: I counted total carbs. In the US the labels don't split soluble and insoluble fiber, and soluble fiber still counts, so I just counted the total (live 10000000_637424646467238_6646023133880909824_n).
Day 34
So how was it going?
Good, I think. All my blood sugar numbers were lower, and they'd stayed lower than when I started. But I'd honestly hoped to be back to normal by then, and I wasn't. I was sticking with it because it was moving in the right direction (live 10000000_637424646467238_6646023133880909824_n).
In my first update video, I'd reported fasted numbers of 105, 108, 103 and 97, down almost 20 points from the 130s and mid-120s (video 9Hk0jRb_9Es).
I was running linear regressions on my readings, which I said right there weren't perfect or accurate. They said I should hit normal sometime between mid-August and early September. I told people: if you're still following me, ask me then (live 10000000_637424646467238_6646023133880909824_n).
And yeah, I'd lost weight. I started at 236 and I was 222 that day, so 14 pounds down. I wasn't doing anything for month one except avoiding carbs and logging food in MyFitnessPal. The week before, I'd come up about 4,500 calories short, which should be a little more than a pound of fat. Weight goes up and down a lot along the way, though. You gain on days you barely ate and lose on days you thought you ate a lot (live 10000000_637424646467238_6646023133880909824_n).
My favorite thing about keto was that I wasn't hungry all the time. But I never bought the hype that the cravings just disappear. I miss mac and cheese. I love pizza. Garlic bread. Potatoes are a wonderful, wonderful plant. Mangoes, pineapple, all of it (live 10000000_637424646467238_6646023133880909824_n).
I stayed anyway. Because the reason I was there wasn't the scale. It was that I really, really didn't want to be diabetic.
What I'd tell you now
The basic move I made, cutting carbs to get my glucose down, has real backing. The American Diabetes Association's consensus report says reducing total carbohydrate has the most evidence for improving blood sugar, and it lists low-carb eating as one of several options, not the only one (Evert et al., 2019). Its current standards say the same: several eating patterns work if they're fitted to the person (ADA Standards of Care 2025). The "50% in three years" figure is my 2017 reading, and the research pages behind this site don't check it, so treat it as one guy's reading and not a statistic. Please don't copy my process with a home meter alone. Get baseline bloodwork with your doctor (blood tests before keto). And if you already take medication for diabetes or blood pressure, talk to your doctor before you cut carbs, because the doses can need changing (why doses change).
More on this: what the ADA says about low carb, net vs total carbs, how to search PubMed, and my first update video, 9Hk0jRb_9Es.
Earlier: How KetoDick Got Its Name · Later: A Dog with Seizures, and a Message from Bangladesh