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There's a meter for that. True ketosis means always above 0.5 in the AM and around or above 1.0 in the PM.

My guess, after getting and using that meter, is that very few low-carbers are in ketosis or at least not all the time. Many probably eat too much protein and too little fat to get there.

Only real way to find out, get that meter and test.
 

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I really have been doing good for 3 days now. I don't want to blow out this time, I'm ready and willing to commit and have been sticking to it with no cheats but today I had about 10 fries, not sure that is really a cheat though because I've not eaten hardly any carbs today. I know my past is shaky and not taken seriously but I'm doing this more and 3 days into with very few carbs and lots of oils and fats is proof I'm trying. I'm not even interested in ice cream or pizza right now. I've been drinking a lot more water too. I'm going to go through this till I get through it.
If you're attempting to both get accustomed to ketogenic WOE and see some results, a good solid month with ZERO slip-ups would be needed.

As for nausea, suddenly eating the amount of fat required may have that effect at first. It took me three weeks for that to totally disappear. Now, three years later, I can't even remember what stomach upset feels like as it has never happened again.
 

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Personally, I would recommend against trying dietary changes and Metformin at the same time. It kind of invalidates your results. You won't know what benefit came from diet and what came from Metformin.

That's the decision I made right after diagnosis. On the third day, I put the Metformin in the trash - along with the statin and some other junk my doctor had prescribed and proceeded learning about diet and making changes. Within 4 months it seemed clear that diet would indeed work by itself and not much longer after that I got to completely normal blood sugars where I've been ever since with no meds of any kind.

Metformin is one of the more benign pharmaceuticals, but that's practically an oxymoron. Even as one of the best, there are still significant side-effects reported:

Nausea and diarrhea
Impaired ability to absorb vitamin B12 resulting in deficiency
Potency issues in males

My view was that if I took Metformin WHILE making adjustments to diet, that just made no sense. If the Met WAS helping that would only mean that I would become complacent with a certain degree of change in diet concealing the knowledge from myself that with a little more rigor in diet I wouldn't need the Met at all. You can't really know that unless you test them separately.
 
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There many reasons for maintaining ketosis other than blood sugar control. If I knew before what I know now, I'd be maintaining ketosis even without diabetes.

Also, I'm not completely sure that ketosis will give you the lowest BG numbers possible. What it will give you is:

The lowest glucose THROUGHPUT possible, and
A constant supply of ketones, the only complete energy alternative to glucose

I can't afford to test enough to confirm this, but I'm fairly certain that when I completely maintain ketosis, many of my readings are actually 10 points HIGHER then I could do with less-than-ketosis low-carb. I also think that is utterly irrelevant and that it is the TOTAL glucose (throughput) which matters.

Another thing is that if you cycle in and out you will never get very far into "keto-adaptation" since every expedition out of ketosis sets you back to square one. Even the very first stage (ketone production) takes at least 3 days up to weeks for some people. The brain takes even longer to adapt to and begin using ketones. In about three weeks it can be most of the way over, but adaptation continues for at least three months or even longer. This whole process can be complete reset back to zero by a couple of bad meals.

My main reasons for choosing to stay in ketosis?

- Alzheimer's
- Parkinson's
- Dementia generally
- Ideal body weight/composition
- Mental alertness and energy
- Blood sugar

in more of less that order!
 

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But if my fasting BG numbers are already in the 70's and 80's, which I guess is a normal non-diabetic level, a 20~30 point drop would mean 40's to 60's, which would be bad news. Although not sure if it would work that way to put you into hypos, or just level you out at a level just above it.
She meant she dropped from too high to normal. A ketogenic diet will never cause lows, only down to where it should be if it's not there already.
 
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I have exactly the same question. Hopefully someone knows the answer.
I've looked for this quite a bit. Bottom line, I don't think the answer is really known. I feel safer staying firmly in ketosis than slipping in and out. Partially I base that on reading that there a tiny amount of your body taking muscle for glucose in the early stages of the crossover, which then resolves itself before you get into ketosis. I've never heard that this is any kind of problem and have never myself experienced any problems the many times I've slipped in and out but still overall, feel safer sticking to one or the other (mostly just one).
 
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