Lowering blood sugar

I am not medically trained, so I'm must winging it here: with a history of pancreatitis, and fluctuating serum glucose levels, it seems you are borderline Type II diabetic? Is this anything anyone has suggested to you? I know nothing about you, height, weight, BMI, CRP score, calcium score, any history of ischemia or kidney/liver disease....other routine prescriptions that you take on a regular basis. Supplements, sleep pattern, daily stress and cortisol levels.....yes, it's really all that complicated.

Every healthy person awakens in the morning with elevated glucose in the blood. It's part of the sunrise response known widely as the 'Dawn Effect', and it's not named after a woman. 😀 Cortisol also rises when we do. That's a stress hormone.

Insulin is a storage hormone. Yes, it is used to regulate blood sugar, but it does that by making adipocytes store sugar by converting it to fat. If your insulin levels are all over the place, I would urge you to consult an endocrinologist or a doctor of internal medicine (internist).

You didn't list the exercise that you are doing. Moving around throughout the day and especially after dinner are proven methods to move the needle, but I'm not sure how much. Muscle mass and sleep also are known to impact blood glucose. How much weight have you lost and has your glucose come down along the way? I imagine the weight loss will help but you might look into how much loss is necessary and how long it takes after the loss for the glucose to come down. Movement should help right away. You might get opinions from the support group for diabetes too. It's the "Diabetes and Endocrine System" group. I'd guess those folks have a wealth of experience to share.

Okay, more specific info.
I'm a retired 70 year old male at 6'3" and 255 lbs. I've been struggling with my weight for years and keto worked the best when I was still employed and way more active.
In March 2025 I had a NSTEMI caused by a completely blocked ramus and 85% blocked RCA and LCX. Blockage corrected with 3 stents and now I'm on Brilinta and baby aspirin 2X daily. I try to get out and walk most days around 2 miles per day but haven't tried returning to the gym yet.
I also have to take 125mcg of Synthroid daily and 150mg of Avapro daily. Prior to my heart attack I was vaping nic salts but since the attack I have quit. I started vaping in 2011 to get off cigs that I smoked for over 40 years...now I'm nicotine free. I drink alcohol only 1-2 times per month and then very lightly.
My liver and kidneys are just fine and I've had an upper GI with contrast to be sure my pancreas is okay as well as my gallbladder.
I was prescribed Repatha after the heart attack to lower my cholesterol and triglycerides and so far so good. No side effects that I've noticed.
If I think of anything else I'll update this.

I have done a lot of reading about keto, along with zillions of the rest of us who feel they need a metabolic do-over, and I seem to recall that if you can't get your A1C down into the normal range, or within a couple of points of normal, that you are diabetic, but more-so that it has been for some time and that there is little hope of reversing it. For those who catch the onset early enough, or just in insulin resistance, it can be brought back to normal with fasting for periods over 36 hours and by keeping carbs very tightly controlled, at least for a few months until your system settles and regains some rejuvenation.

Has anyone ever mentioned metformin to you?

@ibchispas , what is your A1c? Have you been diagnosed with Type 2 diabetes? Have your doctors commented on the BS numbers? What are your goals regarding blood sugar levels?

While I tend to eat low carb, I’ve never been too impressed with keto…..I’m type 1 so rely on insulin regardless of carbs. I focus on healthy fats. If you’re eating low carb, walking and still seeing numbers you feel are too high, I’d discuss it with your doctor and a nutritionist with Endocrinologist office.

I don’t have heart disease, but I still take a statin, exercise, maintain good weight, use insulin pump, maintain good blood pressure and still conduct myself as if I have had a heart attack as a preventative measure.

@celia16 I've been pre-diabetic for about 10 years according to my docs. My A1C has never exceeded 6.0 and my docs didn't seem to be concerned but I don't like being told I'm pre-diabetic because my blood sugar is always above 100 and nothing seems to bring it down. I'm going to try the 3-4 day fast to see if my insulin resistance will reset and then maintain a low carb diet and see what happens with my blood sugar.

@ibchispas Good for you for digging in and getting past these 'comfort zones'. My recollection is that you may have to run several long fasting sessions, with a sensible, safe, break in between, and then you'll possibly, hopefully, begin to see a tweaking of those numbers. I don't recall reading or watching a video where one of the gurus said he reversed his pre-diabetes in a single 48 hr fast. I seem to remember it taking several weeks until the white flag went up.

https://www.frontiersin.org/journals/molecular-biosciences/articles/10.3389/fmolb.2021.698698/full
I take folic acid tablet to lower my triglycerides and have noticed lower A1C.

@ibchispas , I see. Well, it’s good you are aware and diligent with the numbers. As far as naturally getting them down….I hope you find a solution that helps. During my career in diabetes, I’ve attended many conferences, seminars, etc. I’m no expert, but it’s my understanding that even if you do everything right, higher numbers often get higher over time. This is due to no fault of the patient. This is common even with meds, great diet and good control. I think the new meds to lower BG has made a huge difference in helping with this. I realize you were concerned about a med that caused pancreatitis. Are you sure that was your situation? I ask because meds like Ozempic are thought to offer protection to the heart and from heart attacks. With your numbers, would your doctors even consider prescribing it?

Good luck with everything.

@celia16
I have already ruled out GLP-1 meds because of the pancreatitus side effect possibility. I'm not willing to go through that again and risk my pancreas developing cancer because of the acute inflammation. No thank you. Thank you for your feedback and I'll just keep trying to do the best natural things that always seem to work the best.