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Short Summary
Main recommendation: Dr. Ben Bikman says a morning glucose in the 90s, or a rise in glucose on a carnivore diet, is not a cause for worry, and that a higher A1C in these people may reflect longer-lived red blood cells rather than worse glucose control. He notes that the research question of why glucose rises on zero-carb diets is still unanswered, with a study in progress to investigate it.
Key Points
- Bikman says there is no conclusive evidence that a 10 mg/dL difference, such as 85 versus 95, is harmful, and he considers fasting glucose up to about 100 to be within a healthy, normal range.
- His working theory for rising glucose on zero-carb diets is protein sensitivity: high protein intake may stimulate more glucagon release from the pancreas in some people, and glucagon raises blood glucose.
- A1C is a weighted average that reflects glucose bound to hemoglobin over the red blood cell's lifespan, so a person with long-lived red blood cells may read higher even when glucose is normal.
- The reverse can also occur: someone with elevated glucose and short-lived red blood cells may show a normal A1C, which can give a false sense of security.
- The questioner notes that A1C weights the last 30 days more heavily, and concludes that carnivore-style blood markers may simply differ, which the speaker does not dispute.
Details Worth Noting
- Concrete instructions: The transcript gives no step-by-step protocol for a viewer. The only actionable point is for people with a higher A1C or morning glucose on a carnivore diet to interpret results in context, considering glucose levels and red blood cell lifespan together rather than relying on A1C alone. Bikman's view that these levels are not a problem is a viewpoint from the speaker, not a clinical instruction.
- Bikman's glucagon theory is described as his personal hypothesis. A study is underway using continuous glucose monitors, with participants drinking pure protein, pure fat, and pure glucose over several weeks.
- He cites limited case reports for the red blood cell lifespan idea and says it is partly theory, partly backed by data. He says red blood cells may last up to about 50 percent longer in well-nourished people, especially those eating red meat and beef, compared with people on nutrient-poor diets such as veganism.
- He says that in type 2 diabetics, a given protein load can cause a much higher glucagon release than in non-diabetics.
- This is general discussion from a podcast-style conversation, not individualized medical advice. Anyone with concerns about glucose or A1C should discuss results with a qualified clinician.
Bottom Line
Rising glucose or A1C on a carnivore diet may not signal harm, but the cause remains unproven, and the red blood cell explanation and protein-glucagon theory are both speaker hypotheses still under study.
