GKI: Are You Only Seeing 1/2 Of The Picture?

By Dr Ernst
March 25, 2019

Have you recently checked your blood sugars? How about your ketones? While these values are vitally important in determining the status of your health and also the progression of your care in our office, you might only be seeing 1/2 of the picture.

Blood sugars are a wonderful way for us to determine if your diet is conducive to healing – i.e. fasting blood sugar over 99 indicates lack of healing, whereas blood sugars less than 99 indicates healing is taking place.
Ketones are an exceptional way for us to determine the amount of fat burning and fat for fuel energy you are using (vs using carbohydrates for energy). Ketone readings are helpful for us to determine if you are “in/out” of your ideal fat burning state and if your diet has enough fasting combined with fats.

But this is just 1/2 of the picture. I recently attended a functional medicine conference and a 3rd indicator was presented as a stronger indicator of not only the above two but also a great way to predict your overall health, wellbeing and potential for development (or reversal) of disease – the Glucose-Ketone-Index (GKI)

What is The Glucose-Ketone-Index (GKI)

The GKI allows for an overall better view of your current metabolic state, more so than just looking at individual glucose readings or individual ketone readings. For example, you may have normal glucose but zero ketones (an early indicator of metabolic disease) or you may have higher than normal glucose but the presence of ketones (which actually indicates a metabolically adapted state). The GKI was developed as a calculation to allow a more accurate picture of your true metabolic state (which is important because a healthy metabolic state is one of the main foundations of overall health).

Calculating your Glucose-Ketone-Index

To calculate your GKI, simply fast for a minimum of 2 hours and measure both your fasting blood sugar and your fasting ketone. Use the following equation to determine your GKI:

[(Fasting Blood Sugar mg/dl) ÷ 18 ] ÷ (Ketone reading mg/dl) = GKI

Example: Fasting Sugar of 88.0, Fasting Ketone of 1.6 
 (88 ÷ 18) ÷ 1.6 = 3.05 GKI

What Is the Significance of the GKI Number


How to Lower Your GKI and Enhance Your Metabolic State

Obviously, the answer lies in understanding the equation and its variables, blood sugar and ketones. Looking at the equation you can tell that by lowering your blood sugars and, at the same time, elevating your ketones you will ultimately lower your GKI.

The longer you keep yourself in the cellular healing diet (high fat, moderate protein, low to no carb) combined with inflammatory food elimination (grains, dairy, fruits etc.) coupled with intermittent fasting or block fasting, the lower your GKI will be.

Struggling to Lower Your GKI? Pay Attention to These 3 Interferences

I have had several patients email me the following: “Dr. Ernst, I promise you I am following the diet 100%, I’ve been intermittent fasting with even tighter windows or gone multiple days on liquid only fasts, yet I can’t seem to get into ketosis or lower my blood sugars (translation – my GKI is high and it won’t come down) – what should I do?

  1. You might want to consider getting tested for food sensitivities. Food sensitivities are different from food allergies (anaphylaxis to a food type) in that they do not have any outward immediate reactions. Instead, foods you are “sensitive” to will spike an immune response (antibodies IgG, IgE etc.) or will elevate your sugars and stress hormones (cortisol). Sometimes you will feel this – it will be a headache, joint pain, clogged sinuses or just a “strange sensation” after eating the food in question. Locating the exact food can be complicated via elimination dieting and there are blood tests available to not only locate which foods you are sensitive to but also the degree of your sensitivity (mild/moderate/severe). This is important because it could be the answer to lowering your GKI. If you are interested in food sensitivity testing please reach out to me directly as is it a test we do offer.
  2. Emotional and/or metal stress has been shown to increase GKI. This is why it’s not only important that you adhere to your diet but also to lifestyle techniques to lower your stressors (counseling, prayer/meditation etc.). Unhealthy stress increases blood sugars, elevates stress hormones and lowers ketone production
  3. Sleep is another player when it comes to lowering GKI-the less you sleep the higher your fasting blood sugars and the lower your ketones, thus a higher GK. Sleep is challenging for a lot of people – you can find help here.
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