Insulin Resistance, HBa1C and Time

[CherryAA]

https://idmprogram.com/new-science-diabesity-hormonal-obesity-xi/

Interesting article showing how insulin resistance develops over time. It also shows that in a control group of non diabetics fasting insulin is around 50 pmol/litre = 7.2 miUL ( @bulkbiker 3.6 Me 8.3) .

I never even knew it could be tested until I took part in the Tim Noakes study

On my first test the result was 20 miUL = 135 Pmol. Looking at the chart attached God knows what it could have been after 40 years of obesity .

In the last 6 months my hba1C has remained pretty much unchanged 43 down to 42 BUT my fasting insulin has dropped dramatically.

based on the attached data both @bulkbiker and I have fasting insulin levels around or below those of a metabolically healthy non diabetic - despite being horribly overweight on diagnosis and despite still needing to lose more weight now . I am still obses so now I am 41 yrs obsese on their chart instead of 40 !

If you do decide to get your fasting insulin done, it will come back with a range 2- 25 pmol this is clearly NONSENSE - the figures should be closer 2-7 pmol

The good news is that even if you have platuead (like me) if you stick with LCHF the underlying metabolic damage in your body is still being repaired.

Interestingly both @bulkbiker and I don't worry about saturated fats. it would be very interesting to see any results from someone who does - if anyone has it ?

 

[bulkbiker]

Great article and great thoughts thanks @CherryAA .

 

[Guzzler]

This is one of the things I can't get my head around. The evidence is here, now, and it is growing. So why are they still holding onto the fear of fat and the insistence of poor prognosis?

 

[Bluetit1802]

@CherryAA

Thanks for posting this. Can you tell me if your daily readings are anything like your HbA1c results? I am wondering if you are like I believe I am, with longer living RBC hence a higher than anticipated HbA1c.

 

[CherryAA]

I use a free style it usually has average daily readings around 4.6 to 5.4 I haven't seen a 7 in months either actual or average. It tells me based on these averages that my hb1C over 9 months is around 31 not 42 which would be an average 7. However both A1C Now and the medic came up with the higher numbers.

In the end I can't really run much lower on the freestyle, I already get hypo alerts most days when I'm around 3.9 and I don't want to run at much less than 30g carbs because I want the nutrients.

Both my RBC and RBC folate are bang slap in the middle of the ranges. No idea if one can test for the life of ones red cells?

My lipid profile is ridiculously good, my lipoB/ lipoA1 also excellent, trig v low, hdl high .

I do know for me that my hab1c is directly correlated to changes in my weight - so I'm guessing if I do manage to bring that down then maybe the numbers will still improve. In the meantime I'm focusing on the fasting insulin which seems to drive the rest anyway
It does seem that I could have an Hba1C which is still verging on diabetic, but now have fasting insulin pretty much of metabolically healthy non obese person - so maybe you are right!

I do think that a lot of my numbers are as good as they are because I " embraced " the sat fat .

 

[Bluetit1802]

There are tests for the life of red blood cells as they ran them when doing research in this field to determine reliability of the HbA1c, but whether they are available generally I have no idea. I think it is complicated and involves blood taken and then put back again. However, I found this among a load of other stuff:

Human red blood cells (RBC), after differentiating from erythroblasts in the bone marrow, are released into the blood and survive in the circulation for approximately 115 days. In humans and some other species, RBC normally survive in a nonrandom manner. This means that all of the RBC in an age cohort are removed by the reticuloendothelial system at about the same time. In practice there is considerable variation in the lifespan of human RBC. In a normal individual with a mean RBC lifespan of 115 days, this value may vary between 70 and 140 days [1, 2]. Among individuals the mean lifespan varies by approximately ±15% [1]

Seems to show that the HbA1c test is dependent on the person having normal mean RBC lifespan and there are clinical differences in HbA1c results for people without normal mean RBC lifespans.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2581997/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3678251/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3089718/

 

[Tannith]

Does anyone know whether, and how, high RBC count affects HbA1c. I have 150% of normal red blood cells, caused by a lung problem.

 

[Bluetit1802]

These all describe factors that can cause either elevated or lower HbA1c results

http://www.ngsp.org/factors.asp

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3912281/

https://pbs.twimg.com/media/DG4FKXNUQAA2rMo.jpg

https://www.diabetesdaily.com/forum/testing-blood-sugar/83550-measuring-glucose-high-hematocrit/

http://www.pathology.leedsth.nhs.uk/pathology/Portals/0/PDFs/BP-2013-01 Diabetes.pdf

@CherryAA you maybe interested in this phrase from the 2nd link above

uremia may also falsely elevate A1c

@Tannith you may be interested in the 3rd and 4th links

There are many more sites discussing why HbA1c results are higher or lower than other glucose measurements indicate (CGMs finger pricks etc)

 

[ickihun]

This is one of the things I can't get my head around. The evidence is here, now, and it is growing. So why are they still holding onto the fear of fat and the insistence of poor prognosis?

Maybe because some of us still only lose on a low fat diet AND low carb.

 

[Guzzler]

The fear of fat, obesity and bg will have a GP diagnosing and prescribing for T2 and CVD before you sit down in his consulting room. Drugs to 'treat' T2 and statins to guard against the dangers of a sat fat diet that the GP *assumes* you must have.
You are an individual and your needs differ from everyone else's, in time a methodology will become established that aids people in your position. Who knows, it could be diet related but it could just as easily be some kind of gene therapy etc.

 

[CherryAA]

The fear of fat, obesity and bg will have a GP diagnosing and prescribing for T2 and CVD before you sit down in his consulting room. Drugs to 'treat' T2 and statins to guard against the dangers of a sat fat diet that the GP *assumes* you must have.
You are an individual and your needs differ from everyone else's, in time a methodology will become established that aids people in your position. Who knows, it could be diet related but it could just as easily be some kind of gene therapy etc.

I don't see what is wrong with a "SAT FAT " diet
All too often people refer to a SAT FAT diet when what they mean is a JUNK FOOD DIET -

Junk foods generally contain lots of cheap carbs, lots of cheap industrial seed oils , lots of sugar and lots of salt. The ONE thing that they don't have much of - is the expensive ingredient - the MEAT and NOTHING has been cooked in lard and butter for years on an industrial scale .

Look on the back of any packet of junk food and I am pretty certain that the actual contents will NOT include a lot of saturated fat
- I had this argument with a doctor specialising in diabetes only last week - he told me that his patients ate a lot of saturated fat eg potato crisps - ie potatoes cooked industrial seed oils - VERY LITTLE SAT FAT.

It is this constant mixing up of these two terms that is contributing to the difficulty of getting the LCHF message across.

 

[Guzzler]

I don't see what is wrong with a "SAT FAT " diet
All too often people refer to a SAT FAT diet when what they mean is a JUNK FOOD DIET -

Junk foods generally contain lots of cheap carbs, lots of cheap industrial seed oils , lots of sugar and lots of salt. The ONE thing that they don't have much of - is the expensive ingredient - the MEAT and NOTHING has been cooked in lard and butter for years on an industrial scale .

Look on the back of any packet of junk food and I am pretty certain that the actual contents will NOT include a lot of saturated fat
- I had this argument with a doctor specialising in diabetes only last week - he told me that his patients ate a lot of saturated fat eg potato crisps - ie potatoes cooked industrial seed oils - VERY LITTLE SAT FAT.

It is this constant mixing up of these two terms that is contributing to the difficulty of getting the LCHF message across.

Glad to say I have no fear of sat fats, I love the fat on meat, especially lamb. What does scare me is that all fats are lumped together as bad but sat fat has been demonised in particular. And on such flakey evidence, too. Of course fats are only part of the problem i.e there needs to be a complete overhaul, clearing the plate so to speak on food production methods, education and real research that is not money driven.
It may take a while...

 

[Bluetit1802]

I had this argument with a doctor specialising in diabetes only last week - he told me that his patients ate a lot of saturated fat eg potato crisps - ie potatoes cooked industrial seed oils - VERY LITTLE SAT FAT.

Quite right - no sat fat.
12.5g packet has 7g carbs, 65 calories, 1g protein, 4g fat, 0 sat fat, 1g fibre.

 

[CherryAA]

Glad to say I have no fear of sat fats, I love the fat on meat, especially lamb. What does scare me is that all fats are lumped together as bad but sat fat has been demonised in particular. And on such flakey evidence, too. Of course fats are only part of the problem i.e there needs to be a complete overhaul, clearing the plate so to speak on food production methods, education and real research that is not money driven.
It may take a while...

Looking at my results ' I'm pretty convinced that the reason my Trigs are so low (0.8)mmol is so low is precisely BECAUSE I eat plenty of sat fat not despite it. I think the entire point is that if you are eating saturated fats there is no reason whatever to have them in your blood stream They go into your blood stream when other stuff is being converted into sat fats in the body.
I'm very happy with both my 22-26% sat fats in my 1300 calorie diet and the results I am getting in terms of blood sugar and lipids.

 

[CherryAA]

It was at that point that the very idea of going on another date with an ignorant buffoon became totally untenable.

I can understand how one can swallow NHS training hook line and sinker - he's not the only one to have done that, but to be so utterly ignorant of what is actually in the food he is moaning about and then using that ignorance to make his patients iller, just made me sick to my stomach .

 

[Bluetit1802]

I eat sat fat apart from meat fat as I don't like it, but lots of dairy, and use butter for cooking. I put my low trigs and high HDL down to plenty of omega 3 and at least 315g tinned salmon a week, and very low carb..
Trigs 0.6
HDL 2.51

 

[Guzzler]

These all describe factors that can cause either elevated or lower HbA1c results

http://www.ngsp.org/factors.asp

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3912281/

https://pbs.twimg.com/media/DG4FKXNUQAA2rMo.jpg

https://www.diabetesdaily.com/forum/testing-blood-sugar/83550-measuring-glucose-high-hematocrit/

http://www.pathology.leedsth.nhs.uk/pathology/Portals/0/PDFs/BP-2013-01 Diabetes.pdf

@CherryAA you maybe interested in this phrase from the 2nd link above

uremia may also falsely elevate A1c

@Tannith you may be interested in the 3rd and 4th links

There are many more sites discussing why HbA1c results are higher or lower than other glucose measurements indicate (CGMs finger pricks etc)

Ooh, the fourth link is very interesting. I was told that my RBC level was high but in my ignorance I put it down to smoking. App

oops, what happened there? I may just have broken the internnet! Anyway edited to finish - apparently not. Thank you for putting up that link.

 

[Bluetit1802]

Ooh, the fourth link is very interesting. I was told that my RBC level was high but in my ignorance I put it down to smoking. App

oops, what happened there? I may just have broken the internnet! Anyway edited to finish - apparently not. Thank you for putting up that link.

Which particular bit of your RBC were high, and how high were they? You should be able to find this on your lab test report under the full blood count section (if you have your lab reports that is)

 

[Guzzler]

Which particular bit of your RBC were high, and how high were they? You should be able to find this on your lab test report under the full blood count section (if you have your lab reports that is)

This was after the first tests came back. Doctor (locum) said [sic] Your red cell count is high, your liver function test came backy dodgy and your sugar is too high. I will order the tests to be done again so make anappointment to see the nurse. How is your bowel?

No more info than that.

 

[Bluetit1802]

This was after the first tests came back. Doctor (locum) said [sic] Your red cell count is high, your liver function test came backy dodgy and your sugar is too high. I will order the tests to be done again so make anappointment to see the nurse. How is your bowel?

No more info than that.

I thought you got your test results on line? Mine go back years.

Lol. My bowels are fine, thanks, no problems!