One Year On.... Pt 1 - Hba1C , Insulin Resistance

[CherryAA]

Exactly one year into my diabetes journey. Overall a success story and a period of intense learning about my body, how it works and what affects it - and what I need to know about it.


Highlights - 27 kg down in total, Hba1c from 92 to 42 great majority of blood markers improved. steadfast supporter of LCHF whch has delivered everything it promised to deliver so far.


This is all down to this website and the advice received on here so thank you guys.


Feel free to stop reading there !


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Blood analysis

For the first 58 years of my life I received the odd blood test. I looked at it, the figure said normal, or the doctor prescribed a pill to deal with something that wasn't normal. That is how I ended up overweight and on blood pressure tablets.


To test what I had now learned this time I wrote down what I was expecting to see in my first annual blood results post diagnosis for all of the things measured , just to see if I my understanding meant I would get the direction right. Most of the time I did.


I prepared the notes that follow for me : so I don't forget why I am doing what I'm doing and set out what I need to do next. Having got that far, I figured maybe others might find a run-down of what is on the blood profile charts. My conclusions are those of an amateur, but it all seems to tie together nevertheless. Its long so please don't feel obliged to read it, but I figured it might as well go somewhere people can access it.


Diabetes

One year in - and a non diabetic Hba1C reading albeit only just at 42mmol with a fasting blood sugar of 5.3 mmol . Interestingly I knew that my Hba1C would be a tiny bit better than the one done in March - because my weight is a tiny bit better too and I now know that my own Hba1c is directly correlated to my weight . So if I want to get down to true normal ( 31) then I need to lose the next 10-20 kilos in my weight loss journey.


Relooking at my history, and ignoring for a moment the actual " being overweight " issue which has always been present, if I had known then what I know now, I would have been predicting diabetes back in 2011.


Insulin resistance

I've also realised that whilst my Hba1C improvements from 92 to 42 is amazing- its only really telling me half the story - what I really need to know is not just my insulin but my insulin resistance. I only found out one could or should test insulin when I joined the Noakes study - it's not something my own doctor even mentioned. When I had that measurement done in March - my doctor told me I should be pleased because I am now normal with a reading of 20 mIU/l- for a reference range of 2.6 to 24.9mIU/. So I proudly put 20 in my signature and I gave it a nice green colour.


Three months on I realise 20 is a rubbish figure - the reference range includes an inbuilt amount for all that sugar in the world's diet . My numbers should be around 5 or under. I also now know how to calculate my insulin resistance - two methods Homa and Homa2


Using either of these methods I can see that I am not out of the woods yet - back in March I had already achieved an Hba1C of 43 but I was still highly insulin resistant. God alone knows just how bad the figures were at diagnosis - I didn't know the right questions to ask back then.


When I did the Tim Noakes study I was an outlier - my insulin at 20 being far higher than most other LCHF participants which had been at it longer - I had already asked the team to send me insulin correlated to time on LCHF diet data ( unsuccessfully ) and I had only been doing it for 6 months - so I suspected that insulin needs longer than blood glucose to bring under control.


I had been hoping that my insulin would have gone down a bit from that 20 , so I was very pleasantly surprised to find it had dropped to 8.3 - not quite at @bulkbiker levels but on the way.


I know that this number will get better if I just stick to doing what I'm doing.


HOMA - a measure of insulin resistance

http://www.thebloodcode.com/homa-ir-calculator/


According to the tables I am now only mildly insulin resistant at homa 1.9 whereas back in March I was still severely insulin resistant with a score of 5.7 where above 2.9 indicates significant insulin resistance.


HOMA 2

https://www.dtu.ox.ac.uk/homacalculator/


Homa 2 apparently takes this calculation one stage further to give an estimated beta cell function and compare that with a reference population in normal young adults . I only have two insulin measures, March this year 20.3 ( with blood sugar 6.3) and August this year 8.3 (with blood sugar 5.3)


There are three measures %B = beta cell function %, S = insulin sensitivity compared to 100% for a healthy young adult. Both of which are then used to give an IR insulin resistance score


March 2017 % B = 118.2% %S = 36.7%, IR 2.72

August 2017 % B = 89.1% %S = 91.5%, IR 1.05

So overall I'm not far off that of an average healthy young adult now ( despite being 60) and I can see that there are further improvements to come.


My goal is to end up with fasting blood glucose of 4.7 or lower. and insulin of less than 5 - that would put me way beyond the range of a young 'healthy' adult of today .

 

[bulkbiker]

That is a huge success story .. very well done indeed.. Also I love the way you have recorded everything and your aims and ambitions. I think with that kind of approach you are virtually guaranteed success. I wish you all the best and of course if I can help in any way just ask.

 

[ringi]

Has it been tested if HOMA2 works for people eating low carb? I expect most of the experiments used to calibrate the maths were done on people eating a normal diet.

 

[CherryAA]

I've no idea if it does or not.

My thinking is - if I measure the changes to these things over time, then if I do decide to relax my carb intake a little - then I can also see what that does to homa, homa2 and apoliproteinB/apoliproprotein A1 which I'm told is the current best marker for CVD

In the end if these things are all being made better because of LCHF then that would just seem to confirm than LCHF is working

I know I am actually getting less insulin resistant for real because I've eaten a few carby things recently which haven't sent my blood sugars anywhere bad - that definitely got better between March and now - ( eg sweet indian curry sauces with pappadoms- honey glazed ribs , parsnip , beetroot and carrot crisps )

Also posting the GGT figures from the Minnesota heart study here so I don't lose them !

 

[Goonergal]

Great story @CherryAA

 

[CherryAA]

Great story @CherryAA

This is also why I then set out to look if there was any other data in my history that I do have that could have predicted what was happening to me over all those early years - I find it so frustrating that I am working in the dark in terms of understanding what my current figures using entirely new results, mean compared to old figures measuring something completely different


hence then taking a look at the relationship between glucose and trigs
http://www.diabetes.co.uk/forum/threads/you-can-measure-your-own-insulin-resistance.126095/

 

[CherryAA]

https://pbs.twimg.com/media/DJFhSA0UIAEcRlZ.jpg
posting here an image about the interplay between low carb and relatively high fasting blood glucose - in case I need it in due course !

 

[CherryAA]

Insulin resistance

When I did the Tim Noakes study I was an outlier - my insulin at 20 being far higher than most other LCHF participants which had been at it longer - I had already asked the team to send me insulin correlated to time on LCHF diet data ( unsuccessfully ) and I had only been doing it for 6 months - so I suspected that insulin needs longer than blood glucose to bring under control.

I had been hoping that my insulin would have gone down a bit from that 20 , so I was very pleasantly surprised to find it had dropped to 8.3 - not quite at @bulkbiker levels but on the way.

After I got my 20 score in March I suspected that insulin was time correlated just like hba1C. I postulated that theory to the Tim Noakes team and I asked them if they could correlate fasting insulin with time on an LCHF diet in days for the people in their study. My own score of 8 in August rather confirmed what I was expecting.

I got a response this week from the lead researcher

"Thanks for all the info. I was actually very surprised to see that insulin appears to be correlated with time on the diet and I find your reasoning compelling. I really didn't expect to see that.

I've felt for a while that the 'normal' range of insulin, as suggested on the blood test forms, is totally inappropriate and that many people are categorized as healthy mistakenly. It might be a relic from when the insulin assay was very unreliable - I'm not sure. This suggests that insulin levels actually take a very long time to drop down from ~ 20 UL to around 6 UL whereas I've sort of assumed that this would occur quite rapidly after adopting the diet.

Your data and ideas are very stimulating. I will have a closer look at that paper and your results when I get a chance and get back to you with some thoughts."

This rather illustrates that when we , as people with diabetes but non researchers notice things about our own data, we should not assume that the research profession is necessarily noticing that same thing. This is not actually a criticism of the researcher. It is not that surprising because they are of necessity looking at it from the perspective of a sea of data which they cannot personally relate to. We on the other hand are intimately aware of what is happening to our own bodies even if we cannot express it that well.

That is why N=1 experimenters such as @DaveKeto are so important to increasing knowledge.

@bulkbiker If I recall correctly I think you said your fasting insulin was around 4? how long have you been on LCHF?

 

[bulkbiker]

@bulkbiker If I recall correctly I think you said your fasting insulin was around 4? how long have you been on LCHF?

I was diagnosed at the end of October 2015 and started LCHF with iF immediately. Went fully keto about 10 months in. So almost 2 years. And yes my fasting insulin was 3.41 mIU/L.

 

[CherryAA]

I was diagnosed at the end of October 2015 and started LCHF with iF immediately. Went fully keto about 10 months in. So almost 2 years. And yes my fasting insulin was 3.41 mIU/L.

thanks for the info