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Fasting Insulin Tests - NHS says no...

bulkbiker

bulkbiker

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19,569
Location
Worthing
Type of diabetes
Type 2
Treatment type
Diet only
I know I had a thread on this ages ago but thought I'd update you all.
At the end of Dr Trudi Deakins' presentation on Sunday at the PHC (and as she had been another person to mention hyperinsulinaemia) I asked a question as to whether any HCP's in the audience had ever managed to get a fasting insulin test done via the NHS.
There were probably over 50 GP's in the room and not a single one had ever got the test done through the NHS. Dr David Unwin said that he had been told that it wasn't available. Dr Campbell Murdoch said he had got one for a patient but privately and various other people reported doing the same with various price differences.
So it looks like we have to get them done ourselves if we want to know for sure what our insulin levels are.

I have no idea how to try to get this issue raised with NICE or whoever controls the available tests but it would seem to me to be a hugely important piece of information.
 
I think the major importance is it should be given to newly diagnosed BEFORE drugs such as Gliclazide are prescribed. It is totally bonkers to prescribe Gliclazide to someone with high insulin levels and insulin resistance. All Glic does is force the pancreas to produce even more insulin, which totally defeats the object, makes the condition worse, and hammers the pancreas at the same time..
 
A good FIT could be developed as a screening tool in the future to catch the first signs of IR.
 
I agree about glicizide, but other drugs such as gliptins alter those with a poor first insulin response. This extra insulin would of course limit the spike. Thus lowering the need for the pancreas to work harder.

The need for insulin testing, is critical in how those with high levels of circulating insulin, hyperinsulinaemia and high insulin resistance are diagnosed.
Without that necessary data, the viscous circle of high readings including high glucose levels, can be never broken without medication and going into ketosis to lower all the above.
Without this test, the correct program of medication, diet control and exercise, will be oblivious to the doctor and patient!

In my experience, as in the initial post, doctors will test for every other test but insulin levels! It is only done when Hypoglycaemia as a condition or hyperinsulinaemia, is thought to be the cause of the symptoms.
 
Lamont D said:
It is only done when Hypoglycaemia as a condition or hyperinsulinaemia, is thought to be the cause of the symptoms.
Click to expand...
Does that mean you have had it done? As I said there were quite a few GP's at the conference but no-one said that it was available on the NHS anywhere.
 
Bluetit1802 said:
I think the major importance is it should be given to newly diagnosed BEFORE drugs such as Gliclazide are prescribed. It is totally bonkers to prescribe Gliclazide to someone with high insulin levels and insulin resistance. All Glic does is force the pancreas to produce even more insulin, which totally defeats the object, makes the condition worse, and hammers the pancreas at the same time..
Click to expand...
Agreed. I often see posters who have been prescribed Gliclazide as T2s and some with excess weight and I wonder what exactly the GP is trying to achieve stimulating more insulin in someone who may well already have more than enough insulin production thru insulin resistance. A test would avoid the guesswork.
 
Daibell said:
Doesn't the c-peptide test achieve some of the purpose of an fasting insulin level test?
Click to expand...
So have I just been asking for the wrong thing?
Whilst I can see it giving similar info it is measuring something else so I still wouldn't have the right figures to feed into the Insulin Resistance calculator for example.
 
Yes during an extended OGTT!
My endocrinologist asked for it, because he wanted to see how high my second insulin response was and how it affected my glucose readings. I believe it was part of the numerous tests, including c-peptide and GAD, others were included which were sent to a specialist laboratory in London. It was done through a cannula during my second eOGTT.
After my first eOGTT, he noted the high spike within half an hour, the double insulin response, the overshoot of insulin, the continuous drop into Hypoglycaemia, he wanted to know, if he could use different diagnostic tests, including insulin tests.
This test was done again, when I was first prescribed Januvia, to alter my initial insulin response.
Because of the better initial insulin response, the spike was lower and the second insulin response was unnecessary.
Both results were necessary for a true diagnosis and a form of treatment to offset the hyper/ hypo yo yo glucose levels.
Being in ketosis, also helps reduce the insulin response, insulin resistance and the hyperinsulinaemia is not a problem. Having stability in blood glucose levels and insulin levels has helped in my good health I find myself.
 
Lamont D said:
Yes during an extended OGTT!
My endocrinologist asked for it, because he wanted to see how high my second insulin response was and how it affected my glucose readings. I believe it was part of the numerous tests, including c-peptide and GAD, others were included which were sent to a specialist laboratory in London. It was done through a cannula during my second eOGTT.
After my first eOGTT, he noted the high spike within half an hour, the double insulin response, the overshoot of insulin, the continuous drop into Hypoglycaemia, he wanted to know, if he could use different diagnostic tests, including insulin tests.
This test was done again, when I was first prescribed Januvia, to alter my initial insulin response.
Because of the better initial insulin response, the spike was lower and the second insulin response was unnecessary.
Both results were necessary for a true diagnosis and a form of treatment to offset the hyper/ hypo yo yo glucose levels.
Being in ketosis, also helps reduce the insulin response, insulin resistance and the hyperinsulinaemia is not a problem. Having stability in blood glucose levels and insulin levels has helped in my good health I find myself.
Click to expand...
Wow you must have had a very determined endocrinologist. I must admit I was a bit disconcerted when not one of the HCP's in the room could confirm ever had one done under the NHS auspices.
 
bulkbiker said:
Wow you must have had a very determined endocrinologist. I must admit I was a bit disconcerted when not one of the HCP's in the room could confirm ever had one done under the NHS auspices.
Click to expand...

Bulkbiker, until very recently I could have been persuaded that fasting insulin was one of those tests only specialist medics (as opposed to GPs) could order up, but I'm now certain it isn't.

To be honest, I get the impression it's probably not covered in the GP's 10 minutes of training. OK,. gross exageration of the training, but you get the drift.
 
DCUKMod said:
Bulkbiker, until very recently I could have been persuaded that fasting insulin was one of those tests only specialist medics (as opposed to GPs) could order up, but I'm now certain it isn't.

To be honest, I get the impression it's probably not covered in the GP's 10 minutes of training. OK,. gross exageration of the training, but you get the drift.
Click to expand...
I have a sneaking suspicion that you may be correct. I found a company called LabTests Online whose site is linked to from the NHS blood Tests site so have fired off an e-mail to them. See what they come back with.
 
bulkbiker said:
So have I just been asking for the wrong thing?
Whilst I can see it giving similar info it is measuring something else so I still wouldn't have the right figures to feed into the Insulin Resistance calculator for example.
Click to expand...
Hi. The c-peptide doesn't try to measure insulin resistance but does indicate whether you are producing high or low insulin. I had mine done privately as my GP refused to accept that I was T1 and not T2. My test result showed I was right at the bottom end of the normal range indicating I was not T2 but T1 in the honeymoon phase. I'm not how important diving into insulin resistance testing might be bearing in mind it's high cost?
 
DCUKMod said:
Bulkbiker, until very recently I could have been persuaded that fasting insulin was one of those tests only specialist medics (as opposed to GPs) could order up, but I'm now certain it isn't.

To be honest, I get the impression it's probably not covered in the GP's 10 minutes of training. OK,. gross exageration of the training, but you get the drift.
Click to expand...

I believe that this is true!
Only those whose specialty is high enough to have a specific test done can only order certain tests, which is quite expensive and done in laboratories.
I do know that GPs don't have the necessary authority to authorise insulin tests.
 
bulkbiker said:
Wow you must have had a very determined endocrinologist. I must admit I was a bit disconcerted when not one of the HCP's in the room could confirm ever had one done under the NHS auspices.
Click to expand...
I was a guinea pig!
He needed to make sure all angles were covered, as my condition at the time was considered to be either very rare and never diagnosed or didn't exist at all, also, only as a symptom of T2 diabetes.
 
Lamont D said:
I believe that this is true!
Only those whose specialty is high enough to have a specific test done can only order certain tests, which is quite expensive and done in laboratories.
I do know that GPs don't have the necessary authority to authorise insulin tests.
Click to expand...

I don't believe your last sentence is factually correct, but can't expand specifically I hold that belief.
 
Lamont D said:
I believe that this is true!
Only those whose specialty is high enough to have a specific test done can only order certain tests, which is quite expensive and done in laboratories.
I do know that GPs don't have the necessary authority to authorise insulin tests.
Click to expand...
Your correct Lamont my daughter is a GP and that is the case. Apparently there is a gastroenterologist in one area who has told GPs not to do GGT liver enzyme tests.
D.
 
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