Fasting Insulin Tests - NHS says no...

Lally123

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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.
You're right. In my area anyway GPs aren't allowed to order certain blood tests, these can only be ordered by, usually, consultants and covers most of the expensive and specialist blood tests. Even for inpatients the same applies. I remember having to do insulin tests on certain patients, the insulin tests and bottles had to be ordered up in advance of the test being needed and the request forms had to be signed by the consultant rather than the junior drs. Can't remember the precise condition it was for but I do remember the patient having to fast for 72 hours and have their blood glucose checked really often. Not really surprised GPs aren't able to order it!
 

Bluetit1802

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We can have private fasting insulin tests for £39, and insulin resistance tests for £49 with Medichecks. Now I assume they make a profit from this, so not that expensive for the NHS in the grand scheme of things.
 
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Oldvatr

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Neither :) I was replying to @lindisfel 's comment about the liver function eGFR test.
Actually although we may be given a eGFR value with our blood results, it is usually an estimated calculation done by the lab and is usually not very accurate. It is a rough and ready indicator.
 
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kokhongw

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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.

That is because the unfortunate misunderstanding of insulin resistance is ... a condition where insulin has been less effective...so we need to put in more...that is we end up with the vicious cycle of more and more insulin for patients already overflowing with insulin...
 

millenium

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Fasting insulin level should have good
correlation to fasting blood glucose level i think.
 

DavidGrahamJones

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We can have private fasting insulin tests for £39, and insulin resistance tests for £49 with Medichecks.

Thanks for the info, I've had three c-pep tests and three insulin resistance tests done at Genova Labs. I go to the one in London not far from Marylebone Station. By the time I've paid train fare, taxi and the cost of the blood test (that alone more expensive than Medichecks), it's not cheap.

I've always felt that although not essential, it has helped me have a much better idea of my diabetes. The test results are appreciated by my GP although she will not (cannot) send me for those same tests.

BTW, I don't suppose you know if it's possible to have pancreatic beta cell mass measured or is it one of those tests that relies on you being dead?
 

Oldvatr

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Fasting insulin level should have good
correlation to fasting blood glucose level i think.
Not necessarily. BGL levels can be dropped by (1) retricting intake by diet, (2) blocking absorbtion, (3) using up by burning energy, (4) moving out of blood into cell storage.

Insulin is only really required by (3) and (4) but an insulin response is triggered by (1) and (2) and these cause the increase in insulin levels, but in T2D then insulin resistance can negate the effects of (3) and (4) so low fasting bgl does not always equate to low insulin levels.

I note that during some of the better in vivo studies, they use something called an insulin clamp to measure insulin levels, but this is a lab only technique that is expensive to do.
https://www.ncbi.nlm.nih.gov/pubmed/382871
 
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Bluetit1802

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Ah. Apologies. Those are routinely run for me, with each panel, too.

Sorry. I have edited my original post. I should have said, and meant to say, the liver test GGT *(not the kidney test eGFR). Apologies.
 

Bluetit1802

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Actually although we may be given a eGFR value with our blood results, it is usually an estimated calculation done by the lab and is usually not very accurate. It is a rough and ready indicator.

Apologies. I should have said, and meant to say, the liver test GGT, and not the kidney test eGFR) I have added this to my original post.
 

Bluetit1802

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Thanks for the info, I've had three c-pep tests and three insulin resistance tests done at Genova Labs. I go to the one in London not far from Marylebone Station. By the time I've paid train fare, taxi and the cost of the blood test (that alone more expensive than Medichecks), it's not cheap.

The only problem with Medichecks is you need a full vial of blood (not a finger prick) so you have to find a nurse willing to do this for you. They do send you all the equipment you need.
 

Ronnie_dog

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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 had a fasting insulin test done whilst I was in Spain. It’s a simple fasting blood test. All very quick and cheap. My results showed I produce little or no insulin and it enabled me to return to uk and request I went on to insulin. I came off the diabetic meds I was on as they weren’t working anyway and in spite of my best efforts, my bloods were not controlled, which they are now.
It’s ludicrous that we don’t offer the same test here. It’s even more ludicrous Our nhs medics don’t know about it. It would save time, money and upset.
 

DCUKMod

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The only problem with Medichecks is you need a full vial of blood (not a finger prick) so you have to find a nurse willing to do this for you. They do send you all the equipment you need.

As I understand it, they send the vials, but not the needle/cannula. I can't recall which provider @bulkbiker used when he had his done. Maybe he can clarify.
 

bulkbiker

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As I understand it, they send the vials, but not the needle/cannula. I can't recall which provider @bulkbiker used when he had his done. Maybe he can clarify.
One time I had the blood drawn at a local private hospital (cost £25.00 on top of the test). The second time I made sure that I had the test vial when I went in for an HbA1c so asked the phlebotomist to fill the medichecks one as well as the NHS one which she was fine with.. although I had just spent five minutes bemoaning the fact that I couldn't get it done on the NHS while she was digging around in my arm for a vein (I'm quite a non bleeder).
 

millenium

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Not necessarily. BGL levels can be dropped by (1) retricting intake by diet, (2) blocking absorbtion, (3) using up by burning energy, (4) moving out of blood into cell storage.

Insulin is only really required by (3) and (4) but an insulin response is triggered by (1) and (2) and these cause the increase in insulin levels, but in T2D then insulin resistance can negate the effects of (3) and (4) so low fasting bgl does not always equate to low insulin levels.

I note that during some of the better in vivo studies, they use something called an insulin clamp to measure insulin levels, but this is a lab only technique that is expensive to do.
https://www.ncbi.nlm.nih.gov/pubmed/382871

Agree.

But the correlation will be good for those freshly screened out prediabetic and type 2.

For those that restrict carb or block some carb absorption will end up getting less carb in their bloodstream and the body response by secreting lesser and lesser insulin as their insulin resistance improved over a short period with this type of intervention. Should the body do not respond favourably over a short period, there could be other more serious complications.
 

millenium

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But without having the test we will never know that..

Somehow this correlation thing reminds me of the insulin index versus glycaemic index. If i recall correctly, the correlation is strong, except a more processed carb versus a less refined carb with the same gi, the more refined one seems to have a higher insulin index. After that i decided to just make use of the glycaemic index and make sure i do not take a lot of highly refine.
 

DCUKMod

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One time I had the blood drawn at a local private hospital (cost £25.00 on top of the test). The second time I made sure that I had the test vial when I went in for an HbA1c so asked the phlebotomist to fill the medichecks one as well as the NHS one which she was fine with.. although I had just spent five minutes bemoaning the fact that I couldn't get it done on the NHS while she was digging around in my arm for a vein (I'm quite a non bleeder).

When the NHS nurse dug out the blood, did the kit you received have the big, sharp, point needle in with it? That's what I was trying to ascertain.

I have plenty of medically qualified people around me, one way or another, I could ask to draw blood, but would never ask anyone to snaffle anything to do it with.