Catching Insulin Resistance before it becomes Elevated Blood Glucose

[zand]

The problem is not that they don't test for IR, the problem is that they don't recommend low carb diets.

When I went for the results of my 1st HbA1c I told the doctor that I had worked out that I had fatty liver and IR and had reduced carbs for a year or so. He agreed about the fatty liver but said he had never heard of IR. Now if they tested for it routinely alongside BGs at least he would have heard of it!

 

[Member496333]

In my opinion insulin is largely ignored because there are powerful forces at work who stand to lose a great deal if it isn’t.

The science is known. None of this stuff is new, and yet most GPs are seemingly not aware. One has to ask the question: why are they not aware? Why are they ignoring insulin and still using the ridiculous CICO model? Because they’re not taught otherwise.

 

[Guzzler]

In my opinion insulin is largely ignored because there are powerful forces at work who stand to lose a great deal if it isn’t.

The science is known. None of this stuff is new, and yet most GPs are seemingly not aware. One has to ask the question: why are they not aware? Why are they ignoring insulin and still using the ridiculous CICO model? Because they’re not taught otherwise.

I agree, Joseph Kraft was studiously ignored for decades. Catherine Croft alluded that since it became known that she has access to part of Kraft's data there seems to be a clamour to get hold of it. Strange that?

Edit to add.

Call me cynical but I reckon if Big Pharma gets a hold of Kraft's data they will quietly bury it ala cholesterol research with R. Collins.

 

[KK123]

The topic is discussing insulin resistance. Respectfully, it should go without saying that it’s not relevant to preventing type 1. I sometimes get the impression T1 vs. T2 is some kind of competition on here among some

Anyway, as has since been said, T1 diabetics can also become resistant to [exogenous] insulin.

Jim, come on! A competition?, I can tell you now type 2s win that one any day of the week. I only wish I was type 2 instead of type 1, if I was I would be doing exactly what you do, being determined to control it by diet only, I HATE having to use medicine, I am the type that never took so much as a paracetomol prior to diagnosis. I spent the first 12 months saying to my Drs 'but it could still be type 2 though' right up until my Consultant finally said 'I'm telling you straight, it's type 1'.
I reckon ANY person can be insulin resistant, I know quite a few type 1s, some fat, some thin, some that are very IR and others that are not. Surely there are as many variations within the type 1 category as within the type 2s?

 

[KK123]

If someone is obese aren't they bound to have insulin resistance to some extent? What would be the point in testing?

If you mean any obese person then I'm not to sure that would help everyone, there are many obese people who are not insulin resistant presumably, ie, those that are not diabetic and have great levels? My husband is a good 3 stone overweight and his well man check gave him perfect A1c results....great BP, perfect cholesterol and he eats absolute rubbish and does no exercise. I am the exact opposite and yep, you guessed it.

 

[Listlad]

I had my HbA1c done a month back but no accompanyng tests. I am beginning to realise that they should have been done alongside. I shall press for those. I recall the nurse asking about the test as she was expecting to see other blood test results. It seems I will have to drive the instigation of them.

 

[Listlad]

In my opinion insulin is largely ignored because there are powerful forces at work who stand to lose a great deal if it isn’t.

The science is known. None of this stuff is new, and yet most GPs are seemingly not aware. One has to ask the question: why are they not aware? Why are they ignoring insulin and still using the ridiculous CICO model? Because they’re not taught otherwise.

Yes, I think they are slow to twig on to stuff. No doubt they will eventually.

 

[DawnOfTheZed]

It was because of the info on this site that I strongly requested my GP test my c-polypeptide and insulin. They aren't standard tests in my area so my blood sample had to be sent away. I figure the more requests they get, the more inclined the hospital labs will be to get the equipment in to perform the tests themselves.
We need to get the NICE guidelines changed to test for hyperinsulinemia when pre-diabetes is first triggered. Understanding IR could help many change to stop T2 happening, I think.

 

[Mr_Pot]

If you mean any obese person then I'm not to sure that would help everyone, there are many obese people who are not insulin resistant presumably, ie, those that are not diabetic and have great levels? My husband is a good 3 stone overweight and his well man check gave him perfect A1c results....great BP, perfect cholesterol and he eats absolute rubbish and does no exercise. I am the exact opposite and yep, you guessed it.

It could be that your husband is over producing insulin to overcome insulin resistance and keep his BG normal. If he had a test and they said "your insulin is high and one day you may become pre-diabetic" do you think he would change his diet? There is a close correlation between obesity and IR although there are arguments as to which is cause and which is effect. Whichever way around it doesn't really matter as the solution is the same, to reduce carbs. There are those who say "If only I had known I was insulin resistant years ago, I would have done something about it" but what would they have done, no doubt follow the doctor's advice and reduce calories and eat low fat. Which is why I say it is not lack of testing for IR but the lack of advice to reduce carbs that is the problem.

 

[Cocosilk]

A sterling presentation!

You look as though you are on a mission to learn everything you can, well done.

It's amazing how many of these good research videos just appear in your suggestions once you hit on one I didn't have to look far. And each of these scientists, academics or engineers, whoever they happen to be, name-drop others doing research in the field, so after watching one video, I get 4 new names to check out. Easy

 

[Cocosilk]

@Cocosilk thank you for posting this. I am so angry that GPs don't test insulin levels or IR when they are faced with an obese patient. I believe I was insulin resistant for 20 or so years before diagnosis. All that wasted time, all that damage to my body, I only needed to be told it was IR and I would have gone away and reaearched it and helped myself to heal.

It seems that GPs only know what they know and some of this research is new. I went to a GP recently asking about an insulin test and she said "you don't really need one', even though she knew I had just been diagnosed with Gestational Diabetes. So I haven't had an insulin test yet. Still have to find a GP I can work on for that. I think for a GP to be able to order a test without being questioned, they have to have a good reason, and apparently knowing about insulin levels is not the commonly taught method for diagnosing pre-diabetes...yet. So you have to assume an average GP may not be used to ordering an insulin test for just anyone unfortunately. That's how Dr Ben Bikman seemed to explain it anyway. And as an individual, you might have to become a bit hypochondriac (like me to be bothered to find answers elsewhere and then start knocking on doors until a GP gives you the test you think you need. We are just the patients after all.

 

[Cocosilk]

@Jim Lahey there is (and never should be) any competitive element.
Some time ago, I posted a soap box thread about us all being different.
My comments about other types of diabetes are my reminders of this.
I apologise for being clumsy in my reminders sometimes.
But I still believe it is important to consider both the target audience and the complete forum audience when posting.

I apologise to @Cocosilk for any thread de-railing. I will continue to read and learn but not comment further on insulin resistance.

I have Gestational Diabetes at the moment so this video may not even be relevant to me if I get to be one of the lucky ones and find my insulin resistance improves postnatally. But I'm not taking that for granted at my age so anything I can learn about the condition(s) of diabetes is interesting to me right now. A few weeks ago, I had no idea there were so many different types of diabetes, so I don't feel derailed by your comments. It's important to differentiate, especially if someone hasn't fully understood their own condition yet and are likely to be influenced by videos such as these.

 

[Cocosilk]

The topic is discussing insulin resistance. Respectfully, it should go without saying that it’s not relevant to preventing type 1. I sometimes get the impression T1 vs. T2 is some kind of competition on here among some

Anyway, as has since been said, T1 diabetics can also become resistant to [exogenous] insulin.

If a T1 becomes insulin resistant to their medication, then does that mean they would have no choice other than never to eat a carb again or they could die? If your body isn't able to produce or use insulin?

 

[bulkbiker]

It seems that GPs only know what they know and some of this research is new. I went to a GP recently asking about an insulin test and she said "you don't really need one', even though she knew I had just been diagnosed with Gestational Diabetes. So I haven't had an insulin test yet. Still have to find a GP I can work on for that. I think for a GP to be able to order a test without being questioned, they have to have a good reason, and apparently knowing about insulin levels is not the commonly taught method for diagnosing pre-diabetes...yet. So you have to assume an average GP may not be used to ordering an insulin test for just anyone unfortunately. That's how Dr Ben Bikman seemed to explain it anyway. And as an individual, you might have to become a bit hypochondriac (like me to be bothered to find answers elsewhere and then start knocking on doors until a GP gives you the test you think you need. We are just the patients after all.

If you have got a spare £39 you can get your own insulin test done with medichecks..

 

[Cocosilk]

If you have got a spare £39 you can get your own insulin test done with medichecks..

I'll have to see what the equivalent is in Australia. In the meantime, I'm just going to assume that postnatally I will be insulin resistant, even if my BG returns to normal, and just start eating more low carb anyway. It makes sense to do that. We all know what the naughtiest carbs do to us but we like to keep our heads in the sand and enjoy them. I know I do anyway. Well, when you get an opportunity like Gestational Diabetes - a warning that 50% of us or even more are probably heading for Type 2 - we'd have to be fools to ignore that and think we should wait for a proper diagnosis and not start eating differently now.

There are just some extra challenges with pregnancy and breastfeeding and changing diet that I have yet to work out. Most people will tell me that I need extra carbs to produce a good milk supply. And it's one of those things that if you get it wrong, within a day or two, the whole breastfeeding thing can fail with baby becoming hungry and people turning to formula. So for me it's going to be about finding a balance between managing my diet for my own health, and eating the right things to be able to feed my baby efficiently. With my other babies, I was eating as many carbs as I wanted and never had problems with establishing a good milk supply, but you can't always see how much milk the baby is getting and you only find out when the baby isn't putting on weight as expected.

 

[DJC3]

@Cocosilk -- Thanks for starting this thread. Fascinating discussion.

I agree with @zand. For many of us, insulin resistance probably precedes the diagnosis of diabetes by many years if not decades.

Personally, judging from my then round bellie, I was probably insulin resistant for at least 15 years before diagnosis -- but not any of the HCPs I've seen during this time ever remarked on this or did any furher testing.

Possibly, considerably elevated trigs might be a sign of increasing insulin resistance (in addition to the tendency to belly fat). Ted Naiman (a low carb doc based in Seatle) suggests that the triglyceride-glucose index could be used to estimate insulin resistance in lieu of measuring insulin itself. Here is a link if anyone is interested https://burnfatnotsugar.com/TyGIndexCalculator.html

So, even if our blood sugars are still normal, but our trigs go up, this might indicate worsening insulin resistance.

This is interesting Ziggy and not something I’d heard of. I agree it is probably brewing for many years before HbA1c rises.
I couldn’t get the calculator to work on that link but found another
https://www.mdapp.co/tyg-index-calculator-359/
Had to convert my figures to mg/dl first though (x18)
I’ve just paid for an insulin test but this is a lot easier to keep an eye on as trigs are part of my regular lipid screen ( luckily both test and calculator have given results in normal range)

 

[Cocosilk]

Here's another good story https://www.ketogenicforums.com/t/cancer-in-a-remission/24706/26?u=sks23cu

 

[Member496333]

If a T1 becomes insulin resistant to their medication, then does that mean they would have no choice other than never to eat a carb again or they could die? If your body isn't able to produce or use insulin?

In theory it would mean the individual would find that they need to use larger doses of exogenous (injected) insulin in order to maintain the same glucose levels. They would likely also experience weight gain. I say ‘in theory’ because I’m not especially well informed on autoimmune diabetes, but I can’t imagine insulin resistance manifesting in any other manner. The weight gain I would think is very much not guaranteed, just as it isn’t in those slowly developing T2.

 

[DJC3]

Here's another good story https://www.ketogenicforums.com/t/cancer-in-a-remission/24706/26?u=sks23cu

Thanks @Cocosilk having been through cancer myself in 2017 this is a subject I’m particularly interested in. I’m not entirely convinced about the ‘low carb puts cancer into remission’ stories, I think there are many factors involved. However I figure keto is certainly not going to antagonise it, and according to my blood markers ( HbA1c lipid panel and IR) I’m healthy, I feel healthier and happier on this WOE than I have done for donkeys years and I reckon that gives me as good a chance as possible for keeping the big C at bay.

 

[KK123]

If a T1 becomes insulin resistant to their medication, then does that mean they would have no choice other than never to eat a carb again or they could die? If your body isn't able to produce or use insulin?

No, they could either choose to use more insulin or eat fewer carbs so that their insulin needs per meal are less. (For example an IR type 2 COULD use exogenous insulin for the same reason or eat fewer carbs or if they were very IR and chose to eat too many carbs for their bodies they would still live but may well become ill and start to suffer the consequences of high blood sugars). Apart from that there is the insulin required in between meals which is less to do with what you are eating but still crucial, it takes care of the glucose your liver produces to keep things ticking over in between meals. So, even if you didn't eat a single carb your glucose levels would still continue to rise without basal insulin....and then you would die. If you think back to the good old days, the ONLY choice for type 1s was to eat no carbs but even that only kept them alive for a matter of weeks.