Fasting Insulin and C-Peptide

[Montu]

I had an endocrinologist appointment.

DX2011 @24 yr old and 8.7% A1C- Trying to address it in 2020
Controlled around A1C-6.5% with metformin those 9 years. This seemed to impress the endocrinologist. Me too since I did a horrible job of changing my lifestyle (Kept being told pre-diabetic for years).

We reviewed some of my recent labs. Then he wanted to know what I wanted, he didn't have any questions of me. I don't think I like this guy.

I went over some concerns about some mineral supplements I should be taking especially since I am currently on a statin. I asked specifically of Magnesium and Coq-10. He said magnesium is not needed the CoQ-10 can't hurt.

I asked him about getting my fasting insulin and c-peptide checked to run a HOMA-IR or LP-IR. He said he never had anyone request that before. I told him it should have been done when I was diagnosed (Primary Cares failure).
He then asked me, "but what would it change in your treatment your numbers look good."
I said, "It would give me a baseline to work off of to see if I am improving or not. It would also make me feel better to know my insulin production is working "normally" to gauge b-cell function."
He ordered the tests and said we, "will check your thyroid while we are at."

I asked him about coming off my statins if I can get my triglycerides to a normal level. He simply said, "they save lives." More I read about this medication, I feel it could be impeding my work to try and get to a healthier place. Especially since risk mitigation via lifestyle changes blows the absolute risk changes from statins out of the water.

My Lipids and blood pressure have been high and I fear for my cardio health. Doesn't help that I have occasional flare ups of costochondritis (rib cage cartridge). It likes to last for weeks at a time. Its been ongoing now for past 1 and half months. Gotten better with my changes to diet and exercise, still very annoying and worrying.

Anyways last Cholesterol: (fenofibrate 160mg + atorvastatin 10mg) about 2 months on a 100g carb lfhc diet. Numbers improved some but mostly in the LDL and HDL went up some. Been do alternating 24 hour OMAD fasts too.
LDL 54mg
HDL 30mg
TG 345mg

HOMA-IR:
insuline= 31.3u fasting BG = 101mg IR = 7.8
C-peptide = 3.27 ng

The insuline resistance explains my TG from what I understand. I went for LCHF around 100G as full Keto seems hard to plan and prep for especially since I have always been bad at meal planning and prepping.

I have noticed my insulin response has improved when I eat something occasionally I shouldn't. I started around 350lbs and am down to 310 now in about 2 months of diet I am on. Hoping to be down to 280 lbs by next month. Not sure if I need to try to slow down the weight loss at that point or not. I eat somewhere around 1500-2000 calories a day/OMAD. Try to eat less carbs on the OMAD meals.

I really hate that things weren't stressed better when I was younger. Was busy with school and work. I have been kind of obsessed with this the last three months, as I am just now trying to take control of it after 9 years. Not always good sometimes I feel like I am losing my grip on reality. I just got to keep stepping forward and not ignore it anymore.

I appreciate all the information I have found on this forum and welcome any advice or experiences you can share. Sorry about not converting the units.

 

[Daibell]

Hi. The typical tests in the UK to check for late onset T1 where T2 is the default assumption are the C-Peptide and GAD antibody tests. Measuring insulin resistance is not common and interpretation can be difficult. The C-peptide is key as it will show your insulin production level (low and it's T1, high and it's T2). The GAD test is reliable for T1 if positive but if it's negative it proves little as there are many causes of beta cell death including other antibodies and viruses. Th figure you give for your C-Peptide implies you are T2 although quite young for that. Can I ask whether you have excess weight? With regard to statins make sure you have a full lipids test and checkout all the ratios. It's then your choice whether to take them; some might challenge the 'saves lives' statement.

 

[Montu]

Hi. The typical tests in the UK to check for late onset T1 where T2 is the default assumption are the C-Peptide and GAD antibody tests. Measuring insulin resistance is not common and interpretation can be difficult. The C-peptide is key as it will show your insulin production level (low and it's T1, high and it's T2). The GAD test is reliable for T1 if positive but if it's negative it proves little as there are many causes of beta cell death including other antibodies and viruses. Th figure you give for your C-Peptide implies you are T2 although quite young for that. Can I ask whether you have excess weight? With regard to statins make sure you have a full lipids test and checkout all the ratios. It's then your choice whether to take them; some might challenge the 'saves lives' statement.

I am quite large 350, down to 310 at time of this test all in last 2 maybe 3 months. Diet shaky as I figure things out but generally 100g carbs a day and around 1500 to 2000 calories. Been stated that while losing weight I'll have more triglycerides floating around.

BP better below 120/80 now for last month or so.
Whole metabolic syndrome thing. Waist down to 56 from 59ish.

 

[Daibell]

I am quite large 350, down to 310 at time of this test all in last 2 maybe 3 months. Diet shaky as I figure things out but generally 100g carbs a day and around 1500 to 2000 calories. Been stated that while losing weight I'll have more triglycerides floating around.

BP better below 120/80 now for last month or so.
Whole metabolic syndrome thing. Waist down to 56 from 59ish.

Hi and thanks. It looks like you probably are T2 rather than T1. Don't worry about calories. the 100gm/day of carbs is a good target. Just have enough fats and proteins to keep you feeling full and the calories will take care of themselves. I think you will find your figures will gradually improve over the coming weeks.