The only update I have is that I got an appointment to see the endocrinologist at the diabetic clinic at the Edinburgh Royal Infirmary, and amongst other things, asked him why I'd never had my insulin measured, despite having a glucose tolerance test. I also asked whether he knew about the Kraft test (I showed him a print out of
this).
The answers were, an insulin measurement wasn't taken because it wouldn't have any clinical outcome, and no, he'd never heard of Kraft. So I infer Kraft's work is not even rejected as incorrect, it's just not included in the NHS worldview at all, as this was a senior medic. I asked if they have any way of screening for prediabetes, and effectively the answer was no.
I don't really know what I am, as I have a diagnosis of T2, but only because they ruled out everything else they could think of. My HbA1c is quite stable at ~41-43 (~6%), but my fasting blood sugar is quite high, and my response to any carbs in my food is a fairly big spike up to 13-15 mmol/L. I don't currently exhibit any other symptoms besides that. I'd hoped my insulin sensitivity would improve over time, and fall below over 31 (5%), but so far it has not, and I am wondering if I should play safe (as per
Jenny Ruhl's advice) and ask to take metformin as well as managing my diet.
Having read your story linked in your signature, I think you're doing all the right things - and congratulations, sounds you've achieved a fantastic result already. My symptoms were never as bad as yours.
Therefore my advice, as just someone who's read around a bit, would be based on Jenny Ruhl's - play it safe and keep your glucose levels low. Unless you have the cash to spare to get a private test, you will have to guess your insulin resistance based on guesswork from your own observations of glucose tolerance.
I recommend reading Jenny Ruhl's website (and maybe her book), as it seems to me to be one of the best sources of information around, and is packed with scientific references. (I can't claim to have reviewed them all, of course.) Don't expect the NHS to be very much help, at the best of times they're saturated with truly ill diabetics, and like you I don't find them to be very interested in investigating success stories, they just move on to the next patient and apply the NICE guidelines. They don't expect most people to be able to muster what it takes to improve their condition, and may not have heard of the kind of information people on this forum dig up. GPs even more so.
I also found the "Low Carb Down Under" you tube channel to be a useful source of information - although I am still a bit wary about biases there. Things I discovered which I think are relevant and useful for diabetics are:
- The Kraft test! (see link above)
- The cholesterol hypothesis (high cholesterol *causes* cardiovascular disease) may be wrong, the cause is damage through glycolisation of the marker protein on LDL particles (see for example
Ken Sikaris and
Robert Lustig).
- Therefore statins may be ineffective as a treatment.
- The calcium scoring test. This a NMRI scan which I gather can measure your arterial health more accurately than your cholesterol levels, not available on the NHS but you can get one privately, or if if (like me) you can find your way onto a medical study.
I'd liked to have asked an endocrinologist about these, but after learning he'd not heard of the Kraft test, and considering the time it might have taken to do it, I didn't. I regret it, because I waited 8 months for the appointment, and several hours in the waiting room.
I'd be interested to know if anyone else has asked...
