C-peptide and circulating insulin tests

[Swiggy]

Well after more than a year of low carb diet, less than 50g a day my hba1c is 61 and I've lost 5lbs. At diagnosis my hba1c was 143 and I've reduced it without any medication. My GP has referred me for C-peptide and circulating insulin tests. Forum members have encouraged me to keep going and I am quite happy with my diet, I would just like to have normal blood sugar and lose some weight.
What will these tests be looking for?

 

[AloeSvea]

Your level of insulin and therefore considering your type two diabetes - your insulin resistance, simply.

 

[Swiggy]

Your level of insulin and therefore considering your type two diabetes - your insulin resistance, simply.

 

[Swiggy]

Thank you @AloeSvea.

[/QUOTE

Hi @Swiggy ,

Well done on lowering your hba1c! I was also diagnosed just over a year ago, managed to get my hba1c right down but have been battling emotional eating lately and it has crept back up. I managed to get an insulin test after a year of asking - I wish I could have had one sooner. The insulin and c-peptide tests give you an idea of how much insulin your body is producing, which should give you an idea of whether your pancreatic function has been affected or if you have insulin resistance. I was told by the time we are diagnosed our function has diminished quite a bit, but I think for most of us it is a combination of the two.

Let us know how it goes

Hi @Swiggy ,

Well done on lowering your hba1c! I was also diagnosed just over a year ago, managed to get my hba1c right down but have been battling emotional eating lately and it has crept back up. I managed to get an insulin test after a year of asking - I wish I could have had one sooner. The insulin and c-peptide tests give you an idea of how much insulin your body is producing, which should give you an idea of whether your pancreatic function has been affected or if you have insulin resistance. I was told by the time we are diagnosed our function has diminished quite a bit, but I think for most of us it is a combination of the two.

Let us know how it goes

Thanks @rosemaree. A few people on the forum have mentioned insulin resistance which will improve in time with low carbing. I'm just being impatient I suppose, I have stuck to my new way of eating religiously and I'm just not seeing the results I expected.
I don't post very often but I find other people's results very inspiring and I will let you know the results.

 

[Daibell]

Thank you @AloeSvea.



Thanks @rosemaree. A few people on the forum have mentioned insulin resistance which will improve in time with low carbing. I'm just being impatient I suppose, I have stuck to my new way of eating religiously and I'm just not seeing the results I expected.
I don't post very often but I find other people's results very inspiring and I will let you know the results.

Hi. If you are slim and not seeing your BS go down then being T1/LADA becomes possible. The C-Peptide test will show your level of insulin production which can help show whether you are T1 or T2. If it's low then you will be T1. If it's high you will be T2 with insulin resistance.

 

[Swiggy]

Hi. If you are slim and not seeing your BS go down then being T1/LADA becomes possible. The C-Peptide test will show your level of insulin production which can help show whether you are T1 or T2. If it's low then you will be T1. If it's high you will be T2 with insulin resistance.

Thanks@Daibell. I'm not slim and I have only lost 5lbs in 14 months of low carbing. I was having cream in my coffee but I cut that out because I thought it was the calories from the cream that was preventing weight loss. My sugar levels never went below 8 but they rarely went above 10 for a long time and I never got a raise of more than 2mmol 2 hrs after eating. Then I fell and broke my arm and my sugars went up to the high teens and stayed there. I had a cyst on my pancreas as a child and was hospitalised for a while but I don't know any details.
I'm glad that my GP believes me when I say that I don't overeat and that I avoid carbs, I just want to understand why I'm not seeing the expected drop in weight and blood sugar levels.

 

[Daibell]

Thanks@Daibell. I'm not slim and I have only lost 5lbs in 14 months of low carbing. I was having cream in my coffee but I cut that out because I thought it was the calories from the cream that was preventing weight loss. My sugar levels never went below 8 but they rarely went above 10 for a long time and I never got a raise of more than 2mmol 2 hrs after eating. Then I fell and broke my arm and my sugars went up to the high teens and stayed there. I had a cyst on my pancreas as a child and was hospitalised for a while but I don't know any details.
I'm glad that my GP believes me when I say that I don't overeat and that I avoid carbs, I just want to understand why I'm not seeing the expected drop in weight and blood sugar levels.

Hi. Obviously I can't diagnose you but your history of problems with the Pancreas means that your Dr is doing the right thing by checking out how well it is working with the C-Peptide test. You appear to be doing all the right things otherwise so I hope the tests help a better diagnosis. There are some, like my wife, who we think has low 'brown adipose fat' so that her natural metabolism is very low and hence needs to be ultra-low carb to control weight.

 

[Swiggy]

Thanks @Daibell. I didn't even know it had been a serious problem until I filled in a medical form when I started a new job and had to get the GP to sign it.

 

[Swiggy]

Update.
hba1c 69, very disappointed but expected as I monitor after every meal.
Weight loss 8lbs not good after year of lchf.
LDL 3.4
HDL 1.0
Triglycerides 1.2

Doc didn't want to give me the figures but I pestered her for them. I have no idea how to interpret them.

Good news is that fibroscan result is normal which means no scarring to my liver (but there's fat in there). Liver enzymes are normal too.

Plan now is to have the c-peptide test and discuss with GP. Liver clinic doctor wants me on diabetic medication asap but I hate the thought of that.

My sugars are still high. Currently 16.4 fasting since 8pm yesterday.
Dinner yesterday was three slices of back bacon cooked in foil in oven and two eggs fried in butter. I had 50g Wensleydale cheese at lunchtime and drank water and one cup of coffee with milk. Readings were 13.8 fasting and before eating cheese, 15.0 after 2 hrs, 16.3 before eggs and bacon, 17.1 2hrs after eggs and bacon.
I don't understand...

 

[Mbaker]

Update.
hba1c 69, very disappointed but expected as I monitor after every meal.
Weight loss 8lbs not good after year of lchf.
LDL 3.4
HDL 1.0
Triglycerides 1.2

Doc didn't want to give me the figures but I pestered her for them. I have no idea how to interpret them.

Good news is that fibroscan result is normal which means no scarring to my liver (but there's fat in there). Liver enzymes are normal too.

Plan now is to have the c-peptide test and discuss with GP. Liver clinic doctor wants me on diabetic medication asap but I hate the thought of that.

My sugars are still high. Currently 16.4 fasting since 8pm yesterday.
Dinner yesterday was three slices of back bacon cooked in foil in oven and two eggs fried in butter. I had 50g Wensleydale cheese at lunchtime and drank water and one cup of coffee with milk. Readings were 13.8 fasting and before eating cheese, 15.0 after 2 hrs, 16.3 before eggs and bacon, 17.1 2hrs after eggs and bacon.
I don't understand...

Congratulations on halving your initial A1c. If you are perhaps are T1 / LADA that would provide a view as to why your numbers are elevated. Maybe you could try one of the alternative sides of lower carb, which is the higher protein version aka the Bernstein protocol. This could have 2 benefits for you, it provides anecdotal proof in Type 2's for good to great glucose control and for T1's produced in a trial average A1c's of 5.7; so in short could work for you no matter what diabetes status you are.

Practically, the fat would be cut back on in areas such as cheeses, creams and added butter, with reliance on the built in fats for example in meats and fish. By now you would have built up the ability to burn fat for energy, so your body will provide energy from fat stores, helping to drain the liver of fat also. Could be worth a try, with maybe 10 minute walks after each meal and focusing on sleep quality.

 

[LittleGreyCat]

The C-Peptide test will show your level of insulin production which can help show whether you are T1 or T2. If it's low then you will be T1. If it's high you will be T2 with insulin resistance.

Possibly not 100% accurate.

A while back I had a private fasting IR test which showed that I had insulin levels the low side of normal (I was in ketosis at the time) but elevated fasting BG which showed some IR.

Potentially T1 if insulin is (well?) below the normal range (not just low normal).
Standard T2 classification expects insulin to be (well) above normal with IR.

Although as I've noted before definitions are tricky.
If after 15-20 years my pancreas gives up entirely will I then be a mis-diagnosed T1?

 

[KK123]

Update.
hba1c 69, very disappointed but expected as I monitor after every meal.
Weight loss 8lbs not good after year of lchf.
LDL 3.4
HDL 1.0
Triglycerides 1.2

Doc didn't want to give me the figures but I pestered her for them. I have no idea how to interpret them.

Good news is that fibroscan result is normal which means no scarring to my liver (but there's fat in there). Liver enzymes are normal too.

Plan now is to have the c-peptide test and discuss with GP. Liver clinic doctor wants me on diabetic medication asap but I hate the thought of that.

My sugars are still high. Currently 16.4 fasting since 8pm yesterday.
Dinner yesterday was three slices of back bacon cooked in foil in oven and two eggs fried in butter. I had 50g Wensleydale cheese at lunchtime and drank water and one cup of coffee with milk. Readings were 13.8 fasting and before eating cheese, 15.0 after 2 hrs, 16.3 before eggs and bacon, 17.1 2hrs after eggs and bacon.
I don't understand...

Hi Swiggy, you have had many replies about low carbs and so on, but clearly, from what you say, your glucose levels are still high. I would be regularly contacting your GP to get that C Peptide test done (and also antibody tests). IF you are type 1, whether it's lada (slower onset) or full blown as it were requiring immediate treatment, then you need insulin, it's as simple as that. Amounts may vary and there is such a thing as a honeymoon period too even after diagnosis, but it seems for now, no amount of low carb foods is going to get your current levels down to normal levels. It's potentially dangerous, have you been able to test for ketones?

Also, I was diagnose as pre diabetic 3 years before a diagnosis of type 1 and it's believed that this was actually a slow onset of type 1, NOT a pre type 2.

 

[Fenn]

Hi, I too get insane sugars regardless of what I am eating, maybe I (we) just have a worn out pancreas? Its very frustrating doing the right thing and getting the wrong results, I cant help but would just like you to know I understand totally and wish you some speedy answers.

 

[Swiggy]

Congratulations on halving your initial A1c. If you are perhaps are T1 / LADA that would provide a view as to why your numbers are elevated. Maybe you could try one of the alternative sides of lower carb, which is the higher protein version aka the Bernstein protocol. This could have 2 benefits for you, it provides anecdotal proof in Type 2's for good to great glucose control and for T1's produced in a trial average A1c's of 5.7; so in short could work for you no matter what diabetes status you are.

Practically, the fat would be cut back on in areas such as cheeses, creams and added butter, with reliance on the built in fats for example in meats and fish. By now you would have built up the ability to burn fat for energy, so your body will provide energy from fat stores, helping to drain the liver of fat also. Could be worth a try, with maybe 10 minute walks after each meal and focusing on sleep quality.

Thank you @Mbaker this sounds very interesting. I'd miss cheese so much but I'm happy to try.

 

[Swiggy]

Possibly not 100% accurate.

A while back I had a private fasting IR test which showed that I had insulin levels the low side of normal (I was in ketosis at the time) but elevated fasting BG which showed some IR.

Potentially T1 if insulin is (well?) below the normal range (not just low normal).
Standard T2 classification expects insulin to be (well) above normal with IR.

Although as I've noted before definitions are tricky.
If after 15-20 years my pancreas gives up entirely will I then be a mis-diagnosed T1?

Thanks @LittleGreyCat

 

[Swiggy]

Hi Swiggy, you have had many replies about low carbs and so on, but clearly, from what you say, your glucose levels are still high. I would be regularly contacting your GP to get that C Peptide test done (and also antibody tests). IF you are type 1, whether it's lada (slower onset) or full blown as it were requiring immediate treatment, then you need insulin, it's as simple as that. Amounts may vary and there is such a thing as a honeymoon period too even after diagnosis, but it seems for now, no amount of low carb foods is going to get your current levels down to normal levels. It's potentially dangerous, have you been able to test for ketones?

Also, I was diagnose as pre diabetic 3 years before a diagnosis of type 1 and it's believed that this was actually a slow onset of type 1, NOT a pre type 2.

 

[Swiggy]

Hi Swiggy, you have had many replies about low carbs and so on, but clearly, from what you say, your glucose levels are still high. I would be regularly contacting your GP to get that C Peptide test done (and also antibody tests). IF you are type 1, whether it's lada (slower onset) or full blown as it were requiring immediate treatment, then you need insulin, it's as simple as that. Amounts may vary and there is such a thing as a honeymoon period too even after diagnosis, but it seems for now, no amount of low carb foods is going to get your current levels down to normal levels. It's potentially dangerous, have you been able to test for ketones?

Also, I was diagnose as pre diabetic 3 years before a diagnosis of type 1 and it's believed that this was actually a slow onset of type 1, NOT a pre type 2.

Thanks@KK123. I'm going to pick the blood forms up from the surgery this week and I will have the test as soon as possible after that. I haven't tested for keystones for ages, I bought a tub of urine strips about three years ago and they went out of date.

 

[Swiggy]

Hi, I too get insane sugars regardless of what I am eating, maybe I (we) just have a worn out pancreas? Its very frustrating doing the right thing and getting the wrong results, I cant help but would just like you to know I understand totally and wish you some speedy answers.

Thanks @Fenn . Yes I'm finding it very frustrating. I'm really sticking to lchf and enjoying it but I would enjoy it even more if my weight and blood sugars were moving in the right direction.

 

[Daibell]

Possibly not 100% accurate.

A while back I had a private fasting IR test which showed that I had insulin levels the low side of normal (I was in ketosis at the time) but elevated fasting BG which showed some IR.

Potentially T1 if insulin is (well?) below the normal range (not just low normal).
Standard T2 classification expects insulin to be (well) above normal with IR.

Although as I've noted before definitions are tricky.
If after 15-20 years my pancreas gives up entirely will I then be a mis-diagnosed T1?

Yes, the C-Peptide is not an exact measure but near to the extremes it should help the correct type diagnosis

 

[Daibell]

Update.
hba1c 69, very disappointed but expected as I monitor after every meal.
Weight loss 8lbs not good after year of lchf.
LDL 3.4
HDL 1.0
Triglycerides 1.2

Doc didn't want to give me the figures but I pestered her for them. I have no idea how to interpret them.

Good news is that fibroscan result is normal which means no scarring to my liver (but there's fat in there). Liver enzymes are normal too.

Plan now is to have the c-peptide test and discuss with GP. Liver clinic doctor wants me on diabetic medication asap but I hate the thought of that.

My sugars are still high. Currently 16.4 fasting since 8pm yesterday.
Dinner yesterday was three slices of back bacon cooked in foil in oven and two eggs fried in butter. I had 50g Wensleydale cheese at lunchtime and drank water and one cup of coffee with milk. Readings were 13.8 fasting and before eating cheese, 15.0 after 2 hrs, 16.3 before eggs and bacon, 17.1 2hrs after eggs and bacon.
I don't understand...

Ask the surgery to give you online access to your surgery's system including test results. You have a right to that and then you can see all your results and not need to bother or ask the GP.