glucose tolerance & insulin tests

[viviennem]

As a fairly newly diagnosed Type 2 I'd like to know exactly what is going on in my body so that I can treat it properly. My doctors are pretty good with fbg, lipid profiles etc, but I've hit two problems:

1) I'd like an oral glucose tolerance test, but the diabetes doctor said - 'do one yourself using your monitor'. Any thoughts? and if it's possible, how much glucose do I need to drink to start it off? Do I use something like Lucozade (ugh!)?

2) I'd also like a fasting insulin test to know how high my insulin levels are - I think that ought to tell me whether my problems are caused by insulin resistance (insulin levels higher than 'normal' because of the high bg, which the doctor assumes) or whether my pancreas is beginning to fail (insulin levels lower than 'normal', causing the high bg). (Have I got that right?) This seems self-evidently necessary to me - how can you treat a problem if you don't know the exact cause? - but hey, I'm just an ignorant beginner. What do I know? This request was met with a blank stare and a pitying smile! No discussion.

I'm pretty certain that the reason she won't let me have either is because of cost. I'm happy to do the OGGT myself if you all think it's possible. Does anyone know where/whether I can get a fasting insulin test done privately, and how much it might cost?

Is there anything else which can tell me whether my pancreas is functioning correctly?

Of course, she may be quite right and just not have explained things properly. On the other hand, she's the one who thinks my IQ is in inverse proportion to my BMI!

Hope I'm not being a nuisance - my questions will stop when I've found out all the things I need to know. Thanks for all your help and support!

V

 

[HLW]

Do you think you might have type 1 diabetes? It would be quite unusual at your age, and I assume as you refer to your BMI that you are overweight, so that is a risk factor for type 2, so that is why they think it is type 2.

Why do you want an oral glucose tolerance test? As far as I know, these are only used to diagnose diabetes, and only when they need too, eg I never had one, as it was obvious I had diabetes - I had symptoms, and the fasting blood test was very high.

I've never heard of a fasting insulin test.

In my case, I was diagnosed type 2 diabetes (I have no idea why, I was far too young and not overweight enough - just an ignorant GP I guess) for 4ish years. The tablets kept having to be increased, and I asked to be referred to the diabetic clinic at the hospital. The consultant said it would be very unusual for it to be type 2 diabetes, as I was under 40 and not that overweight. I was tested and it was type 1. So it is possible for it to be diagnosed wrong.

The tests for type 1 diabetes are listed here: http://en.wikipedia.org/wiki/Latent_autoimmune_diabetes

Why do you need to know if it is type 1, if the metformin is controlling it OK?

The pancreas doesn't fail in type 1 diabetes. Bits of it are killed off by the immune system. Other bits are left that still do useful stuff. Also it's not just the insulin producing bits that die. But the other bits don't matter so much. The consultant explained it all, and I promptly forgot the details.

 

[viviennem]

Thanks very much for responding to my question!

No, I don't think I have Type 1. I'm not even sure I'm definitely Type 2, as after a fasting BG of 9.2 and an HbA1c of 6.5 last April, I managed to reduce my fasting BG to 6.4 and my HbA1c to 5.6 in the next 3 months by low-carb dieting, without metformin, and have lost 2 stone so far. I'm now fasting BG 6 and HbA1c 5.2, at my last 'official' testing. Self-testing, my fasting reading in the morning is usually the highest of the day, though never over 7.2 so far.

Those high levels were after 3 extremely high-stress months, downsizing from a three bedroomed farmhouse to a one-bedroom bungalow, preparing for unemployment and having mobility problems after being on statins.

I've only been above the NICE recommended ranges, since I started testing, on some early mornings (apart from an 11.0 2 hours after a mince pie!). I was registered in early December 2010 and asked for and was given metformin then. I hope it will help with weight loss. It's the generally okay BG levels taken together with the high morning tests (never over 7.2) that make me think a glucose tolerance test would be informative.

However, even if I'm not truly diabetic now I'm very much on the slippery slope, so it seems sensible to treat myself as being diabetic so I don't let it progress any further.

I'd like to know about my insulin levels because I think it would help me understand what's happening. I'm afraid I'm the sort of person who passed her driving test and immediately did a car maintenance course - I like to know how things work! The test really does exist and it's out there somewhere.

As far as I can tell - and this is why I hope someone on here can help - there are two basic reasons for high blood glucose - insuin resistance in the cells, or bad insulin production by the pancreas. And bad diet which the body can't deal with, of course, but mine has never been of the cakes/sweets/fizzy drinks sort, or vast amounts of bread, cereals and pasta. Unfortunately I like my food and have a problem with portion control unless I'm very strict. I also drink too much red wine, and I was certainly doing that over the move. Yes, I know that will lower BG levels, and I think now that I was actually getting nocturnal hypos sometimes, but it was also adding to my carb and calorie intake.

I'm back on my low carb diet now and have stopped drinking, but I'd really like to know what's going on inside!

 

[HLW]

6 is not a normal fasting reading. 4ish is a normal fasting reading. It's pretty steady in someone without diabetes, it doesn't vary much. I don't know if they would bother treating someone with fasting readings of 6 though. Metformin won't hurt you (or at least it won't cause permanent harm , it might make you sick at first) though.

Good idea re: taking action so it doesn't progress (so the insulin resistance doesn't increase - type 2).

If it is type 1 diabetes (lowered insulin production in the pancreas due to destruction of beta cells by immune system), which it almost certainly isn't due to your age, then nothing you can do will stop it progressing.

What is (probably) going on inside is that your body is resistant to insulin, due to having been exposed to lots, or due to some genetic predisposition, I don't think you can find out why. There is nothing wrong with your insulin levels (well they might be raised, your body's attempt to counteract the insulin resistance).

 

[hanadr]

I don't think you'll have any luck asking to have your insulin levels tested. It's definitely not routine and if it costs a lot, you won't get it
Hana

 

[CuriousJohn]

Hello,
Did anyone ever find out how much an insulin test(s) cost. I too want to know if it's pancreas or glucose intolerance. I got myself out of Diabetes 2 into pre-diabetes levels through diet and/or exercise. Now I am experimenting with different types of exercise. I'm greedy, I want to get readings lower still! So my full readings are required. Try mentioning all this to a Doctor and you'd be lucky if they don't throw their BP monitors at you!
Many thanks,
CuriousJohn

 

[TheProtectedTrader]

As a fairly newly diagnosed Type 2 I'd like to know exactly what is going on in my body so that I can treat it properly. My doctors are pretty good with fbg, lipid profiles etc, but I've hit two problems:

1) I'd like an oral glucose tolerance test, but the diabetes doctor said - 'do one yourself using your monitor'. Any thoughts? and if it's possible, how much glucose do I need to drink to start it off? Do I use something like Lucozade (ugh!)?

2) I'd also like a fasting insulin test to know how high my insulin levels are - I think that ought to tell me whether my problems are caused by insulin resistance (insulin levels higher than 'normal' because of the high bg, which the doctor assumes) or whether my pancreas is beginning to fail (insulin levels lower than 'normal', causing the high bg). (Have I got that right?) This seems self-evidently necessary to me - how can you treat a problem if you don't know the exact cause? - but hey, I'm just an ignorant beginner. What do I know? This request was met with a blank stare and a pitying smile! No discussion.

I'm pretty certain that the reason she won't let me have either is because of cost. I'm happy to do the OGGT myself if you all think it's possible. Does anyone know where/whether I can get a fasting insulin test done privately, and how much it might cost?

Is there anything else which can tell me whether my pancreas is functioning correctly?

Of course, she may be quite right and just not have explained things properly. On the other hand, she's the one who thinks my IQ is in inverse proportion to my BMI!

Hope I'm not being a nuisance - my questions will stop when I've found out all the things I need to know. Thanks for all your help and support!

V

Hello

I had the same issue with my GP when I asked about a fasting insulin test

I did research and found it is available privately. you can also do a lot of blood tests and you don't need a referral as they have privateGPs.

I got it done and found my fasting insulin was 33 and normal range is 5-25 and preferably below 10

I was on pills that made the pancreas produce MORE INSULIN ! The doctor had not heard of this test - I think this is much better that fasting glucose test as you can check if your pancreas is producing INSULIN

Best

Ashwin

 

[TheProtectedTrader]

The cost of the Fasting Insulin test was £60

My Best

Ashwin