Insulin resistance test providers and types

Just wondering if the standard A1c is enough? If something changes, it’s either insulin resistance or not enough.

LaoDan said:

Just wondering if the standard A1c is enough? If something changes, it’s either insulin resistance or not enough.

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No, the HbA1c is a measure of the glucose in your blood. This may have no link to your insulin resistance if you are managing your diabetes with exogenous insulin, or a major link if you are managing with diet and exercise (and haven't changed your lifestyle).

Seacrow said:

No, the HbA1c is a measure of the glucose in your blood. This may have no link to your insulin resistance if you are managing your diabetes with exogenous insulin, or a major link if you are managing with diet and exercise (and haven't changed your lifestyle).

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But t seems it would for T2s, for example if I maintain my current diet and exercise routine over the course of a few years, and my A1c rises over that period of time, then either I’m producing less insulin or I’m becoming more insulin resistant. Similarly with the inverse. But in that case, I must be becoming more insulin sensitive.

maybe an annual c-peptide + A1c

I think it is very important, for me I wanted to know if I was throwing more insulin on top of already too much so was very keen to know how much I produced.

If I was producing a lot I think I would have tried to get back to very low carbing in an attempt to cut out the insulin altogether, this way of eating although worked incredibly well did not suit me long term, I grew to hate it, I grew to hate cheese and steak as silly as that sounds, I started to feel that eating "normally" was more important than my health, so I switched to low carb and have found it much better, I also cheat but try not to cheat a lot. but would have been prepared to try again.

If however I wasn't producing much, I would happily carry on as I am going, but strive to be better behaved with food.

So I think everyone should get C-Pep tests either regularly or when diagnosed or if something changes. I don't really know how I ended up seeing an endo consultant but I did, he wanted to change something, I explained I wasn't comfortable taking insulin if I was already producing enough etc. and asked for the test and he agreed without a fight. perhaps I was just lucky.

Why can't they have an option of, this test costs the surgery £100 and we cannot justify it, if you would like to have the test, it will cost you £100? although I suppose that could be a slippery slope.

Sax said:

I got interested in doing an insulin test after reading this thread
https://www.diabetes.co.uk/forum/threads/type-2-progression-to-insulin.183218/

It seems to me that it'd be useful to take a baseline reading now and then repeat every 2- 4 years to see if my insulin behaviour starts to change even if I manage blood sugars OK, in case an underlying trend develops (although to be honest, I have no idea what I'd do with that info.). I'm thinking I can get the test from a suitable provided and then plug into the HOMA 2 model?

https://www.dtu.ox.ac.uk/homacalculator/

I'm based in Scotland but it looks as though to get a decent test I may need to make an Xmas shopping trip to London to do so; Medichecks:
https://medichecks.com/products/insulin-resistance-blood-test

Blue Horizon are a bit vague as to where they do their tests frankly:
https://privatebloodtests.co.uk/col...ducts/private-blood-test-for-insulin-in-blood

I also found this for a home test, but not so sure about this one, and seems expensive for a home test:
https://hormonelab.co.uk/products/insulin-in-testing-kit-blood-spot

Anyone know of any others I've missed or have any critical guidance I should know of before starting down this testing rabbit hole?

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Cheap person's insulin resistance test is available on the NHS:
1) fasting bg and HBa1c for those with type 2/pre diab though not for those who haven't got to that threshold yet.
2) Trig/hdl ratio is reckoned to be a good proxy for insulin resistance as a depleted hdl and increased trig level show how well you tolerate carbs in your diet. Levels vary by race and sex but you could compare levels now to levels down the line.
3) Visceral fat and BP can be good indicators and are easy to measure with a tape measure and bp monitor.
Or invest in body fat scales I use Omron Karada scan scales for my PT clients, which are medical grade. They are an investment but are likely to be cheaper than private homa/ir.
None of these things are 100% reliable of course but may give you useful feedback over months let aloone years.

NicoleC1971 said:

Cheap person's insulin resistance test is available on the NHS:
1) fasting bg and HBa1c for those with type 2/pre diab though not for those who haven't got to that threshold yet.
2) Trig/hdl ratio is reckoned to be a good proxy for insulin resistance as a depleted hdl and increased trig level show how well you tolerate carbs in your diet. Levels vary by race and sex but you could compare levels now to levels down the line.
3) Visceral fat and BP can be good indicators and are easy to measure with a tape measure and bp monitor.
Or invest in body fat scales I use Omron Karada scan scales for my PT clients, which are medical grade. They are an investment but are likely to be cheaper than private homa/ir.
None of these things are 100% reliable of course but may give you useful feedback over months let aloone years.

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Could non diabetic people not have these conditions?

Something to consider when looking for blood tests at the moment is the blood vial shortage at the moment in the UK.
Or at least England and Wales according to this article - https://www.diabetes.org.uk/about_us/news/vial-shortages

So options may be very limited and rationed.

Fenn said:

Could non diabetic people not have these conditions?

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Diabetes t2 is just one symptom of the underlying condition of hyper insulinemia so yes you could have those conditions but not have got to diabetes yet.
In the US only 12% of the population have a clean bill of health for the markers I mentioned above which I am amazed by. I don't suppose we're far behind in the UK!

LaoDan said:

But t seems it would for T2s, for example if I maintain my current diet and exercise routine over the course of a few years, and my A1c rises over that period of time, then either I’m producing less insulin or I’m becoming more insulin resistant. Similarly with the inverse. But in that case, I must be becoming more insulin sensitive.

maybe an annual c-peptide + A1c

Click to expand...

Yes, so it works for you because your HbA1c is ONLY affected by diet and exercise. I'm on insulin, and my HbA1c is totally unrelated to how insulin resistant I am. My HbA1c is also not related to my c-pep levels. I don't know about other diabetes medications, but I suspect they also unlink your HbA1c and insulin resistance. My HbA1c measures how well I match my insulin dose to my carbohydrate intake.

Sax said:

I got interested in doing an insulin test after reading this thread
https://www.diabetes.co.uk/forum/threads/type-2-progression-to-insulin.183218/

It seems to me that it'd be useful to take a baseline reading now and then repeat every 2- 4 years to see if my insulin behaviour starts to change even if I manage blood sugars OK, in case an underlying trend develops (although to be honest, I have no idea what I'd do with that info.). I'm thinking I can get the test from a suitable provided and then plug into the HOMA 2 model?

https://www.dtu.ox.ac.uk/homacalculator/

I'm based in Scotland but it looks as though to get a decent test I may need to make an Xmas shopping trip to London to do so; Medichecks:
https://medichecks.com/products/insulin-resistance-blood-test

Blue Horizon are a bit vague as to where they do their tests frankly:
https://privatebloodtests.co.uk/col...ducts/private-blood-test-for-insulin-in-blood

I also found this for a home test, but not so sure about this one, and seems expensive for a home test:
https://hormonelab.co.uk/products/insulin-in-testing-kit-blood-spot

Anyone know of any others I've missed or have any critical guidance I should know of before starting down this testing rabbit hole?

Click to expand...

Sax, if your chosen test provider uses a postal service you could find a mobile phlebotomist in your area?

I have remote lab tests several times, for one reason or another. Some tests can be done from blood collected from a finger prick test (more than your home blood glucose meter needs), and some require venous blood.

If you Google "Phlebotomist near me", you might be surprised what you find.

One lady we have used will use whatever you have been sent by your testing lab. She also does blood draws for NHS tests. For the NHS tests, all she needs is the paperwork from your doctor. She provides everything else, and will even drop her collected samples to the NHS lab directly. She has 6 people working for her. I live in a truly no-horse-town.

Good luck with whatever you decide upon.

Realise this thread is a few months old now but just to say I used Blue Horizon to get a private Insulin test. Paid online (£144) then rang the most local of their list of private hospitals where you could get blood drawn and got an appointment for the very next morning (Wednesday) and results through today. All very efficient albeit expensive, and travel time obviously dependant how close you happen to live to one of the hospitals they have a contract with.

Other option was Medichecks using their central London clinic, which would have been £99 but would have cost me another £40 or more for return peak travel.

Results wise, 98.7 pmol/L which they say is normal but the internet would suggest is moderate insulin resistance at best. Which I was expecting to be honest. Not yet diabetic nor prediabetic but increasing waistline, trouble losing weight, lethargy, PCOS and family history had me suspicious.