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Insulin resistance

Winnie53 said:
It's useful, because it often is difficult to persuade your doctor to order an insulin test for you.
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Winnie53,Im going to be getting a ton of labs done on 9/11/2019 at VA clinic.What exactly is the insulin test name I want to get? Im also going to try to get fractionalized LDL/triglycerides (VAP test maybe that one is called?),but it looks expensive so they might not go for that.
 
I started looking but Saturday night isn’t the time to take it in it seems. It appears trigs and ratios of trigs to hdl have been used as estimations of IR instead of the more usual clamp, homa and quicki methods using insulin, c peptide, fasting glucose and OGTT tests and calculations. I’m not taking it in right now about how effective they are.

Like I say with a sample of ,1 I’m cautious as I don’t respond to carbs at all well despite being just about normal on the link above. Who knows perhaps my insulin is actually low. Possible I suppose as I’ve seen no significant reduction in bgl or fasting numbers since the initial drops in the first 3 months and see a steady overnight rise on libre (only one I admit) from falling asleep not just dp from 3am ish. No chance of a peptide or insulin test on the nhs and medichecks no longer do a postal insulin test.
 

Ahh, then that's of interest @Winnie53

those guys are way smarter then me, so i'll go with their opinion.

And while it probably (guessing) can never be as accurate as an actual blood type test,
like many of the things i have learned with my T2D since being welcomed here, it's not necessary to have information to the nth degree, for many patients.(well for me)

like the Meter reading (code free) or my trackers, ( one Mi fit 3 excellent does my steps, heart rate but not BP..i have another cheaper one from china that while not as good in my opinion as the Mi Fit 3, ) BUT the cheapey DOES do my SPO2 and more importantly at the moment my BP.

Now the Mi fit was a close to spot on when i had my heart check done at hospital (god knows what that machine costs )
my chinese cheapey tracker matches it almost to the number, it's a little less then my BP cuff,
(but it is wrist worn and the web does say that's not as accurate)..but it all just gives me a trend to follow and spot if something is improving or amiss.
The spo2 seems to match my 'feeling' i have asthma and i'm pretty much in tune with my breathing, if that makes sense.

( i must, i keep promising myself, find a decent brand tracker that does the BP. as well..so many seem to fail at the review level "too easily break", "frozen screens" "poor customer service," etc... to make me want to make the investment..if only the Mi fit offered it, i'd snap it up )

so for my uses they all, including the IR checker offer me the 'trend' to see if things are going well.

So far pleased with the delivery of Data, from so many sources..
Blood test at docs,
tracker Now /day / week / month
scales; smart ones.
and now insulin resistance checker ..
(i've become a Data geek, but i probably always was.)
The IR was a Nice to add to my list.

So hoping what @HSSS, finds isn't too disparaging of it.
but like i say, nice to know the 'Mechanics' of how it works seems to be supported by such doyens of the Diabetic debate.

Kind regards @Winnie53
 
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Well HSSS is better at researching things than I am, and now I'm not sure what calculation Volek and Phinney refer to as estimate of insulin resistance...so perhaps I don't have the answer. Waah.

jjraak, you sound like my husband - (he's a geek too). I think everything you're doing is great. I need to move more into that direction myself.

1spuds it's the fasting insulin test. It's a good one.

The VAP or NMR or I think there is another one now, not sure, is one I haven't done yet, but want to.

It's best to have lipid panels done when you're not losing weight because your results will be elevated (and it might unnecessarily cause you to worry). It's always best to have this type of panel done when you're weight has been stable for a few weeks. Looking forward to reading you're test results.
 
Thank you so much Winne53,thats really helpful! On my few interactions with VA so far,they have been more than willing to order a boatload of tests,so I'll get whatever I can,they even did the vit-D tests and it was a send out lab and NOT cheap.
 
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Dx T2 12 Jun 18, HbA1c = 54, No meds. Began eating low carb/Keto.
5 Sept 18, HbA1c = 44, Prediabetic levels
3 Dec 18, HbA1c = 42, 17kg lighter and weight stable
29 Mar 19, HbA1c = 43,
26 Jun 19, HbA1c = 40, Normal, non diabetic level!

Always wonder, is there anyone here who has succeeded in managing type 2 with just diet without losing weight? my brother is type 2, but his BMI is 17.6, height 1.75cm, weight 54kg, so he can not afford to lose a single kg
 
The triglyceride index to help determine insulin resistance has been discussed previously on this forum, albeit about 2 years ago. I calculated mine at the time and made some notes, which are here.

Triglyceride-glucose index

Trigs x BS x 796.5. (for mmol/l units) Then enter result in natural log calculator
http://www.rapidtables.com/calc/math/Ln_Calc.htm (natural log converter)

https://jcbr.goums.ac.ir/article-1-22-en.pdf

https://academic.oup.com/jcem/artic...Product-of-Triglycerides-and-Glucose-a-Simple

http://www.diagnosisdiet.com/wp-content/uploads/2017/06/insulin-resistance-tests-rev-3-15-17.pdf
 
bisalimo said:
https://idmprogram.com/insulin-causes-insulin-resistance-hormonal-obesity-x/

But how can someone with optimal insulin level and HOMA IR of 0.56 have type 2 diabetes?
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I am not sure how you measure optimal insulin level as it varies continuously to cope with demand. If you mean a low fasting level, then that, and HOMA-IR, represent the static balance between the liver releasing glucose and the pancreas releasing insulin. Insulin resistance also occurs in the muscles and other tissue and while the fasting condition may be ok that does not mean that there is not a problem when there is a large increase in glucose from eating. Also some Type 2's just don't produce enough insulin, or quickly enough, to cope with a sudden increase of glucose, if they are fasting then there wouldn't be any sudden increase to deal with.
 
Winnie53 said:
How old is your brother? Why do you think he has type 2 diabetes?
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He is 35, and he is type 2 not because i think he is type 2, but his doctor told him he is type 2 as confirmed by his lab result, BTW why do you think that i just think he is type 2
 
His fasting insulin is 3.3 and 2 hour after glucose administration is 10.2 mIU/L , if that doesn't mean anything, then what parameter we should use to know that we are insulin resistant or insulin sensitive?
 
Mr_Pot said:
Also some Type 2's just don't produce enough insulin, or quickly enough, to cope with a sudden increase of glucose, if they are fasting then there wouldn't be any sudden increase to deal with.
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If they don't produce enough insulin, it is called insulin deficient not insulin resistant, which means they produce LESS than required insulin, the link is about how injecting MORE than required insulin can cause insulin resistance
 
bisalimo said:
He is 35, and he is type 2 not because i think he is type 2, but his doctor told him he is type 2 as confirmed by his lab result, BTW why do you think that i just think he is type 2
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You're asking an important question. I'm taking your question seriously and asking for more information. What is his A1c? What is his fasting glucose level? What's his pre-meal glucose level and 2-hour post-meal glucose level? In other words, how do his glucose levels range throughout the day?

How long has he had type 2 diabetes? Is he using insulin or any diabetes medications?

Please do not be offended. When I was in high school, I ate normally, but had the same BMI as your brother (which is in the underweight range). Many years later I learned I have a condition called subclinical HYPERthyroid. Is he, like I was, eating 3 meals a day and snacks, in other words normal amounts of food, or more food than others but still underweight? Or is he restricting his food intake? What kinds of foods is he eating throughout the day? Is he excessively exercising daily, or is he like I was, normally active, not doing anything unusual?

I'm just trying to get a good understanding of what's going on with your brother. As you point out, his HOMA-IR score is not typical for someone with type 2 diabetes. Also, 35 is a bit early to develop type 2 diabetes, but if he was previously consuming large amounts of starches and sugars, it's entirely possible. Even young children will develop type 2 diabetes if they are doing this.
 
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I've heard stories over the years of people being diagnosed with type 2 diabetes only to find out later that their elevated glucose levels were due drinking excessive amounts of orange juice daily when it was made available at their work place. The individual's glucose levels returned to non-diabetic levels after he stopped drinking the orange juice which is very high in sugar.

This is just one example of what could be happening.
 

Fascinating read, @Bluetit1802
thank you so much for posting.

Now i may be way off base here, but underlying all that is it really saying that the trig calculator
is a reasonably reliable test, in comparison with the expensive full on IR checks ?
because that's how i read it.

and much as it seems to say it is NOT 100% accurate,
for me..the IR is already there, so that's a given, considering i actually have type 2.
and the Blood scores lipids, correspond with a drop in my HBA1c readings,
which i would guess, would mean my resistance SHOULD be lowering..??
which it seems to be.

So quite pleased that there MAY indeed be some merit to using it.

(it's not entirely mission critical, of course, but it's still a nice little measuring tool to have in the testing toolbox, none the less )
 
From his lab report and if i remember it correctly his A1c was 7% and his fasting glucose was 129 mg/dL, don't know about his pre meal and 2hr pp. Again I don't know how long he has been type 2 diabetic, but the lab report was three years ago, no medication as far as i know

Ehm....what made you think i'am offended?, he's been in the same height and weight since high school, no hyperthyroid, T3, T4 and TSH are normal, i don't watch what he eat, but as far as i remember he never exercise excessively

Err....i've never told you his HOMA-IR, because i don't know, that was from my other post, that was the case of a member of this forum, you always write a post based on your own assumptions
 
jjraak said:
which i would guess, would mean my resistance SHOULD be lowering..??
which it seems to be.
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By what method/evidence are you thinking IR is lowering?

I know initially my hb1ac, bgl, weight and lipids dropped. All linked undoubtedly. But since then little change in any of them and no noticeable change in my ability to deal with carbs. A slice of toast still has the same effect it always did (IR the same?) I just don’t have it now - other than as a rare test
 
bisalimo said:
Err....i've never told you his HOMA-IR, because i don't know, that was from my other post, that was the case of a member of this forum, you always write a post based on your own assumptions
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got to be honest,,i read it as your brothers as well..
 
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