Jason Fung confused

Oldvatr said:

I believe it is similar to the C=Peptide test and needs a specialist lab to measure it, I know C-Peptide can be done in UK, but the fasting Insulin seems to be only available privately. Think NHS will cover C-Peptide but it is not a common test now.

There is also a technique called an insulin clamp test, again used mainly in a lab, that can give a rough idea, and it is commonly used during research experiments, not in vivo.
Previously discussed in
https://www.diabetes.co.uk/forum/threads/fasting-insulin-tests-nhs-says-no.147742/

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The hyperinsulinemic-euglycemic clamp test is often referred to as the gold standard for insulin resistance testing. It is not practical to use this test apart from in research as it is too complex and invasive. It's advantage is that it is a dynamic test that measures the ability to disperse glucose as levels are increased. The fasting insulin test is a static test that shows the balance between insulin and gluconeogenesis by the liver, it is an indication but not a measure of overall insulin resistance and varies with ethnicity and gender. Professor Mathews stated that HOMA-IR index, derived from fasting insulin, should only be used to compare populations not individuals. So a reluctance to use fasting insulin as a standard test is probably due to the difficulty in interpreting the results.

mazza 2 said:

Well done on your HBA1c results. It's strange, but since my last blood test in November 2018, my result was 44 and yet I'm still on 4 metformin tablets per day, and the surgery have never contacted me or told me to reduce or stop them. I have heard good things about metformin, but to be honest, I detest taking tablets and I remember when first put on them getting really upset because I know that some doctors, once they put you on medication they never take you off them. Just wondered if the doctor decided to take you off medication or you took yourself off them. It's good to hear you were never overweight, nor was I, but maybe, like you I store fat in the wrong places. Did you get a private ultra sound or did your doctor send you for one. Sorry for all the questions but was just interested in how you went about it. Thanks

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Answers :- 1) I took myself off them from 3/day to zero over a 12 month period, dropping them one at a time, with colusion with my diabetic nurse, metformin gave me very loose bowel movements and lots of them !! :-( . 2) Dr sent me for ultra sound on a visit for a strained rib as I had been humping weights around and overdid things, he poked around and thought that my liver was enlarged so ordered the ultra sound.
I should add that I played professional sport, ran marathons up until a few years ago, I still run an aerobics class with HIIT, weights and floor work, plus lots of walking in the Dales, so people in general can't believe that I am diabetic, including my doctor who thinks it's in the genes.

Hello

I weigh 8 stone 10 and exercise and eat healthily not too many carbs I am still diabetic.. my great great grandmother was diabetic my aunt was diabetic my great aunt was diabetic my mothers coz diabetic .. I was diabetic in my first pregnancy aged 19 at that time when I became pregnant I weighed seven and a half stone! So its not always weight that is the problem as I have never been overweight but I still have diabetes type two which I was told when I was 19 in that first pregnancy that I would get when I was over 40. Did not become diabetic till I was 55. So how does all this fat causes it work with me? Obviously it must be genetic?

Mbaker said:

@jpscloud, @mazza 2, below are both the macros and the recipe with both Coconut and Almond Flour Alternatives, this makes 2 (but maybe halve the mixture for 1 serving). I have mentioned brands as I went for low carb versions of the ingredients that my family have tested. The Salmon amount could be cut in half, I was stuffed on 225 grams, which impacted dinner later:


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Again I can't taste almond with that version of flour, the extra fine is expensive, but in my view worth it, as almond meal can be a bit grainy. These are great for burgers and the like and can be toasted, and last at least 24 hours.

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Thanks! I need to get some extra fine almond flour, I just have ground at the moment which makes a nice scone type muffin with strawberries and cream but doesn't quite have the right texture for savoury things.

Oldvatr said:

There are instances being reported on this forum from T2D who were on insulin long term who have managed through diet to be able to stop the insulin treatment. Now this may be a honeymoon effect and short term, but then again there may be some who have a different issue with the pancreas where it cannot be reversed, such as pancreatitis [sp] or bloodclots or other damage.

I know my pancreas is still pumping insulin after some 15 years as a T2D.

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Yes - I was on insulin (Novorapid and Lantus) for 4 years. Have now been off the insulin (and also take no meds) for well over a year. Hba1c isn't as good as I would like but at end of March was 42 - down from 44 in September.

I actually think it will probably drop lower. This week have been getting some really low numbers - only just hovering over 4 - even after eating. This is very puzzling - but maybe I have started another phase of my recovery and I have suddenly become more insulin sensitive or beta cells are pumping out more insulin.

I have noticed this week that I do feel more energetic also. I feel that, for me, low carb is for life because I just don't want to risk the T2 coming back.

Cinderella56 said:

Hello

I weigh 8 stone 10 and exercise and eat healthily not too many carbs I am still diabetic.. my great great grandmother was diabetic my aunt was diabetic my great aunt was diabetic my mothers coz diabetic .. I was diabetic in my first pregnancy aged 19 at that time when I became pregnant I weighed seven and a half stone! So its not always weight that is the problem as I have never been overweight but I still have diabetes type two which I was told when I was 19 in that first pregnancy that I would get when I was over 40. Did not become diabetic till I was 55. So how does all this fat causes it work with me? Obviously it must be genetic?

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You might be an outlier, but I still think there are always optimisations that can be tried. I remember when I was working out quite hard (harder than I am now) and getting fbg's just over 5 for quite some time (whilst still on metformin and weighing less). I was seeing some getting mid 4 fbg's and thought that was out of reach for me. I recall research from Israel on the gut microbiome - I was prepared to ultimately travel there to see if they could help me some more. I have not had to go down this route.

What has changed things for me is resistance training. I had still kept up cardio but avoided resistance training as the advice for hypertensives was clear. I did general gym workouts with dumbbells and static equipment, and noticed a drop in fbg to around 4.7. Long story short this morning I was at 4.2 after only 1 heavy weights session at noon yesterday (a lazy day for me). I would encourage everyone who can to try powerlifting; the science makes sense for blood glucose control, for me it is easier than 45 minutes on the treadmill, it is very satisfying getting the technicalities right (tight core, alignment, breathing and execution). I feel for persons who are petite the worst that can happen is healthy weight gain without bulk (it is a different world becoming muscle bound). Maybe worth a try.

Krystyna23040 said:

I actually think it will probably drop lower. This week have been getting some really low numbers - only just hovering over 4 - even after eating. This is very puzzling - but maybe I have started another phase of my recovery and I have suddenly become more insulin sensitive or beta cells are pumping out more insulin.

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Been noting that myself actually, last night the fry up sent my blood from 5.1 to 4.4! Not sure what I saw going on there but I’m appreciating it.

Guzzler said:

Unless or until some boffin invents a home insulin meter then bg measured with a glucometer is our only marker. That and trying our best to limit the frequency and duration of insulin responses.

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What about human insulin Elisa kits?

Caeseji said:

Been noting that myself actually, last night the fry up sent my blood from 5.1 to 4.4! Not sure what I saw going on there but I’m appreciating it.

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There are two phases of insulin response that we normally get in response to eating carbohydrates. Stage 1 insulin is triggered as soon as sweet carbs hit the tongue by releasing the enzyme amylase, and then Stage 2 starts when carbs start being digested in the duodenum and the small intestine. The first stage is fast acting and is to soften the initial sugar spike, then the second stage lasts while carbs are being absorbed into the bloodstream. The body normally handles turning these insulin taps on and off automatically, but in T2D it seems we either lose the ability for stage 1, or we do not switch off Stage 2 at the correct time. Some artificial sweetners are bad for T2D in that they also trigger amylase stage 1 even though there may not be any significant carbs to follow, and this does not help hyperinsulinemia.

So as Insulin Resistance reduces following an appropriate diet, then we may see an improvement in post prandial readings as the insulin response improves, and this may give some surprising drops after a meal, especially if the Stage 1 response improves. Stage 1 is normally associated with the insulin to muscle pathway, and this often responds first with the glycogen stores being depleted by the diet leading to weight loss with the associated water loss. This may explain why the 2 hr PP can drop so suddenly, but the 4 hr PP may not drop so much. For example the Newcastle diet which is calorie restricted diet, noted that there was an early improvement in blood sugars directly correponding to weight loss, which was actually the glycogen stores depleting. It took longer to start depleting the liver stores and the adipose fat needed to achieve remission.

Barbara79 said:

What about human insulin Elisa kits?

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Is this really a home use kit?
https://www.bosterbio.com/human-ins...m=paid+listing+ppc&utm_campaign=product+list:
Needs more than a fingerprick of blood, I imagine.
However, it may be what the private labs use. and does not need a mass spectrometer for the assay.

Barbara79 said:

What about human insulin Elisa kits?

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After a quick google, these sound like lab kits. One brand requires a centrifuge and an incubator. And the kits carry a hefty price tag.

@Oldvatr That was a really comprehensive post, thank you for that and it could explain why I am shooting down these days even 4 hours later I am a little bit lower sometimes and closer to the 3's. Taking it as a good sign that a lot of my fatty tissue is starting to be used up with my fasting so I appreciate that. The science behind this condition is rather astounding.

Caeseji said:

@Oldvatr That was a really comprehensive post, thank you for that and it could explain why I am shooting down these days even 4 hours later I am a little bit lower sometimes and closer to the 3's. Taking it as a good sign that a lot of my fatty tissue is starting to be used up with my fasting so I appreciate that. The science behind this condition is rather astounding.

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It is fascinating at times, isnt it? Ivor describes human metabolism as exquisitely complex, he's not wrong.

Yeah I dig it big time. Perpetually fascinating.

Guzzler said:

It is fascinating at times, isnt it? Ivor describes human metabolism as exquisitely complex, he's not wrong.

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He isn’t.

I think I learned more about the human body from reading up about diabetes than I ever did back in biology if I'm honest. Fine tuning my metabolic processes has been fun in a strangely morbid way.

Guzzler said:

It is fascinating at times, isnt it? Ivor describes human metabolism as exquisitely complex, he's not wrong.

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Ivor? Is that Ivor Cummins? The Fat Emperor? I thought he was mainly talking about the heart and lipids.

Oldvatr said:

Ivor? Is that Ivor Cummins? The Fat Emperor? I thought he was mainly talking about the heart and lipids.

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Insulin Resistance got him started, he then moved on to Cholesterol and then to the CAC scan and heart health. He still covers all three topics in his podcasts.

eta.

I think it was ferritin levels at an MOT that got him started in the first instance, getting blank stares from GPs when he asked them what these levels actually meant.

Caeseji said:

I think I learned more about the human body from reading up about diabetes than I ever did back in biology if I'm honest. Fine tuning my metabolic processes has been fun in a strangely morbid way.

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Me too. I had a “deprived” childhood. And never did biology at school. It wasn’t an option or mandatory.

Guzzler said:

Insulin Resistance got him started, he then moved on to Cholesterol and then to the CAC scan and heart health. He still covers all three topics in his podcasts.

eta.

I think it was ferritin levels at an MOT that got him started in the first instance, getting blank stares from GPs when he asked them what these levels actually meant.

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OK. I have not read his work so far - I tend to dive into the quagmire that is a published report from an endocrinologist or two reporting a new breakthrough, hence the term gobbledegook that I used earlier. They speak a different language! I started with the Krebs Cycle (Citric cycle) many years ago, and try to keep up with it, but it moves so fast now. I am not a biologist or a biochem geezer, but I did the rudiments at school many moons ago.