Triglycerides:HDL - Insulin Resistance

[IncogKeto]

You need to bear in mind that the conversion factor when moving from mmol/L to mg/dL is different for Triglycerides as it is for HDL and LDL. See how there are separate sections in the omnicalculator:

Convert Cholesterol Levels Measurement Units

Cholesterol unit calculator converts mg/dL to mmol/L for total serum cholesterol, HDL, LDL, and triglycerides.

www.omnicalculator.com

If you’ve arrived at a ratio of one by using mmol/L but are then using reference ranges that were arrived at using mg/dL then you’re going to come a cropper. [I appreciate that anyone would think that the ratio would be unit agnostic, but don’t shoot the messenger.]

Carefully read this screenshot. I entered the values 1.4mmol/L in the lower part and it autofilled the upper part.

 

[coby]

I had the scan in London. I've had to dig around in the report for those data. Android to Gynoid ratio 1. In the 13th centile for visceral fat (low is good). Visceral fat area 95 cm² ( below 1 is good).

Hi I just wondered if you do any intermitant fasting (apologies if you do and I've missed the thread) as this is what brought mine down and helped it remain at 38 for two years. Mine's risen to 40 this last check but I'm under stress with a loved one now in end of life care

 

[HairySmurf]

I've never had a post meal reading either above 8 or more than 2 greater than before eating, My body seems to have no problems managing blood sugar. I already eat very few carbs.

Hi Roy,

Everything you've posted appears to indicate little to no problem with insulin resistance. That might leave your liver and pancreas as possible culprits, or as @Lupf indicated, some healthy people might just have a high HbA1c. If that's the case you might be entirely fine.

Just to clarify your post above - Is this the case when you eat a lot of a high-GI food? A plate of pancakes or a lot of white bread for example? Does your blood glucose still drop rapidly after eating regardless of what you eat, or have you only tested while on a low carb diet?

 

[Melgar]

I'm assuming that the 'pre-diabetic' ranges we have in place across the globe are not just random figures plucked from the sky, they are there for a reason and that reason is higher than normal blood sugars will damage the body's vascular system. 'Raised' blood sugars damage the human body at a slower rate than if one's blood sugars are in the diabetic range, but those raised blood sugars are still slowly damaging blood vessels and nerves endings. They are out of the 'normal' healthy range. My Canadian private health insurance is paying for my strips and anything else diabetic related. And I would bet everything I own that they would not be paying out huge amounts of money for diabetic stuff if there is not a good reason to do so. These private health insurance companies are profit orientated - full stop. There are a number of reasonings and outcomes that have been clumped together under the diabetes type 2 definition - insulin resistance, obesity/over weight, sedentary lifestyle, unhealthy diets, visceral fats and genetics. All these factors put together are said to cause type 2 diabetes. Yet, if you have someone who does not have any of these factors, then do they even have a type 2 form of diabetes? Is there another diabetic category that better explains unhealthy blood sugars? Is it autoimmune or some other reason that doesn't fit the type 2 umbrella? How frustrating it is for someone to do everything right; have completely normal weight, good diet, active lifestyle, no insulin resistance, normal blood pressure and trigs and yet have blood sugars that are high enough to damage their bodies. I maybe completely over simplifying, but these are legitimate queries by people who don'tr fit the type 2 umbrella.

 

[HairySmurf]

@Melgar - Apologies, you are entirely correct and I should not have said that the OP 'might be entirely fine'. It was ignorant and insensitive of me.

 

[Melgar]

@Melgar - Apologies, you are entirely correct and I should not have said that the OP 'might be entirely fine'. It was ignorant and insensitive of me.

HairySmurf no need to apologise, in fact, I was talking in general terms and it certainly wasn't aimed at you. And I totally understand where you are coming from because there is a world of difference when we talk about our blood sugars being in range hovering between 6 mmol/ls and 10 mmol/ls and then we have people who are so far out of range they are dealing with 20 - 40 mmol/ls it's frightening. Sorry if my units of measurement seem weird. I'm using Canadian units.

 

[Melgar]

I'm type 2 simply because I don't have a category and there no other place for me. My c-peptides are not high, in fact they are in the lower half of the normal range. That doesn't make my type 1 either, unless I'm type 1 in waiting and my immune system is unstable and all it will take is a trigger to activate a destructive immune response, but all that is speculation. I did the ultra low diet thing for 9 months and it simply did not work. It's frustrating because like other people here our blood sugars are not behaving like type 2's. I lost weight, great, but my weight was still normal before the weight loss. I am very fit for my age. I'm doing everything right and yet it's simply not working. We can suggest tweeks here and there to our diet but really it's spitting into the wind. There are no persuasive answers.

 

[Roy Batty]

I'm assuming that the 'pre-diabetic' ranges we have in place across the globe are not just random figures plucked from the sky, they are there for a reason and that reason is higher than normal blood sugars will damage the body's vascular system. 'Raised' blood sugars damage the human body at a slower rate than if one's blood sugars are in the diabetic range, but those raised blood sugars are still slowly damaging blood vessels and nerves endings. They are out of the 'normal' healthy range. My Canadian private health insurance is paying for my strips and anything else diabetic related. And I would bet everything I own that they would not be paying out huge amounts of money for diabetic stuff if there is not a good reason to do so. These private health insurance companies are profit orientated - full stop. There are a number of reasonings and outcomes that have been clumped together under the diabetes type 2 definition - insulin resistance, obesity/over weight, sedentary lifestyle, unhealthy diets, visceral fats and genetics. All these factors put together are said to cause type 2 diabetes. Yet, if you have someone who does not have any of these factors, then do they even have a type 2 form of diabetes? Is there another diabetic category that better explains unhealthy blood sugars? Is it autoimmune or some other reason that doesn't fit the type 2 umbrella? How frustrating it is for someone to do everything right; have completely normal weight, good diet, active lifestyle, no insulin resistance, normal blood pressure and trigs and yet have blood sugars that are high enough to damage their bodies. I maybe completely over simplifying, but these are legitimate queries by people who don'tr fit the type 2 umbrella.

I think all the ranges and classifications are based on data and more often than not distribution graphs. Perhaps there are a few outliers at either end that seem to defy the norms i.e. those with low blood sugar but have other symptoms of metabolic syndrome and those with elevated blood sugar but no other symptoms. In my case with low CPR levels, which indicates little or no inflammation, is the pre-diabetic HbA1c level telling the whole story. If elevated blood sugar causes inflammation that damages blood vessels and nerve endings, why is my CPR level low?

Thanks for replying and helping me to understand a little better.

 

[Roy Batty]

You need to bear in mind that the conversion factor when moving from mmol/L to mg/dL is different for Triglycerides as it is for HDL and LDL. See how there are separate sections in the omnicalculator:

Convert Cholesterol Levels Measurement Units

Cholesterol unit calculator converts mg/dL to mmol/L for total serum cholesterol, HDL, LDL, and triglycerides.

www.omnicalculator.com

If you’ve arrived at a ratio of one by using mmol/L but are then using reference ranges that were arrived at using mg/dL then you’re going to come a cropper. [I appreciate that anyone would think that the ratio would be unit agnostic, but don’t shoot the messenger.]

Carefully read this screenshot. I entered the values 1.4mmol/L in the lower part and it autofilled the upper part.
View attachment 65992

Thanks, that's great detective work and counterintuitive that different units changes the ratio. I'm struggling to work out how that happens and I'll read a little more about it.

Nevertheless, my ratio of 2.3:1 still doesn't seem to indicate insulin resistance. In this study https://www.escardio.org/Journals/E...io-as-surrogate-marker-for-insulin-resistance IR is indicated at >2.75.

I'm going to have my triglycerides, cholesterol and C-Peptide tested later this month.

Thanks again.

 

[Bcgirl]

This is so interesting because I thought I was the only one who couldn’t budge my numbers with diet, exercise, weight…all the things. I get so darn annoyed. I know my pancreas has damage but honestly my c peptide is middle of the road normal, my fasting insulin is low but in range, blood numbers are good, blood pressure is good,inflammation markers are low…..frustration level is high. My extreme diet hasn’t taken me out of the prediabetic range.
I watch this thread with interest for sure….

 

[Roy Batty]

This is so interesting because I thought I was the only one who couldn’t budge my numbers with diet, exercise, weight…all the things. I get so darn annoyed. I know my pancreas has damage but honestly my c peptide is middle of the road normal, my fasting insulin is low but in range, blood numbers are good, blood pressure is good,inflammation markers are low…..frustration level is high. My extreme diet hasn’t taken me out of the prediabetic range.
I watch this thread with interest for sure….

There will always be outliers, the data and conclusions on blood sugar aren't immutable unlike the laws of physics.

I've learnt that my Triglycerides to HDL ratio isn't what I thought it was, although its still below the threshold used to determine insulin resistance.

I'm going to try and shift 2 or 3 Kgs then have another DEXA scan along with Cholesterol, Triglyceride and C-Peptide tests.

It's known that too much visceral fat is harmful and although I score low on it already perhaps my body is more sensitive to it's effects. We can't possibly all reapind and react in the same way.

It wouldn't hurt me to lower my Triglycerides and raise my HDL. Losing a little weight should help this.

I should worry less about my fasting blood sugar in the morning and be more aware if the difference pre and post prandial. This seems a good indicator of how well my body deals with blood sugar.

I don't think i need to make big changes, more like marginal gains.

 

[LivingLightly]

I should worry less about my fasting blood sugar in the morning and be more aware if the difference pre and post prandial. This seems a good indicator of how well my body deals with blood sugar.

I don't think i need to make big changes, more like marginal gains.

 

[LivingLightly]

I should worry less about my fasting blood sugar in the morning and be more aware if the difference pre and post prandial. This seems a good indicator of how well my body deals with blood sugar.

I don't think i need to make big changes, more like marginal gains.

Absolutely. You may be consuming more carbs than you realise. Small adjustments to meals may be all that's required to bring your HbA1c results down out of pre-diabetic territory.

 

[Roy Batty]

It's difficult to see where and how I'm consuming too many carbs. I'm not on a keto diet but I eat no UPFs, no fast food, no takeaways, no potatoes,no bread, no rice,. no pasta, no cakes, no biscuits, no cookies, no potato chips, no sweets (candy). I never drink sodas. I minimise fruits and vegetables that are high carb. My alcohol consumption is one to two pints of beer per week, or two glasses of red wine.

 

[IncogKeto]

Nevertheless, my ratio of 2.3:1 still doesn't seem to indicate insulin resistance. In this study https://www.escardio.org/Journals/E...io-as-surrogate-marker-for-insulin-resistance IR is indicated at >2.75.

What are your thoughts on the reference ranges in the screenshot I posted?

It's difficult to see where and how I'm consuming too many carbs.

I stand by my previous suggestion of getting hold of a CGM on the 14 day free trial.
It would also give you an insight into how exercise is affecting your BG.

 

[Melgar]

I hear you Roy Batty and this is your thread so I don't want to blow you off course. I'm guessing if you are consuming more carbs that you thought and the your trig calculations are off then I can see how your blood sugars may stay elevated. None of that applies to me. I was consuming about 35 grams of carbs a day while burning over 2500 calories a day for over 9 months. I was in nutritional ketosis . Weight dropped off me, like 35 lbs of it. So my body was burning fat. Trigs low (calculated by the lab), BMI at 19. C-peptides low/normal. Blood sugars hardly moved.

 

[Outlier]

It can be startling to find how many supermarket prepared foods are hotching with carbs. For instance, zero or low fat yoghurt which has starch thickener, prepared sliced meat dusted with starch to keep the slices easy to separate, many kinds of dressed salads with sugary sauce, every ready meal or soup you've ever seen, grated cheese with added starch, and I'm sure others have suggestions of what we ought to avoid. Until I had to reduce my carbs to as near zero as possible, I never realised how many innocent-looking foods had them added. Individually it may not be all that many, but as the Scots say: "mony a mickle makes a muckle".

 

[Melgar]

It can be startling to find how many supermarket prepared foods are hotching with carbs. For instance, zero or low fat yoghurt which has starch thickener, prepared sliced meat dusted with starch to keep the slices easy to separate, many kinds of dressed salads with sugary sauce, every ready meal or soup you've ever seen, grated cheese with added starch, and I'm sure others have suggestions of what we ought to avoid. Until I had to reduce my carbs to as near zero as possible, I never realised how many innocent-looking foods had them added. Individually it may not be all that many, but as the Scots say: "mony a mickle makes a muckle".

You are not wrong. I have Coeliac so I make everything I eat from scratch. I don't risk the hidden glutens in food manufacturing processes. These hidden supermarket gems are disturbing. Here in Canada you have to list ingredients in bold like soy, wheat, peanuts etc, but what they are not forced to list are the things that go into the manufacturing processes. Ingredients that are imported, which are then used to produce the final product.

 

[Roy Batty]

It can be startling to find how many supermarket prepared foods are hotching with carbs. For instance, zero or low fat yoghurt which has starch thickener, prepared sliced meat dusted with starch to keep the slices easy to separate, many kinds of dressed salads with sugary sauce, every ready meal or soup you've ever seen, grated cheese with added starch, and I'm sure others have suggestions of what we ought to avoid. Until I had to reduce my carbs to as near zero as possible, I never realised how many innocent-looking foods had them added. Individually it may not be all that many, but as the Scots say: "mony a mickle makes a muckle".

I never buy prepared meals, UPFs, takeaways or fast foods.

My breakfast is generally either 10 -12 blueberries, or 6; raspberries with Greek yoghurt (high protein), pumpkin and sunflower seeds and a gew nuts.

My dinner last night was a Greek salad I made myself.

I'm not Greek.

 

[Roy Batty]

Could you expand on that a little i.e. provide some website links, units and when and how you got those numbers - I seem to remember that you’ve previously had tests done in America.

The data came from the trial I participated in at a London hospital. I had another blood test late 2023.