Triglycerides:HDL - Insulin Resistance

[Roy Batty]

Non-diabetic people have on average an HbA1c of 38 mmol/mol, but there is a distribution, see diagram. The standard deviation is +-3 mmol/mol
and looks like a Gaussian or normal distribution. Thus about 2% of the sample have an Hb1Ac above 44 (or below 32) mmol/mol, which is well into the prediabetic range. I tag @KennyA, he has shown such a distribution before. Figure is taken from https://www.semanticscholar.org/pap...nsen/d753c7ba8eef5dc1d63407f5e9e8728cd43a52eb

Maybe then your HbA1c is ok, and you shouldn't worry at all?
View attachment 65988

Thanks, that's very helpful.

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

I'm tending towards the school of thought that considers that insulin level and not blood sugar is the more important metric.

 

[HSSS]

And if every other enquiry yields no answers perhaps you simply don’t have typical red blood cells and they last a bit longer than average therefore glycate more in that extra time causing a higher hba1c despite perfect blood glucose scores. Hence possibly look at other testing methods to support the blood glucose (OGTT, fructosamine) as I mentioned before.

 

[Roy Batty]

And if every other enquiry yields no answers perhaps you simply don’t have typical red blood cells and they last a bit longer than average therefore glycate more in that extra time causing a higher hba1c despite perfect blood glucose scores. Hence possibly look at other testing methods to support the blood glucose (OGTT, fructosamine) as I mentioned before.

Thanks. I'm tending towards taking more interest in my insulin level and how my body responds to and handles blood glucose. If my C-Peptide is okay along with an improvement in my Triglycerides to HDL-C ratio then I'll carry on as I am.

I'm should stress that I'm more perplexed than worried.

 

[Melgar]

I have just returned from a Dr consultation. He said I have 'Brittle diabetes' and we cannot rule out autoimmune diabetes. Those were his words. So Roy I would certainly get your c-peptides checked out. I should mention that my brother has LADA and his Trigs were not great. He was and still is on Statins.

 

[jjraak]

When first diagnosed @IncogKeto
(clever play on words btw )
and getting to grips with lchf, I used this calculator to work out my ratios, in mmols.

Cholesterol HDL/LDL/Triglycerides Ratios Calculator (SI Version in mmol/L)

Pretty sure I used an insulin resistance one too, but I wasn't the one already posted

Let me see if I can find it again.

 

[AndBreathe]

If you are interested in your insulin levels, why are you not have them tested, under controlled conditions?

 

[Antje77]

I'm tending towards the school of thought that considers that insulin level and not blood sugar is the more important metric.

I wouldn't agree with that, although it's an interesting metric.
High insulin levels are the cause of insulin resistance and eventually T2 diabetes.
High blood glucose is the leading cause of amputations, blindness and kidney disease.

I appreciate you have prediabetes and are therefore not very likely to develop diabetic complications, but I would choose high circulating insulin levels over high blood glucose any day.
In fact, I do. As a T1, I get to choose how much insulin I want in my system, and I can easily lower my insulin level by not injecting insulin. The problem is that this would kill me rather quickly.
I could choose to inject as much insulin as a healthy person without insulin resistance produces. Which would kill me slower and more painfully (I need relatively high doses to maintain normal BG) because it would cause me to have constantly elevated BG in the high teens or so.

 

[Roy Batty]

There are a few reasons why.

1. I'm British but not currently in the UK. If I were in the UK I could get an appointment with the GP (General Practitioner) I'm registered with. She or he isn't going to be too happy to see me, I'd definitely be in the worried but well category. Although, as I've previously said, I'm perplexed not worried. My GP is unlikely to agree to any blood tests that are to satisfy my curiosity. The NHS is under stress at all levels, GPs and labs included.

2. If I were in the UK another route would be to pay privately for blood tests, which I have done in the past.

3. As I'm not in the UK and there's no medical reason for any blood tests I would have to pay. But, right now and for the next weeks at least I'm far from any walk in lab.

I will have much better access to a lab later this month.

 

[Roy Batty]

We all react and respond very differently. What may be a harmful level of blood sugar to some, is not to others. Likewise, there are outliers in the distribution graph of normal blood sugars i.e. not harmful. Some of these outliers have a blood sugar level above the threshold used to determine pre-diabetes.

There's a school of thought in the medical science and nutritional community that the focus should be on insulin, not glucose levels, at least for non T1 diabetes.

I'm managing my blood sugar by limiting the amount and source of carbs I eat. It seems that my body is responding adequately and producing insulin to reduce this.

If blood sugar was causing damage to capillaries, nerve endings, internal organs etc wouldn't this be indicated by raised levels of CPR? My own level is near the bottom of the range.

If I've misunderstood anything please correct me.

Thanks

 

[AndBreathe]

There are a few reasons why.

1. I'm British but not currently in the UK. If I were in the UK I could get an appointment with the GP (General Practitioner) I'm registered with. She or he isn't going to be too happy to see me, I'd definitely be in the worried but well category. Although, as I've previously said, I'm perplexed not worried. My GP is unlikely to agree to any blood tests that are to satisfy my curiosity. The NHS is under stress at all levels, GPs and labs included.

2. If I were in the UK another route would be to pay privately for blood tests, which I have done in the past.

3. As I'm not in the UK and there's no medical reason for any blood tests I would have to pay. But, right now and for the next weeks at least I'm far from any walk in lab.

I will have much better access to a lab later this month.

I'm not in UK at present, but did have my insulin levels tested here a couple of years ago. I just walked in, ticked the box on the blood test menu, paid my money and they emailed me my results as soon as they had them.

The fasting insulin test took longer to come back than the others I had done - fasting glucose, A1c and full thyroid panel, from memory.

Even in the UK there are options to pay for blood tests, with zero input from, or to your GP. I certainly don't expect the NHS to pander to my every curiosity, and as someone who has only every had a single A1c in the diabetes diagnostic ranges, I didn't think the NHS would stump up, so I put my hand in my pocket..

 

[Roy Batty]

I'm not in UK at present, but did have my insulin levels tested here a couple of years ago. I just walked in, ticked the box on the blood test menu, paid my money and they emailed me my results as soon as they had them.

The fasting insulin test took longer to come back than the others I had done - fasting glucose, A1c and full thyroid panel, from memory.

Even in the UK there are options to pay for blood tests, with zero input from, or to your GP. I certainly don't expect the NHS to pander to my every curiosity, and as someone who has only every had a single A1c in the diabetes diagnostic ranges, I didn't think the NHS would stump up, so I put my hand in my pocket..

Exactly as I said, I've paid for private blood tests in the UK without any involvement by my GP and I'd do so again. If I were ill though and needed confirmation of a diagnosis I would expect for this to be provided by the NHS. They are very different situations.

 

[AndBreathe]

Exactly as I said, I've paid for private blood tests in the UK without any involvement by my GP and I'd do so again. If I were ill though and needed confirmation of a diagnosis I would expect for this to be provided by the NHS. They are very different situations.

I don’t consider my diabetes diagnosis as an illness. It is, in my view, a condition I am fortunate enough to be able to control whilst living a good, unhampered life.

 

[HSSS]

I just had a very comprehensive set of bloods done with randox (discovery package), with a new year 20% discount too. When i added up the ones I wanted that weren’t widely available elsewhere insulin, cpeptide, hormones, thyroid antibodies, detailed lipid breakdowns etc it was by far the cheapest option I could find even if some tests were a bit redundant as I’ve already got those on the nhs for various reasons. I’ve used thriva and medichecks before for some of the more basic tests but they and others either didn’t do them all or the cumulative cost ended up a lot higher.

 

[Roy Batty]

Thanks for that information. I'm not in the UK so I wouldn't be able to use it until I returned. I looked it up online and saw that the cost is £195 (US $240), which might be prohibitive for some. Nevertheless, worth knowing it's an option.

 

[HSSS]

Thanks for that information. I'm not in the UK so I wouldn't be able to use it until I returned. I looked it up online and saw that the cost is £195 (US $240), which might be prohibitive for some. Nevertheless, worth knowing it's an option.

It’s certainly not cheap. And even with the regular 10-20% discount it is still a lot. (It was my Christmas present from the family that I waited years for). But my point was that is the cost (or higher) of getting all those tests privately that the nhs won’t do. Individually some are much more affordable. Depends which ones you want

 

[Bcgirl]

Have you ever done the HOMA-IR calculation? It’s very useful in determining insulin resistance.
you need a fasting insulin test and a fasting glucose test.
heres a link to the calculator….be sure to use the correct units (this link provides conversion tables)

Calculators - The Blood Code

HOMA IR – Insulin Resistance Calculator HOMA-IR stands for Homeostatic Model Assessment of Insulin Resistance. The meaningful part of the acronym is “insulin resistance”. It marks for both the presence… read more →

thebloodcode.com

 

[jjraak]

When first diagnosed @IncogKeto
(clever play on words btw )
and getting to grips with lchf, I used this calculator to work out my ratios, in mmols.

Cholesterol HDL/LDL/Triglycerides Ratios Calculator (SI Version in mmol/L)

Pretty sure I used an insulin resistance one too, but I wasn't the one already posted

Let me see if I can find it again.

Link had expired, sadly.

This was still available and the full thread was very interesting

Insulin resistance

It's useful, because it often is difficult to persuade your doctor to order an insulin test for you. :) 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...

www.diabetes.co.uk

 

[AndBreathe]

Thanks for that information. I'm not in the UK so I wouldn't be able to use it until I returned. I looked it up online and saw that the cost is £195 (US $240), which might be prohibitive for some. Nevertheless, worth knowing it's an option.

Roughly where are you on the globe, Roy, and how long are you away?

 

[Roy Batty]

I'm in the southern hemisphere and I've found a lab that I can use in 2 weeks time. I'm going to have my C-Peptide, lipids panel and APOB tested.

Thanks

 

[AndBreathe]

I'm in the southern hemisphere and I've found a lab that I can use in 2 weeks time. I'm going to have my C-Peptide, lipids panel and APOB tested.

Thanks

Do they not do a fasting insulin (and fasting glucose) test to go alongside the c-peptide? That'd make for a nice panel, in my view.