Triglycerides:HDL - Insulin Resistance

Roy Batty said:

Why fasting insulin as well as C-Peptide? Isn't C-Peptide more reliable because it's half life is longer than insulin?

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Fasting insulin + fasting glucose helps calculate your HOMA-IR, as descibed at a very high level here: https://www.rdm.ox.ac.uk/about/our-clinical-facilities-and-units/DTU/software/homa

There's quite a bit out there on HOMA-IR

Roy Batty said:

I now realise that fasting insulin amd fasting glucose are used to calculate insulin resistance, not the level of insulin. Thanks

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No worries, we're all learning every day.

Roy Batty said:

I'm drinking small cups, the milk content is very low and full fat. It's far from a milky drink like a latte.

I worked it out, a small cappuccino with 85ml of milk is 4 mg of carbs. So I'm getting 8 mg daily from milk.

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Personally, I normally consume 10 net grammes / 20 total grammes of carbs daily, so 8g just for 2 small drinks sounds like a lot to me. I am influenced by Dr Eric Westman and his "Prescription Strength keto". 20g total carbs is his recommendation, though not necessarily for life. You might like at least to experiment with estimating how many carbs you are consuming daily and reducing them. Just an experiment, no need to continue any longer than suits you. Dr W posts interesting videos almost daily on Youtube, including lots of advice on "Starting keto right".

I am very impressed by your excellent régime, especially your exercise. I wish I was doing the same!

Btw, I learned about double cream in hot drinks from these Forums long ago. I have banished milk from my fridge and life. But how delicious the cream is, in coffee and even tea! (Cream in tea is a little odd at first, but fine once one is accustomed. I see from 19thC novels that cream in tea was once the norm, at least for those who could afford it.))

Alexandra100 said:

Personally, I normally consume 10 net grammes / 20 total grammes of carbs daily, so 8g just for 2 small drinks sounds like a lot to me. I am influenced by Dr Eric Westman and his "Prescription Strength keto". 20g total carbs is his recommendation, though not necessarily for life. You might like at least to experiment with estimating how many carbs you are consuming daily and reducing them. Just an experiment, no need to continue any longer than suits you. Dr W posts interesting videos almost daily on Youtube, including lots of advice on "Starting keto right".

I am very impressed by your excellent régime, especially your exercise. I wish I was doing the same!

Btw, I learned about double cream in hot drinks from these Forums long ago. I have banished milk from my fridge and life. But how delicious the cream is, in coffee and even tea! (Cream in tea is a little odd at first, but fine once one is accustomed. I see from 19thC novels that cream in tea was once the norm, at least for those who could afford it.))

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I’m still baffled by why people count total carbs. They are almost always from the USA or using their resources and I suspect it’s simply because of the way fibre is included in their carb counts. Just about everyone reaches ketosis at 20 (net) carbs and many do so at levels up to 50ish (net) grams.

Fibre isn’t digested. It doesn’t raise glucose, it can even mediate it meaning less of a spike (possibly extending the gentler rise’s duration though). By counting fibre you restrict things like low carb/glucose veg unnecessarily and thus the micronutrients they contain. Most of the world doesn’t have carbs included in their carb count and therefore no such concept of net and total carbs for a reason.

What an interesting thread. Sorry I came to it so late. But from the word go - I didn't get the trig reading and the trig hdl ratio being an indicator of insuln resistance or sensitivity @Roy Batty. My understanding is it is an indicator of the health of your LDL particles (and therefore part of your cardio vascular health signifiers). ie - good tri hdl ratio means more big and fluffy LDL particles, rather than the dangerous small ones. I keep an eye on my trig hdl ratio for that reason.

Nothing about insulin levels! As in, how much your own body is producing. (Remembering that too much is a mighty big sign of insulin resistance, as in your pancreas is churning it out to deal with too high levels of glucose in your body - your common garden variety insulin resistance based type two diabetes, or in Roy's case - prediabetic levels as in getting too high but not too high yet etc etc.)

I get my C-peptide ordered to keep a track of how much insulin my poor old body is churning out (as in - when it is getting too much, when it is getting closer to normal etc etc ). My country is in the throes of a healthcare funding crisis these days, so I don't dare ask for c-peptides at the moment.

I am nervous that I am the only one mentioning that the trig hdl ratio isn't about signifying one's own insulin production, as in - have I been wrong all this time? (As in when I first really came to understand about blood lipid interpretation, maybe the second year post my diagnosis? Eight years ago now.)

Very happy to be corrected. If I have been wrong - I want to be corrected!

Bcgirl said:

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….

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I think that one explanation may be pancreas damage. If it can’t produce enough insulin to move the blood sugar out of your blood and into fat cells, your level will be a little raised even on a low carb diet.

Is that diabetes 1.5?

Have you measured your blood insulin levels?

Michellenz said:

I think that one explanation may be pancreas damage. If it can’t produce enough insulin to move the blood sugar out of your blood and into fat cells, your level will be a little raised even on a low carb diet.

Is that diabetes 1.5?

Have you measured your blood insulin levels?

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A damaged pancreas (by drugs/surgery/pancreatitis etc) is often termed type 3c. Very similar to type 1 in that a lesser or no insulin is produced, except type 1 is considered autoimmune rather than direct injury. 1.5 is a slower onset in adults of type 1.

Roy Batty said:

I had the results back from blood taken on 19th March, today is the 21st.

Hba1C 42 down from 45 on 6th January

Total cholesterol 5.7 down from 6.9 (June 2023)

HDL-C 2 up from 1.4

LDL-C 3 down from 4.86

Triglycerides 1.6 up from 1.4

TC:HDL-C 2.8 was 4.9

TG:HDL 1.8 was 2.3 (I used the Blood Code calculator as this takes account of the different units and their conversion factors). Now in the optimal range and not a signal of insulin resistance.

I've lost 3 Kgs since the beginning of January, more importantly I strongly suspect I have increased the % of muscle as well as reduced the % of fat.

I have a DEXA scan scheduled for 5th April so I'll have better data on my body composition and distribution.

I aim to shed another 3 to 5 Kgs of fat, I'm confident this will bring my Hba1C down further and out of the pre-diabetic range.

I don't know why my Triglyceride level has gone up.

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Trigs often go up when weightloss is on the scene. It is often mentioned. I'm sure if you do a forum search you will find discussion around the topic.

If that were me, and I was actively, and deliberately losing weight, I'd note and shelve the Trigs score until my weight had stabilised for a short while.

AndBreathe said:

Trigs often go up when weightloss is on the scene. It is often mentioned. I'm sure if you do a forum search you will find discussion around the topic.

If that were me, and I was actively, and deliberately losing weight, I'd note and shelve the Trigs score until my weight had stabilised for a short while.

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Some meds like propranolol can raise Triglyceride levels..

Roy Batty said:

An update after tests at the end of February 2025.

My HbA1c has gone up from 42 to 46, although I've been on a LCHF and high protein diet for 14 months.

I don't eat UPFs, fast food or takeaways. I have pasta or rice maybe once a month, I don't recall when I last had a pizza. I don't eat desserts. I don't drink any pop, soda, fizzy, sugary drinks. I rarely (once a fortnight) eat cookies, biscuits, cakes or pastries.

I exercise a lot, I saw my GP after getting the results and I was asked about my routine, she called me a machine. I do plenty of resistance exercise, either with free weights, bands or body weight. I also get plenty of walking every day.

My Triglycerides have gone down to 1.0 mmol/L 89 mg/dL.

My HDL-C is 1.6 mmol/L 62.4 mg/dL.

TG:HDL is 1.4, apparently this is in the optimal range.

My weight has remained static, but there has been an increase in muscle and loss of visceral fat.

My BP is consistently 110:70.

I have a very low stress lifestyle and I sleep great.

I'm frustrated by my blood sugar, intrigued and perplexed but not worried.

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Hello Roy, I wish I did anything like the exercise you are doing. How would you feel about trying a very low carb diet? That is under 20 total carbs daily? (I eat less carbs than this and I still can't get down to the bg I would like to see, though nowhere near as high as yours.) For inspiration, you could watch some of the videos from Dr Eric Westman on Youtube. He starts his patients off on what he calls his "Prescription strength" diet which is 20 total carbs, then lets them add in a few more carbs if this succeeds for them. Or you could have a look at Dr Richard K Bernstein's site where he gives away for free lots of sections from his great book "Dibetes Solution". He lists there no-no foods and also what you CAN eat.