Type 2 progression to insulin

Oldvatr · Aug 3, 2021

LaoDan said:
So, if I wanted to measure IR at home so I can measure progress, is there a way to do this? Maybe measure some cheat meal once per month?

Perhaps use an OGTT with a CGM monitor and compare graphs. You can buy ready made test solutions but it is just a fixed amount of glucose in a fixed dilution mixture, and so long as it is repeatable then the graph comparison should hold true. The faster the rise and the height of the first peak (if seen within 2 hrs) gives an indication of high IR or poor insulin response. The decay time after the peak gives an idea of IR if slow, and again the basal insulin response. The lower the peak the more insulin is being used to remove it. These are general observations of what I would expect to see, but I could be wrong since I have never undergone this test. You may be able to read across to a Homa result, if it is from fasting, and the equations are published online somewhere. I believe there are more than one variant of the equations though so beware. If your levels are still higher than the start value after say 6 hours, then you are in trouble no two ways about it.

These are just my observations so do some research of your own since I am sure others have done home tests too.

PS during the testing period, do NOT consume anything! Obvious really, but needed saying.

PS the nearest equivalent I have used is a Chinese sweet and sour from the takeaway. That is my goto.

LaoDan · Aug 3, 2021

@Oldvatr lol, it’s probably easier to buy glucose than sweet and sour chicken here.

Im going to try it, probably just use a meter and measure at intervals. Might be useful to track my progress.

Oldvatr · Aug 3, 2021

LaoDan said:
@Oldvatr lol, it’s probably easier to buy glucose than sweet and sour chicken here.

Im going to try it, probably just use a meter and measure at intervals. Might be useful to track my progress.

It's better than ignorance, that's for sure. Glucose is cheaper. Test strips, not so. If you use a spreadsheet, then you could plot the baseline starting values, and superimpose several different tests on the same sheet. Something like Open Office would do. Good luck. If it works, then write it up on the forum for others to follow.

HSSS · Aug 3, 2021

Oldvatr said:
I still stand by my definition when it comes to the pulse/response tests. The 2hr OGTT is only covering the stage-1 response. A 4hr timespan would start to show part of the basal response but is still insufficient in that respect. It would require monitoring and recording of at least 6 hours to get an idea of the overall IR response. I believe HOMA is similar in its coverage too, it being based on a step change from fasting and limited time recording.

As regards the effect of diet, the Stage-1 response is triggered by amylase, which is in turn triggered by any carbs entering the mouth. It is in the saliva response to dietary carbs. This is a fixed trigger and is not dependent on carb load except in respect of eating and chewing time. But amylase has two stages. the first is as above, the second is the one that occurs in the gut when carbs are detected in the digested food within the gut, and this controls the basal response. This second stage is carb load dependant. There are other enzymes such as lactase, protease, lipase etc that come into play at this stage. This amylase is also GI dependant to a certain extent. It is also food transit time dependant since it occurs mainly in the upper bowel tract, There is a further stage that occurs in the lower bowel that happens as fibre is digested. This last stage is fermentation that produces sugar products to feed the gut fora and enzymes and does not really enter the bloodstream.

Some artificial sweeteners have been shown to trigger an insulin response, and this can lead to raised insulin levels since there are few accompanying carbs to work on. It does not seem to trigger the second stage of amylase and basal insulin since there are no carbs going into the gut. Thus the basal response does not follow.

Since it seems to be the stage 1 response that goes walkabout in T2D, then the OGTT will be mainly showing the start of Stage 2 basal response. It will certainly show if the stage 1 is compromised, or held back by mitrochondrial IR. It will also show if pancreatic insufficiency is present or inhibited by adipose IR but would probably not be suitable for a quantitative evaluation.

I was merely clarifying what I meant by my statement not arguing with your points. I was recommended a HOMA/OGTT combined test lasting 3 hrs not 2. An improvement but possibly still not enough. Thanks for the detail.

Type 2 progression to insulin

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Type 2 progression to insulin

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