OK, so without tests how do we know if we produces too much insulin? Can we assume that if we eat very low carb, have no excess weight, don't put weight on, have normal BG levels most of the time, and don't crash too low that we don't have excess insulin floating about?
This is where it starts to get complicated.
Slim people can have insulin resistance (although being overweight is a good indicator that insulin resistance is present).
And people can have normal blood glucose and insulin resistance at the same time.
Everyone produces insulin all the time. It functions like the basal insulin that T1s inject. it keeps our blood glucose steady and 'normal' when we don't eat. Then everyone also produces bursts of extra insulin when they eat carbs (and protein), to stop the glucose that is released from food (like the bolus injections T1s use).
But someone with insulin resistance needs MORE insulin to achieve these things than someone who hasn't got insulin resistance.
So if you set two slim people with normal blood glucose side by side, one can be producing much more insulin to achieve the same blood glucose control. I have seen lectures where particularly insulin resistant people are shown as needing 4 or 5 times more insulin to achieve blood glucose that tests as 'normal'. If this happens for long enough, then the insulin resistant person
may start to show the signs (raised blood glucose and possibly weight gain, that will lead them to be identified as pre-diabetic). But the insulin resistance and hyperinsulinemia can be present for decades before this happens. Likewise, insulin resistance can still be present in someone who has lost weight and got normal blood glucose after 'reversing' T2. They may have less insulin resistance, but without a test, no one can say how much insulin resistance they still have.
If you have a look at the Ivor Cummins videos that I linked to above, they show that hyperinsulinaemia is a big driver of inflammation, heart disease, weight gain, affects cholesterol and a few other things.
Traditionally these health conditions are linked to Diabetes (raised blood glucose), but Cummins cites numerous sources suggesting that they (and T2) are symptoms of hyperinsulinemia. Kraft's work provides ample evidence of this, over decades. So the root cause isn't raised blood glucose. It is raised insulin.
I take the view that controlling blood glucose is a great and wonderful thing, which I work at every meal of every day. But my real enemy is raised insulin and insulin resistance. And I don't believe that being slim, 'reversing T2' and being able to tolerate eating carbs while retaining 'normal' blood glucose is a sign that all is well. Only a test to discover insulin production levels would reassure me.
The ways I know of to reduce insulin resistance are (in this order)
Exercise (short term)
Diet (low carb, long term)
Fasting (short term, with longer term benefits)
Drugs (metformin is one)
- and I can work on all of those without having to be slim to do them.
Avoiding injected insulin is also a goal of mine, since the more insulin we have floating about in our systems, the more insulin resistance we develop.
