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Why isn't hyperinsulinemia talked about more

N

NatJS

Well-Known Member
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71
Location
UK
Type of diabetes
Type 2
Treatment type
Tablets (oral)
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Diabetes
Someone linked me this article on another thread that has got me thinking a lot about a less discussed cause of a myriad of problems, which is chronic high insulin levels in type 2s.

http://insulinresistance.org/index.php/jir/article/view/18/25

You barely see it mentioned here and I wonder why. I guess getting blood sugar down is very important in the short term, and presumably helps to reduce insulin levels too. But I'm curious if other people know about this, if anyone keeps track of their fasting insulin etc.
 
My daughter was born with it. It's exceptionally dangerous as they don't produce ketones, so can go super low. She thankfully has out grown it after 2 years of injections.
 
Hi @NatJS - Hyperinsulinemia is something that is discussed from time to time on the forum, and a fair number of participants are aware of it. The issue comes down to tracking it as there is no way to do this without clinical tests, which in the UK at least, are not given out freely.

I'll let other T2s respond as to their point of view.
 
Its a really good point since overproduction of insulin is the driver of insulin resistance and hence the symptoms of diabetes. So in focussing on what we can measure (hlood sugar) I think we might be missing the point that minimising insulin needs by reducing intake of carbs is a good place to start. Lower blood sugars are great but if you are having to take lots of meds and eventually insulin, you may be winning the battle but losing the war against your metabolic disease.
 
I'm always banging on hyperinsulinaemia.

Trouble is, getting on top of diet, exercise, lifestyle and getting meds sorted out is a big enough challenge for any newly diagnosed T2. And when/if people do get to that stage, with a set of blood glucose readings they are happy with, a reduced waistline (if appropriate) and a new way of eating, then taking the next step into the more nebulous and largely unmeasurable world of hyperinsulinaemia is a bit of a leap - especially when everyone around them is saying things like 'that's brilliant, you have reversed your T2!'.

It often seems that it is only the ones who fail to lose weight on LCHF, or who get into Fasting, who are willing to look at insulin resistance and hyperinsulinaemia. (I tick 2 of those boxes)

Fortunately, the word is spreading, partly due to people like Kraft, Jason Fung and Ivor Cummins.

Edited for clarity.
 
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Perhaps the obvious reason is that there is no billion dollar pharmacological solution to address chronic hyperinsulinemia.

Chronic hyperinsulinemia is a condition that is effectively resolved by carbs reduction and intermittent fasting, not medication, gene therapy, chemotherapy etc.

So if that is identified as the driver of most chronic illnesses, obesity, T2D and cancer, then
1) what should the world do with the all multi-billion dollars block buster glucose and cholesterol lowering medications?
2) Where are we going to dump all the grains and low fat products that is flooding our supermarket shelves?

Perhaps...this may be all too dangerous...for the world economy.
 
kokhongw said:
Chronic hyperinsulinemia is a condition that is effectively resolved by carbs reduction and intermittent fasting, not medication, gene therapy, chemotherapy etc.
Click to expand...

Actually I've been reading about this and it sounds like Actos might possibly be a drug based solution? Although obviously it has potentially awful side effects in some people. But it's referenced here and there online as being a drug that can significantly improve insulin resistance and also reduce insulin levels. Metformin is another that we're more familiar with.

The problem without being able to easily measure insulin levels is that we just don't know what effect changes are having. Imagine trying to deal with type 2 doet changes without a glucose meter. I'd be very interested if anyone has come across a way of measuring insulin levels at home!
 

NatJS - I don't know of any means, like there is to test blood glucose, but there are several companies offering lab tests; done by mail order, and often the blood collection is from a finger prick test.

An example of these companies is Blue Horizon, which can be found here: http://bluehorizonmedicals.co.uk/ep...b91-b6f9-4318-864a-f492cbae7827/Products/INSU

There are several alternatives, if you feel like consulting Dr Google. Prices vary, and most of these providers do offers from time to time. You don't need a GP referral to use these services, but of course, you would need to foot the bill yourself.

I have no relationship with Blue Horizon.
 
As @Brunneria has already given a good lot of information about how hyperinsulinaemia is not very good for anybody.
I suffered through hyperinsulinaemia because of ignorance and GPs lack of training.
The viscous circle of excess insulin, insulin resistance and hyperglycaemia does lead to obesity and T2. Excessive insulin is a leading reason why there is so many T2 diabetics. If there was a test done every few years as a preventive measure before prediabetes occurs, a great many would be saved from years of suffering.
Meds are being developed to help with chronic hyperinsulinaemia, but if it is not tested what good will they do?
Gliptin drugs do change the chemistry of how the glycogen and glucagon stores are used to offset hypers which limits the amount of insulin is produced for the glucose produced from food.
Insulin tests are expensive, hence a reluctance to use it!
In my experience, most GPs don't have the knowledge or experience to diagnose hyperinsulinaemia and would always stick with treatment that are designed to lower blood glucose levels, but still mostly advocate eating carbs, because of the fear, too low a carb count could cause problems, which is of course the cycle completed.
Too many carbs, too much insulin, too high glucose!
Regardless of treatment, too many carbs will still exacerbate the excessive insulin production.
I was obese, I had hyperinsulinaemia, I stopped eating carbs!
I am no longer obese, I don't have hyperinsulinaemia!
 
When I asked my GP here in Australia about getting a fasting insulin test, he looked at me like I was insane and said "it's not on the list".
 
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?
 
We don't!
But as with my example as a benchmark, I know if i do stick to a very low carb intake, my health and my life signs improve and my symptoms go away!
I'm sure you know a lot better now, if you go too high or too low?
 
I have mentioned many many times that a fasting c-peptide test is valuable info. I am one who has a very hard time losing weight even on low carb and I do have hyperinsulinemia. I am in Canada however and have a doctor willing to do this test every 3 months with my A1c. It infuriates me when doctors put T2's on insulin without bothering to find out how much insulin production there is.
 

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.
 


And maybe l arginine supplementation if suitable to help reduce insulin resistance
 
I agree and hold similar views myself. BUT.......but I take Gliclazide, which helps me, but which works against me in terms of high insulin levels. I have already reduced from 4 tabs a day to 1 tab a day, and I now intend splitting it into two half tabs to cover the whole day, since I am now regularly dropping 6 mmol'l after my main meal of the day, but have a high midday fasting level.

My GP has asked me to drop Glic completely, which is a design aim I share, but I am finding my bgl is creeping up even when low carbing. So I will start playing around with intermittent fasting soon.

Although I believe my IR has reduced, I have no means of proving it. But it has always puzzled me as to why we are advised by NICE to eat carbs and then add more meds to force our bodies to absorb excess glucose just to get it out of the blood. It is shifting the problems elsewhere IMO.
 
I find exercise, r-ala supplement and skipping meals great tips to reducing insulin resistance but only weight loss lasts the longest.
Weight loss for me is the answer to reducing my huge insulin resistance.
Always has.
 
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