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You can measure your own Insulin Resistance !

Discussion in 'Diabetes Discussions' started by CherryAA, Sep 7, 2017.

  1. Safi

    Safi Prediabetes · Well-Known Member

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    Appreciate your thoughts @CherryAA :)

    At the time of my diagnosis (I was 40yrs ish with a bmi of 22 ish very physically active) I actually thought my doctor was being a bit dramatic. I'd gone to see her about a sebaceous cyst that had gone rogue so she took some standard bloods & gave me some antibiotics. Called me three days later to say I had the 6.3 FBG & she'd ordered an OGTT - it was at this point I did some research & went LCHF. Some ten days later or so I toddled off to do the test thinking I'd pass and that the higher FBG was due to the cyst. Of course I failed the **** thing :bigtears: I had no HBA1C at this stage & unfortunately was only given the starting & the 2 hour measurements.

    3 months ish later (still LCHF), given my complete lack of any family history or of other metabolic markers (good bp/good cholesterol/good height to waist ratio) I sought a second opinion. At this point I had lost maybe 6kg & my bmi has hovered around 20 ever since. This second doctor did my HBA1C which was 5.1.

    Sorry for the wall'o'text but I thought some background was important. To this day I wonder if I failed the OGTT due to having gone LCHF in the interim or if maybe the antibiotics played some role (gut bug changes & whatnot) but I've made my peace with the possibility/probability that I have a somewhat deranged metabolism & as LCHF has seemingly done me nothing but good I'll stick with it.

    I hated my OGTT & am loathe to experience it again BUT if I could get one with insulin measurements I'd be all over it!

    I don't post a lot these days but I've enjoyed your research & contributions. I'd be fascinated to see if there was any kind of discernible pattern for those forum members who have reactive hypoglycemia but who aren't diabetic - so producing lots of insulin but still very sensitive to it.........
     
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  2. Ch.R.

    Ch.R. Type 1.5 · Well-Known Member

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    Just As My Opinion.
    I think to detect the probability to develop Type 2 should been looked at the Genes
    and if someone has weight problems resulting and how to overcome them by different
    food and/or possibly even surgery because the Genes cannot been changed.

    I visited Hawaii several times because it’s so beautiful by the crystal clear water,
    but have seen the original natives there today totally Overweight and to about 90%
    have all Type 2 Diabetes and this even to a degree where some could not take
    a public bus anymore because could not pass the doors by its dimensions !
    A Doctor Dentist I asked, what did happen with this native People here
    and he told me that by it’s Genes they have the preconditions for eating
    just various plants and for protein just fish with a superior digestion to
    survive, but by the American stile Super Markets today and our kind of
    food they cannot adjust themselves and the result is seen.

    .
     
  3. Bluetit1802

    Bluetit1802 Type 2 (in remission!) · Legend

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    I expect it was eating Low carb that gave you a fail. For diagnostic purposes, you have to eat in excess of 150g of carbs for 3 days beforehand, otherwise you may experience the "last meal effect" whereby your pancreas has been producing very little insulin due to the low carb. You then give it a big blast of glucose and it is taken by surprise, only producing the same insulin it has been doing on low carb. It takes a while for the pancreas to catch up.

    http://www.nhslothian.scot.nhs.uk/S...imaryCare/The Oral Glucose Tolerance Test.pdf

    There are many NHS sites saying the same thing........... and you only failed by a pin prick.
     
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  4. Safi

    Safi Prediabetes · Well-Known Member

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    Yeah - it's a distinct possibility & I'm a bit put out that the doctor didn't mention it! As I said though I do seem to do & feel very well on a low carb woe so I'll continue :)
     
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  5. Guzzler

    Guzzler Type 2 · Master

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    On this point I have to agree. The western (rather than American) diet is killing us.
    If you visit any large supermarket in the west and measure the area taken up by whole, fresh food and compare that to the area taken up by processed, sugar laden and carb dense pap it becomes obvious where some of the problem lays. I say 'some' as, obviously, other factors come into play.
    I have come to think of it as the 'Al Tesco' effect.
     
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  6. Ch.R.

    Ch.R. Type 1.5 · Well-Known Member

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    The majority like to think that all Humans about the same, but if we look
    to it objectively how food is really digested by everybody, then we can
    see huge differences in the Genes already, where one like me all my life
    could eat anything and still was always a little underweight by my faster
    digestion with less efficiency and others not even eating the same, but
    have a slow digestion by resulting increased efficiency gain weight.
    I presently have to eat daily CH 300g just to gain monthly 1kg I need
    to complete 7kg more to get back to my normal little underweight and
    this by T1.5D I luckily can achieve by HbA1c in Normal Healthy Range.
    This beside and additionally of today’s BS Food in the Markets and
    if something is healthy in some small corner then maybe expensively,
    where it should be the contrary, but the Govs . . . .
    I have some simple Diet for People with overweight problems by 1 Egg-White
    per 11kg of Ideal-Bodyweight mixed with Milk and Fruits like a tasty Milkshake
    in the morning, with for the rest of the day just Vegetables, Reis, Beans, Salads,
    Fruits, Etc. and also women would not have any monthly problems because of
    the necessary Protein the body need and nicer Skin without any Cellulites.

    I think as prevention there should be some smart Gene Test for awareness
    and this long before of any Type 2 Symptoms !

    .

    .
     
  7. Guzzler

    Guzzler Type 2 · Master

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    Perhaps there will come a day when a 'profile' will be available as perhaps like the heel prick tests babies are given soon after birth. A screening test that is accurate and whereby risk factors per nature/nurture could be monitored. I may be having pipe dreams, though.
     
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  8. Oldvatr

    Oldvatr Type 2 · Expert

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    Doctors are trained to assume that their patients are either eating badly or are using the recommended Eatwell Plate diet so will not need to forcefeed carbs to change their response in time for the OGTT as prescribed. They are not really accepting or understand the ramifications of an LC diet.
     
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  9. Oldvatr

    Oldvatr Type 2 · Expert

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    The term cholesterol you use above - are you thinking TC or Trigs? The test described by CherryAA uses Fasting Trigs value not TC.
    It is reported that when an LCHF diet starts, and during the period of greatest weight loss at that start, then the LDL level rises due to having higher diet fat intake, and also the body creating more LDL through neolipogenesis making fats from carbs in response to the lowered bgl and the associated liver dumps also emptying the fat stored in the liver (assuming ketogenic action is happening)
    As a respomse to the rise in LDL above, the body then increases HDL to cope with the increase, and so the TC value rises, but the Trigs value may not rise during this phase. Eventually when things settle, there is evidence that the keto diet catches up and burns off the dietary fat intake so LDL drops and TC lowers,

    The above treatise I give does not involve insulin, so does not affect the IR test result until the final stage when the trigs value responds to the LCHF diet. So the formula will respond to both the FBGL dropping due to the retricted carb input, and also the change in trigs.

    So my question is that this formula appears to be very diet sensitive The corollary is that medication can also reduce FBL so apparently registering an improvement in IR, BUT most T2 meds work by forcing glucose into the fat stores, so actually making IR worse (going by current thinking wrt fatty liver / pancreas being behind IR) This seems to me to be a dichotomy in the test itself.
     
  10. LittleGreyCat

    LittleGreyCat Type 2 · Well-Known Member

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    Just to remind myself and inform others, these are my latest test results from 30th March 2017 when I am pretty sure I had been in nutritional ketosis since early January. Not using QUOTE box because I find it hard to read and have become used to skipping it anyway.

    "
    Coded entry Serum TSH level 2.92 miu/L [0.27 - 4.2]
    Coded entry Serum cholesterol/HDL ratio 4.47 mmol/mmol
    Coded entry Serum HDL cholesterol level 1.78 mmol/L [0.9 - 1.45]
    Coded entry Serum triglyceride levels 1.44 mmol/L [0.3 - 2.3]
    Coded entry Serum cholesterol level 7.95 mmol/L
    Coded entry Serum free T4 level 17.1 pmol/L [12 - 22]
    Coded entry Haemoglobin A1c level - IFCC standardised 40 mmol/mol - HbA1c levl - IFCC standardised HbA1c levl - IFCC standardised, (TMcC327) - Normal - No Action
    Coded entry Serum lipid levels - Serum lipids, (AMS327) - pn Dr CS
    Coded entry Thyroid function test - Thyroid function test, (AMS327) - Normal - No Action
    Coded entry Serum HDL cholesterol level - Serum HDL cholesterol level, (AMS327) - pn Dr CS
    Coded entry Haemoglobin A1c level 5.8 % [4 - 6.3] - Haemoglobin A1c level, (TMcC327) - Normal - No Action, Please note, there has been a change in current HPLC, HbA1c standardisation resulting in a uniform lowering, of results across the analytical range by:, NGSP HbA1c 0.1 - 0.3 %, IFCC HbA1c 1 - 3 mmol/mol, Please take this into consideration when interpreting, HbA1c results., An HbA1c of 48 mmol/mol (6.5%) is recommended as the, cut point for diagnosing diabetes. A value of less than, 48 mmol/mol (6.5%) does not exclude diabetes diagnosed, using glucose tests.
    Coded entry Serum LDL cholesterol level 5.51 mmol/L - Serum LDL cholesterol level, (AMS327) - pn Dr CS, Consider the possibility of FH (familial, hypercholesterolaemia), especially if there is, personal/family history of premature CHD (MI <60 in, first degree relative or <50 in second-degree, relative). All with FH should be offered a referral to, the Lipid Clinic for confirmation of diagnosis and, initiation of cascade testing. NICE guideline 71.
    "

    The surgery has switched from EMIS to Systemonline to align with other practices they are collaborating with.
    The format of the report is new and has some additional information but is very poor compared to the EMIS system which gave me wonderful analytics of historical test results plus the ability to print them out and export them.

    Anyway, highlighted certain areas.
    Please note the comments about the lowering of HbA1c results by changes in standardisation.

    The fly in the ointment of my blood lipids is the high LDL level which in turn puts the TC to HDL ratio out of normal. If my LDL measurement was lower all the other figures would be peachy. This test was fasting (by my choice, not declared as such). Note the triggers to get the GP to have a quiet word with me.

    As I have said, since it doesn't give a FBG number I can't check against the formula.
     
  11. Bluetit1802

    Bluetit1802 Type 2 (in remission!) · Legend

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    Mine doesn't say that. It simply says Note change to IFCC HbA1c (mmol/mol) reporting as of 23/01/12. Equivalent DCCT diabetic target range is 48 to 59mmol/mol.

    I wonder if when your lab did the change their machinery didn't cope as well? All labs are different and there are several types of machinery. I have read elsewhere that differing machinery can produce different results.

    Did you do your own FBG that day, or do you have an average you could use?
     
  12. LittleGreyCat

    LittleGreyCat Type 2 · Well-Known Member

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    I didn't test before my blood test because I saw no need. I may do in the future.
    However the thing I have most problems with on this is the use of FBG as part of the formula.
    FBG can go up or down from day to day for no apparent reason.
    Unless triglycerides change on a daily basis in strict relation to FBG so the formula is consistent then I can't see that it can be an accurate measure of IR.
    Even so if my test is in the afternoon (I can easily fast that long) how does the trig value relate to the BG value some 6-8 hours earlier?
    Presumably I would have to finger prick just before or just after the blood sample was taken.
     
  13. CherryAA

    CherryAA Type 2 · Well-Known Member

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    This data seems entirely consistent with the theory to me . My reading would be you have been extraordonarily blessed with very stable trigs in 9 tests of 0.5 to 0.6 both years ago and today.

    From 2011 that started rising and culminated with both cancer diagnosis in 2013 and a diabetes diagnosis in 2014 and possibly an unknown highpoint Thereafter you gradually got back to your base line 0.6 after a few years of LCHF.

    My own trigs were also very low for a number of years until they started to rise consistently and my diabetes diagnosis was the high point of my trigs before I have started to bring them back down with LCHF though not yet quite to my personal baseline which was 0.4.

    My interpretation of this would be that it is not the ingestion of carbs per se that causes high fasting trigs -
    Therefore while metabolically healthy it would seem that is it possible to process those carbs efficiently without damage.

    With age and increasing obesity comes a difficulty in carrying on that processing and thus it is the metabolic derangement that is the first manifestation of insulin resistance/ carb intolerance that then contributes to the rising trigs.

    Having then lost the ability to process the carbs through that derangement - cutting out the carbs gets you back to where you should be. Whether you can ever actually be " cured" - which in my book in these terms would be - eating unrestricted carbs within the context of a healthy non wait gaining diet composed largely of real foods, whilst still having the same low base of trigs you started with years ago and normal hab1C and fasting glucose. or whether it is always going to be a question of "control" is obviously what is being tested at present via a variety of means. ,
     
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  14. CherryAA

    CherryAA Type 2 · Well-Known Member

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    As others have now confirmed that it is indeed an " existing" test - I think this particular debate is at an end.
     
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  15. CherryAA

    CherryAA Type 2 · Well-Known Member

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    My current experience has been reduced trigs on fasting today on LCHF, higher trigs on fasting when diagnoses, reduces trigs on fasting when young and healthy and deteriorating trigs on fasting in between. All pretty much as the formula predicts .

    If recent studies link the trig detritus to atherosceleroris and increasing study suggests that atheroscelorosis is itself at least to an extent a function of the action of insulin ( along side practically all other diseases it seems ) then the seems consistent to me as well . ( from an accountants perspective - I emphasise - not a medical one) !
     
  16. Bluetit1802

    Bluetit1802 Type 2 (in remission!) · Legend

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    I have everything crossed that the trigs/glucose test does give a good indication of insulin resistance. My current result from this test has me as normal. :) I agree my data is consistent with the theory.
     
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  17. CherryAA

    CherryAA Type 2 · Well-Known Member

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    That's really interesting so basically looking at my own 20 years of data, I pretty much got your age, weight and diagnosis conditions right :)

    Maybe there is something to this accountancy lark :) . In any event given all of the data now coming about the balance of carbs/ fats in the human diet, it sounds like your first GP probably did you a bit of a favour, even if she did also give you a hell of a fright ) !
     
  18. CherryAA

    CherryAA Type 2 · Well-Known Member

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    I would expect that the two figures for any test need to be taken at the same time to maintain some kind of internal consistency, including this one . In my own case the doctor reports back my glucose levels from the same blood sample as the lipid profile so it is consistent.

    I doubt very much that FBG changes for no apparent reason - Its certainly true that at present we don't actually know what the reasons actually are - (which is a tad annoying ! )

    I do now know I can change my FBG fairly reliably by choosing what and when to eat the day before and choosing how long to keep that particular regime up. That is not to say that these are the only factors but they certainly seem to play a big part.
     
  19. CherryAA

    CherryAA Type 2 · Well-Known Member

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    Thank you @darkhorse . As I've already said - my reason for looking into this was to see if there was any indication with my own blood tests over many years, consistent with the development of diabetes.

    My thinking had been that given we now know it takes years for insulin resistance to become diabetes, and when it does that diabetes is implicated in myriad diseases - then it seemed to be extremely unlikely that its development would not manifest somewhere over the years from a standard blood sample. Thus if one could identify which ones of the tests might be relevant then it was worth seeing if someone had done it. I started with trigs because that one seemed to be the most obvious . It also means that now I have a baseline to compare my latest results with my former healthier self ( fasting trigs of 0.44 - current 0.8 ) so someway to go yet - also a similar story to my hab1C of 42 for which I have no healthy comparative !)
     
  20. CherryAA

    CherryAA Type 2 · Well-Known Member

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    Or another way to put this, would be is that the original natives have similar genes to all the rest of us, and they,like all of the rest of us, are being poisoned by a high carb, high processed food diet and could equally be " cured " just like the rest of us with a proper real food diet.
     
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