You can measure your own Insulin Resistance !

Mr_Pot said:

From the various references people have provided it seems TyG index is a thing rather than the idea of one doctor as I assumed from the original post. I think @CherryAA has been criticised unfairly, apologies if that includes me.

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Ch.R. said:

.

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 !

.

.

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badcat said:

I kind of understand the theory but not sure I see the point once the threshold into diabetes has been crossed. Results of other tests ( BS, Hba1c etc etc) will give a good indication of improving / deteriorating levels of IR. Seems more likely to be of any clinical use prior to diagnosis

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Oldvatr said:

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.

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LittleGreyCat said:

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.

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Oldvatr said:

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.

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Oldvatr said:

I agree with the points you make here, but I am still having difficulty understanding the theory behind the formula, and how it mught relate to either my level of resistance to insulin, or even my level of insulin in my bloodstream.

If we forget the log function and the times 2 factor which are fixed values, the two variables are fasting trigs and fasting bgl.
Now my trigs currently changes once a year which is the only time my GP will authorise a lipid panel blood check, What it does on the remaining 364.25 days I have not a jot of evidence,

My FBGL varies on a daily basis, and can be heavily influenced by what I ate the night before, So unless there is a mechanism for averaging it before putting it into the formula than it is also just a moment in time, but not indicative of where I am at generally. (Note the lab check is also not daily and tends to be a 3 monthly or yearly blood test like the trigs check mentioed above)

So I have this dilemma, The formula is very dependant on what my last meal was before the sample was taken, and may jump suddenly once a year. How does it explain how successfully my insulin is generated or utilised? If I change my meds regime during the year, or change my diet during the year then these may have strong influence on the figures.

This is why I prefer to consider the OGTT as a basis for measuring my actual resistance by tracking the first response insulin phase following a defined step change stimulus. I think that with the introduction of CGMs then they will be able to develop a support app to measure the AUC (area under curve) of the response as an automatic function, so making the measurement repeatable and open to all without needing a lab check in the back room.

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