Has Anyone Actually Been Tested for Insulin Resistance?

(Windmill Tilter) #1

Like a lot of folks, I found the ketogenic diet through Dr. Fung’s “The Obesity Code”. Dr. Fung’s contention that insulin resistance is a key driver in obesity made a lot of sense to me. I also believe that I am insulin resistant, although I have no evidence of that. I’d be curious to know what my level of insulin resistance is now, so that I have a baseline (I’m only 1 month into keto). I’d like to take another fasting insulin test in 3 months so that I can quantify the improvement in my insulin resistance.

We talk an awful lot about insulin resistance on this forum. Many of us here believe it is the key driver in our obesity and metabolic dysfunction. I see hundreds of pictures of Keto Mojo readings for ketones and glucose, but I have recall seeing a single mention of fasting insulin. People may think that tracking glucose is a good proxy for insulin resistance, but that isn’t actually true. They are related, but insulin resistance is defined by metric HOMA IR ( Homeostatic Model Assessment of Insulin Resistance). The calculation is (Fasting Plasma Insulin * Fasting Plasma Glucose)/22.5. Just knowing your glucose level is insufficient. For those data geeks out there, it’s a big ol’ #DIV/0!.. :slight_smile:

Has anybody here actually quantified their insulin resistance? Does anybody know what it costs out of pocket (no insurance).

Here is an interesting article on testing fasting insulin level and the calculation methodology for insulin resistance.

https://www.thebloodcode.com/insulin/

(Bob M) #2

I have had a two hour OGTT (oral glucose tolerance test) done. They take blood sugar and insulin, give you a bolus of glucose, retake blood sugar and insulin at the 1 and 2 hour marks. Unfortunately, the idiots misread the order and only took the data before the bolus and two hours afterward. I did have my continuous glucose monitor on, though.

My doctor said it looked to her as if I was insulin sensitive. This is my (former) doctor:

https://www.amazon.com/Deep-Nutrition-Your-Genes-Traditional/dp/1250113822

Sadly, she got hired away from a medical practice to work at a corporation.

(bulkbiker) #3

I had mine tested here in the UK privately using a company called medichecks.

https://www.medichecks.com/diabetes-tests/insulin-resistance-test

(Bob M) #4

By the way, that link is for HOMA-IR, which I’ve found to be useless. My insulin changes all the time. I’ve had very high and very low fasting insulin levels while being on low carb the entire time. See the following:

Insulin-Glucose

You can see that my HOMA-IR varies radically, for no reasons I can figure out. My HbA1c went down but my insulin and HOMA-IR went up?

#5

Insulin changes by the moment, which makes it (and thus HOMA IR) only moderately useful as a measurement. In one of the 2KD podcasts, Dr Croft (I think) said that in her mind, anything over 30 means you’re insulin resistant but numbers under 30 are pretty much useless.

#6

She did?! Where is she working?

(Bob M) #7

I don’t know. The company is based in Florida, and she was mainly working from home in her Connecticut home, and then traveling to Florida when necessary. Or at least that was the plan the last time I saw her.

She did give me the name of another doctor who is low carb. But this new doctor is over an hour’s drive away from work (farther from my home). Dr. Shanahan was only 15 minutes away from my house. I do have an appointment set up for next month, so I’ll see how she is.

#8

ok, thanks. I did one phone session with her once (she looked at my tests and we discussed a good strategy going forward) and I liked her!

(Windmill Tilter) #9

That’s really interesting. HOMA-IR doesn’t look very useful after a quick look at your chart. It looks like the two hour OGTT (oral glucose tolerance test) looks like a better test. The whole 2-hour part makes me nervous about the cost though.

My bariatrician referred me to get an RMR test done for $900 not covered by insurance (it’s $100 everywhere else with the same equipment). Lab testing seems like the ultimate billion dollar oligopoly scam.

Thanks for setting me straight on the HOMA-IR! :slightly_smiling_face:

(Jennibc) #10

I just went and had my blood drawn for insulin levels yesterday. I have NEVER been tested and I am curious where I am now. I started gaining really rapidly in 1995 about 8 months after I started taking an SSRI for severe anxiety (Paxil) before it was all over I’d been on four of them over the course of 13 years (with a short break for child bearing purposes) and had put on 120 pounds. Back in early 2008 I had one of those Vo2 tests as I’d gotten so heavy even with exercising daily and eating reasonable amounts of food with 60% carb, 20%fat, 20%protein. The guy running the test said “It’s really interesting, you are only burning sugar, very little fat” and my MBR was a little low for my weight. I’d always suspected the drugs were at fault because I was able to lose about 30 pounds once during that period when I was off the drugs trying to conceive. But other than that I was weight loss resistant. So I tapered off the drugs. Knowing what I know now, I believe that class of drugs causes hyperinsulinemia in some people and that’s what happened to me. Being that I have managed to lose 106 pounds since tapering off those meds back in 2008, I will be interested to see what my insulin levels are today which is why I sought out the test. Maybe I should go and do another VO2 test and compare the results from 10 years ago. These last 11 months, where I have been eating a higher fat very low carb diet has been the most I’ve lost in a single year at almost 40 pounds so I do think insulin was the big culprit for me.

Of course, reading the above, maybe it was a waste of money. We will see.

(Windmill Tilter) #11

It’s amazing how significantly medications can impact weight gain. Congrats on your amazing success! It would be cool to see how VO2 max has changed over the last 10 years. There’s nothing better than having a “younger” body than you did 10 years ago. :smile:

I’m buying a indirect calorimeter next week. It measures: RMR (resting metabolic rate), VO2 max, and RQ (respiratory quotient). I’d be happy to measure your VO2 max on the house if you’re interested. If you live in the Hudson Valley of New York, shoot me a PM!

(Jennibc) #12

Thanks! But, alas, I am in Texas. UT does it for a reasonable price here (that’s where I did my DXA scan a few months ago) so I may make an appointment for early March. When I did the DXA back on Halloween, they told me I had 17 pounds of fat I still needed to lose to be in ‘fit’ territory. That was kind of disappointing because I was thinking I was pretty close to HWP territory. But I am now only 4 above goal so I know I will want to go have another one of those. All of this is adding up! No wonder I am wearing my old clothes that finally fit again vs. buying a new wardrobe.

(Full Metal KETO AF) #13

So I was reading an article this morning that said the insulin sensitivity created by the ketogenic diet is a false notion. Even though insulin is kept very low on the keto diet as soon as we eat carby foods we have a more drastic response to it than we did before keto. This is mentioned countless times on the forum as post carb hangover like symptoms. Usually the article stated when people on keto do the glucose tolerance test they fail miserably compared to pre keto testing. I have never had any insulin testing so I can’t speak personally about this. Maybe it’s a therapy more than a cure. Opinions?

:cowboy_hat_face:

#14

It’s recommended to carb up for ~a week before doing the tolerance test. Some people will test falsely low for insulin, like near the T1D range, if they get an OGTT without doing so.

As to long term insulin sensitivity gains, that depends largely on pancreas, liver and adipose tissue health as much as anything. Healing the root cause of the high insulin your body produces is a gradual process. There can be a change in insulin levels over time. Of course, if you go back to eating gobs of sugar, then it’s going to reverse the progress.

(Bunny) #15

I thought this might be an interesting experiment to try to see where the insulin resistance is at.

Take your blood glucose two hours after you eat, if it is an average of 145 or lower then you are probably not insulin resistant?

Test after each meal and record the stats?

Do another set of stats post meal but with exercise to relocate GLUT4 transporters?

…then compare

References:

[1] “…Normal and diabetic blood sugar ranges. For the majority of healthy individuals, normal blood sugar levels are as follows: Between 4.0 to 5.4 mmol/L (72 to 99 mg/dL) when fasting. Up to 7.8 mmol/L (140 mg/dL) 2 hours after eating. …”…More

(Ian) #16

Presumably to assess your potential for continued insulin resistance you would need to eat a relatively high carb meal (at least a 75 g bolus?) to test how quickly your blood glucose returns to normal, rather than a keto meal which will not trigger a high enough spike in blood sugar?

PS thanks for that link to the normal and diabetic blood ranges.

(Bunny) #17

Yes I was going to mention that too but you beat me to the punch line…lol

#18

It’s the increased insulin at normal post meal glucose range that is an early indicator of trouble.

(Full Metal KETO AF) #19

That sounds suspiciously like becoming “carb adapted” again. Which was kind of my point that the insulin response on keto is kept healthy but may be deceiving as an indication of real metabolic health. If we are only showing insulin sensitivity in the absence of carbohydrates is that really insulin sensitivity?

Of course I have never done the test but I was diagnosed as pre diabetic/diabetic with an HbA1c test and keto brought me into a normal range now. But if I took the test without a week of carb up it would show high insulin resistance if I got this right. Does your pancreas “forget” it’s job when we eat a ketogenic diet for an extended period of time and need time to get back in gear? Is this even an issue when we decide on a low carb lifestyle? It’s often stated that diabetes isn’t cured, it’s put in remission on keto. Eating carbs again rekindles the diabetes cycle of insulin response rising and insulin resistance climbing again. This was all brought up in my mind while reading an anti keto diabetes healing article that seems to be pushing macros of 80-85% carb / 5% fat / 10% protein as the best anti diabetes diet which just seems crazy to me. But the insulin resistance/sensitivity argument he put up was intriguing enough to finish an article that seemed like just another bunch of BS. Links at the end included stuff like heal your diabetes with lots of fresh fruit. Although diabetes absence isn’t the whole picture of health they ignore any other discussion on how this diet would affect other conditions. The crux of it was that protein and saturated fat are the diabetic demons, not carbs. :cowboy_hat_face:

#20

I think we’re talking about two different things here. One is physiological insulin resistance (PIR) which is a temporary condition during keto that goes away after a carb up.

The other is reversal of diabetes, which yes can un-reversed if the same stimulus is applied that was the original problem. But I believe there’s also an improvement of the condition depending on how damaged the body is. Losing visceral and adipose fat will make a long term difference. It might be possible to go back to more carbs of a not-so-toxic type further down the line, especially if caught in the early stages.