Question about insulin resistance when NOT T2D

(Cindy) #1

When someone is not a diabetic, is there any way to know how insulin resistant they are? Obviously, I’m asking about me…I’ve been overweight to some degree or other since my late teens (53 now) and I know from reading that overweight=insulin resistant. But my blood sugar has always been fine, A1C normal, etc. I’m not on any medications…so I’m curious about how insulin resistant I might be.

I’m also not sure there’s any practical application to that question. Is there any correlation between adjusting to a ketogenic diet with level of insulin resistance? I feel like I’ve been able to transition to keto (day 10?) relatively easily and with no adverse effects.

#2

You can get a fasting insulin test but I’d get it before you’ve been keto too long as that can skew the result.

(Cindy) #3

Ah, hadn’t thought about that. It’s never been tested despite years of going to my GP. She’s always like “Of course, you need to lose weight.” And she’s willing to prescribe some new weight loss drug. :frowning: But never tested for insulin levels. I’m pretty sure that if I went to see her now and asked her to run a fasting insulin, she’d question why and I really don’t care to try to educate her. So I think I’ll just trust the “keto process” and let that take care of insulin levels.

My mom and step-dad have been T2D for years…and have never had a fasting insulin drawn. sheesh.

#4

Apparently your fasting triglyceride to HDL ratio is a good proxy - you want low trigs to high HDL. You could probably easily convince your doctor to run that - they loooooove cholesterol tests.

Edit: also [spoiler]fuck[/spoiler] this

(Cindy) #5

Fasting triglycerides to HDL have always been good. It’s one of the frustrating things about being fat. LOL On paper, I look very healthy. The only time things were way out wack was when I was anemic off and on for a couple of years. That was due to crazy menstrual periods, but my then doctor didn’t want to believe that, either. Wanted me to have upper and lower GI scans to check for an internal bleed. Funny thing…when I had an ablation with my ob/gyn to stop the period madness, within 6 weeks, I was no longer anemic.

Can you tell I don’t have a lot of respect for conventional doctors? While I was anemic, my doctor also tested for RM spotted tick fever (because she saw a bite that I told her was from a tick) and it came back positive. But it was only positive because lab norms are only “norms” when you have a normal amount of RBCs, WBCs, etc. She prescribed some heavy duty antibiotics “just in case, because it’s nothing to mess with.” But I had NO other symptoms. I didn’t take them.

Half the time, I feel like I’m the one trying to educate my doctors. So yeah, fuck that. :wink:

(Running from stupidity) #6

Can you change docs? Is that possible? Mine is awesome. Despite being from New Zealand :slight_smile:

(Cindy) #7

Not easily. Very few doctors around here take new patients. They also have to be within our insurance plan. I’ve had mainly 2 GPs over the years so I realize that’s not a good sample, but I just don’t have the patience to try out a new one, find out that they’re the same as the other two, find another new one, rinse and repeat. At least my current one pretty much let’s me do my own thing. If I want something, like for a sinus infection, she’ll prescribe it. If I say no, it’s not that bad, she leaves it alone. So she’s not super pushy, but will listen when I say “I need this.”

(John) #8

https://requestatest.com/glucose-tolerance-test-2-hour--testing

(Robert C) #9

I am not a doctor but I do not think it is easy to determine how insulin resistant you are.

If you go with Dr. Fung’s analogy (not sure if I have this exactly right).

It is similar to listening on headphones for a while, feeling like you cannot hear them well enough, turning them up, again not feeling like you hear well enough, turning them up - over and over. You build up a resistance to the sound.

That is the same as your body producing extra insulin to push sugar out of your blood stream, eat more carbs, produce more insulin - over and over.

The answer is to turn down the headphones and let your ears adjust or to deal with insulin, to eat less carbs (or fast).

But, the point is, if you ask the person listening to the headphones if they can hear the music - they’ll answer “yes, just fine”. But, on that spiral, they will eventually go deaf.

Same with insulin resistance (I think) - if you test your A1C or glucose - everything looks okay. The overproduction of insulin has kept the blood glucose normal. But, just like going deaf, that will work until it doesn’t work anymore. Then, suddenly, inexplicable, blood sugar goes way up because you can’t produce enough insulin to clear the blood - you are maxed out - so doctors recommend insulin injections.

Since you have been overweight your whole life - you might want to assume you are on that track (especially if there is any family history of diabetes). Being thin and on keto just about guarantees you are not on that track. Really, what is the alternative, assume a good A1C and blood sugar numbers means it is okay to stay overweight? Many things catch up to people in their 50s and 60s (troubled sleep, joint pain, balance issues etc.) - all are made better if you are lighter (and do at least some exercise).

(Cindy) #10

Rob, I’m certainly not looking for a reason to stay overweight. I’ve fought it with one diet after another, and even weight loss surgery. I’ve always been active, from being an overweight aerobics instructor, an outdoor educator (lots of hiking up and down a gorge), riding horses, lifting weights, working out with personal trainers, and I’m a 2nd degree black belt.

Of course, I have a better understanding now of why those diets failed, but at the time, I was trying to do what I was told was right. :frowning:

(Robert C) #11

I’m a little older than you and I’ve been in the same battle but - not nearly as active as you!
I too have good A1C and good glucose but, also almost always overweight (and some high blood pressure).
Even so, I’ve decided to assume I’m building resistance and cut the carbs (and fast).
As far as I know, keto and fasting are the best way to cut insulin resistance (as well as increase health span and life span).

(Candy Lind) #12

That’s not a Doctor, it’s a pharmaceutical rep. Fire her.

(Cindy) #13

I’m thrilled with keto so far. For so long, I’ve felt guilty for not eating breakfast or even “3 squares a day.” I’ve always struggled to eat when (and what) I should (per the old dogma)…so I’m loving this. I ate breakfast this morning about 10 am and then some dinner about 7pm. Wasn’t hungry in between and no guilt for “skipping” lunch.

I’m already doing a bit of fasting. Maybe 18 or 19 hrs so far? But not intentionally as a fast…just letting my hunger determine when I eat. I do, at some point, want to try 24 or 36 hrs, but everything I’ve read says that I should wait until I’m truly fat adapted…and/or let the initial “honeymoon” phase of keto pass. Please correct if I’m wrong on that! I’m actually kind of looking forward to my first longer fast.

(Cindy) #14

She was my GP from years ago…so no need to fire her. :wink:

(Robert C) #15

You do not need to be truly fat adapted to fast (which is really hard to determine anyway).
Anyone can fast anytime - but coming from some diets (especially the standard American diet) would be a bumpier road.
If you are already past any signs of keto flu and not hungry between meals, you’ll probably feel fine fasting for a day (or more).

BTW - fasting gets you fat adapted faster!

Just try a dinner to dinner if you want (24) and then a dinner, skip a day and eat breakfast (36) or lunch (42).
These (especially 36 and 42) are what Dr. Fung suggests in the IDM program.
If you are overweight, you have several months worth of food on your body - you’ll be fine (and happy with the accelerated weight loss).

(Cindy) #16

I’m reading Dr. Fung’s book now. Haven’t finished it because I read at night after my work is done…it’s a great way to NOT want to snack. :wink:

So to make sure I understand (since I haven’t finished the book)…there’s no need to have a “normal” or feast day between? So for example (not sure why these numbers mess with my head but they do), we’ll use tonight. I had dinner…so nothing (but water, tea, etc) until dinner Saturday (there’s the 24), but then the clock re-starts, nothing on Sunday, breakfast on Monday (36) or lunch (42). Right? No need to eat more on Sunday , and re-start the clock Sunday night?

I know from what I’ve read so far that it’s ok to break a fast (duh) if I’m not feeling well or something, but I don’t want it set myself up for something too difficult in the beginning.

(Robert C) #17

Not exactly right.

I was not recommending them back-to-back to start - sorry about the confusing wording.

I think putting several days of keto in between would make it more enjoyable/acceptable.
Building up to 2 or 3 36 to 42 hour fasts a week over the next few months might be a good goal (and would be a lot of weight lost).

(You've tried everything else; why not try bacon?) #18

Isn’t that what an oral glucose tolerance test shows? Dr. Kraft believed it was possible to tell someone was diabetic twenty years before trouble would show up in the fasting glucose number. I believe that there’s a video knocking around of a presentation Ivor Cummins and Dr. Gerber did on Dr. Kraft and his work.

(Cindy) #19

Ah, ok, got it! Not sure yet when I’m going to try it, but it’ll be interesting!

(Empress of the Unexpected) #20

Not necessarily. I have been keto for seven months, and cannot skip a meal due to stomach pains . My doctor is investigating a possible ulcer.