What is the measure of insulin sensitivity?


#1

I have read many times what metabolic syndrome or insulin resistance syndrome is generally but what is the quantitative measure of insulin sensitivity? What is “good” vs meh baker bad and how is it measured?

TIA


#2

I saw this before: IF one doesn’t wanna go down the blood testing road.
is this what your asking about kinda?


(Michael) #3

Every type of cell can be insulin resistant and at different levels. You can measure you fat cell IR called lipid IR using NMR lipidprofile markers or using trig/HDL ratio. You can use blood tests to measure HOMA IR and Quick IR which I think looks mostly at overall cell IR using bloodwork and considering blood glucose and insulin. Not every cell type has a specific test, like lipid IR.


#4

While that might be an approximation I am actually happy to consider blood tests


#5

yes the blood tests are literally showing values on a physical body and an individual put against other outside sources like what is the physical body one is doing the bloodwork on…overweight and short or a leaner body without big fat deposits and taller and where is one with other real medical issues and meds etc they are handling…alot of big variables thrown in it all kinda. I feel ya on that.


(Bob M) #6

The best measure you can get is a Kraft test. Measure blood sugar and insulin while fasting > 12 hours. Drink glucose. Measure blood sugar and insulin at least at 1 hour and 2 hours. Some suggest 30 minutes, and the original Kraft test went something like 5 hours.

See this:

Also, some suggest eating 100+ grams of carbs for 3 days before the test. I did not do that, however, and my 2 hour results were pretty good. Glucose was fine, insulin was either fine or slightly high, depending on where you look

There are other tests where they “clamp” things, see this for instance:

I’m not sure you can get this done, though.


(Bacon enough and time) #7

Also known as an oral glucose tolerance test. You beat me to mentioning it!

Bikman says eating carbs 24 hours before the test is sufficient. The “problem” is that after we have been on keto for a while, the pancreas stops storing insulin for what is called the first-phase response. So that gives a “false” reading when one takes an OGTT. The problem is not that the resulting reading is inaccurate, but that it is misleading when the patient is on keto. So a bit of carb before the test, and no one gets alarmed by the response pattern to the glucose stimulus. It appears that a lot of medicine is going to have to be reworked, once most of the population goes keto.


#8

That’s your LP-IR score. It’s included with an NMR LipoProfile, not sure if you can get one on it’s own, pretty sure you need all the other numbers to come up with it.

You can also get a half descent idea by just doing your own GTT, hit yourself with 100g of dextrose and check your levels vs baseline at 30mins and an hour, if not back at baseline check again at 1.5hrs and 2hrs. Once you hit baseline you’re done. If you hit the 3hr mark, you’ve done the Kraft test.

NOTE: If you never eat carbs, like never above 20g, you’ll bomb a GTT as your body will over react to them. At that point it’s really not to trustworthy to make decisions on.

It doesn’t really matter where your sugars / Insulin go after carb-y meals, it matters how quick you return to baseline. The faster you get back to baseline or realistically back in a normal range, the more insulin sensitive you are.


(Bob M) #9

Here’s my data from a 2 hour Kraft test. They were suppose to take glucose and insulin at the 1 hour mark but did not:

Here’s the CGM data:

I meant to take blood sugar using my CGM and pinprick monitor at 1 hours, but I did this on Saturday morning with no coffee, and I could not keep my eyes open.

Even though I was keto beforehand and did not take in any carbs beforehand, my blood sugar at 2 hours was fine. This seems to say my insulin at 2 hours was fine:

Now, the peak glucose response was probably higher than it would have been if I would have “preloaded” by eating carbs. But the end result was fine.

As for LPIR, I’ve only had this done once:

This test was done 12/28/20.

I can guarantee that I was not more “insulin resistant” in 2020 than in 2018.

I personally have doubts about the relevance of the LPIR score.


#10

73!!! Damn dude! Somethings gotta be off there. That doesn’t seem to mentally work given how fast your peaks go back down near baseline. I’d agree though, going with near no carbs into an LP-IR is going to cause an over reaction, though I wouldn’t think like that.

I think they’re touchy-er than they let on, like cholesterol. My 2 tests were 3mo apart and I went from 36 to <25, that’s after going to my TKD/CKD thing I do, wish I got one while doing standard keto.