Question:
How can we be tested for Insulin Resistance without a GTT?
9 mons out and I think that my Insulin Resistance has returned but I am curious on how I can be tested for it without taking a Glucose Tolerance Test which I know as a post-op I obviously can't take. Has anyone had IR return after surgery? I'll be seeing my endocrinologist at the end of the month but he's not so "up" on WLS and I want to be able to give him some ideas on how to better test me. Thanks. — KDFJones (posted on June 14, 2006)
June 14, 2006
Ask to have a FASTING INSULIN LEVEL drawn with your next fasting labs. Not
a glucose and not an HbA1c. Before surgery my insulin level was 16
(reference range 1-16) and I was on 2000mg per day of Glucophage ER. (My
insulin level woudl "shoot through the roof" whenever I ate,
according to my endocrinologist.) My last level (and I am 3.5 years out)
was 9 (same reference range) and I am not on any medications. When you are
insulin resistant, your glucose levels and HbA1c can be perfectly normal
because your pancreas is pumping out a LOT of insulin to keep things
normal. Another way you can check this yourself, if you have a glucose
monitor, is to check you blood sugar 1 hour after a meal, then 2 hours
after that. If insulin resistance has returned, your one hour reading will
be above normal, and the one two hours later will be very low. This is
because, after you eat, you don't have enough insulin working, but two
hours later, after you have pumped out a bunch, your blood sugars will run
low do to the over abundance of insulin.
— koogy
June 14, 2006
Hi Susan K...I have a follow up question - Why won't a HbA1C test tell you
what you need to know about insulin resistance? Thanks,
Sue T
— lovey063
June 15, 2006
n HbA1c will not show insulin resistance. An HbA1c is sort of a "time
line" snapshot of blood sugars. If your HbA1c is running high that
means your measurable blood sugars are generally running high and you don't
have enough insulin. If your HbA1c is normal, you may be making enough
insulin to handle the blood sugars, BUT since the human body struggles to
maintain balance, you could still be pumping out an over abundance of
insulin to keep your blood sugars stable, because your cells are still
insulin resistant. So, the HbA1c can be entirely normal until such time the
pancreas can't keep up the over production and - viole' - the HbA1c starts
to rise because the blood sugars are no longer controlled and diabetes
begins. That is why it's so important to treat insulin resistance and
doctors are just starting to realize that.
— koogy
June 15, 2006
Thanks Susan and Kim!
— lovey063
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