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