High Fasting Insulin Levels

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Why Are Fasting Blood Glucose Numbers High?

Stumped by high fasting blood glucose results? Join the club. "It just doesn't compute. When I snack before bed, my fastings are lower than when I limit my night nibbles," says Pete Hyatt, 59, PWD type 2. "It's logical for people to point the finger for high fasting blood sugar numbers at what they eat between dinner and bed, but surprisingly food isn't the lead villain," says Robert Chilton, M.D., a cardiologist and professor of medicine at the University of Texas Health Science Center at San Antonio. The true culprit is compromised hormonal control of blood glucose levels. The Essential Hormones During the years (up to a decade) that type 2 diabetes develops, the hormonal control of blood glucose breaks down. Four hormones are involved in glucose control: Insulin, made in the beta cells of the pancreas, helps the body use glucose from food by enabling glucose to move into the body's cells for energy. People with type 2 diabetes have slowly dwindling insulin reserves. Amylin, secreted from the beta cells, slows the release of glucose into the bloodstream after eating by slowing stomach-emptying and increasing the feeling of fullness. People with type 1 and type 2 diabetes are amyl Continue reading >>

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Popular Questions

  1. hangry

    I read on the forum about individuals who have had their insulin level checked. My docs have never mentioned the possibility, nor the cost. I did know that a really expensive test existed for this some years back. I know the standards on some things have changed. Yesterday morning I spoke with a fellow sufferer of Diabetes who spoke of the unpleasant, many times he underwent many hour Glucose Tolerance testing. I don't think Glucose Tolerance tests are used so much any more. I don't know of their value, or why such tests are not done. I am glad I did not have to do it.
    I am looking forward to when we have a Continuous Glucose Monitor that is non invasive, and includes simultaneous Insulin levels.
    Anyway. How might I be helped by knowing my insulin levels? What is the probablity of my doc ever testing for it? Under what conditions?

  2. john-c-3

    Fasting insulin is a standard test that the Dr can add if he wants to. Mine added it when I asked for it. I wanted to see if my insulin was coming down because that is my goal. To reverse insulin resistance, not only reducing hyperglycemia. There is no "home" test. Insulin is a lot harder to measure than glucose and requires special equipment you would find in a lab.
    Fasting insulin is not a very accurate number because it does not correlate so well with insulin resistance, but it's better than nothing. A number <5 usually means you are in good shape. A number like 15 is not so good but exactly how bad is not clear. Higher numbers are more obviously bad. It's a little more useful (maybe) when applied in the HOMA-IR formula along with fasting glucose. HOMA-IR has an 80% correlation with insulin resistance.
    Healthy Range: 1.0 (0.5–1.4)
    Less than 1.0 means you are insulin-sensitive which is optimal.
    Above 1.9 indicates early insulin resistance.
    Above 2.9 indicates significant insulin resistance.
    My first HOMA-IR after Dx was 3.5, and my second was 2.5 which implies I am making progress.
    If I can get my insulin down to 5.0 with an FBG of 80 that would be a HOMA-IR of 1.0
    The best way to measure insulin dysfunction is with a Kraft Insulin Assay. A glucose tolerance test that also measures insulin. Then you get the dynamic response which is more informative.

  3. t1wayne

    Frank - the usual test used to determine insulin production is the C-peptide test. C-peptide and insulin are BOTH produced by the pancreatic beta cells, in matching quantities, during the production of insulin, which involves the breakup of proinsulin, a precursor to the insulin hormone (that's a very simplistic summation, but the gist of it). Anyway... C-peptide is a much easier (and therefore, cheaper) substance to test for. When trying to determine what type a diabetic is, this is the standard test used... T1's have NO (or virtually no) C-peptide or insulin, while T2's have more-than-"normal" (non-diabetic) levels of C-peptide and insulin.
    An actual insulin test can be performed as well... but this test is generally used in more limited circumstances. The primary one of these is suspected insulinoma, subsequent testing to verify that the tumor removal was successful, and later to verify that the tumor has not returned/recurred. After that... docs use this test to verify the success of islet cell transplants (in T1 diabetics), and to determine if/when a T2 diabetic may need to start injecting insulin. With any luck, you'll never need this test.
    Generally speaking, the C-peptide test is considered adequate to confirm insulin resistance... if there is excess C-peptide present, there is excess endogenous insulin present, because the one is a byproduct of the other. OTOH - if exogenous insulin is being injected, the lab performing the insulin test must be notified... and the test will be more expensive than usual (it must then be specific for endogenous insulin).
    The OGTT is the gold standard of diabetes diagnosis tools... but it's expensive, and the comparatively inexpensive HbA1c test has become the go-to test... NOT because it's better - it's NOT; as a matter of fact, it took years before the standard-setters would accept the HbA1c test as a diagnostic tool. It's ONLY advantage is it's relative cheapness.

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