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Low Insulin Levels

Low-carb Lab Testing – Part 2 – Fasting Insulin Test

Low-carb Lab Testing – Part 2 – Fasting Insulin Test

This is the second installment in a series of articles exploring pertinent lab tests for people following low-carb diets, and how a slightly different perspective is needed when interpreting the results compared to results from people following high-carb diets. In the previous post in this series, we looked at three measurements related to blood glucose: fasting glucose, hemoglobin A1c, and fructosamine. We left off saying that while these are important to monitor regularly, they offer a limited view of a much larger metabolic control system. Blood glucose, hemoglobin A1c (HbA1c), and fructosamine indicate only what’s happening with blood glucose. They reveal nothing about insulin, which we will explore in this post. Knowing your numbers is an important step for anyone who wants to transform their health. Heads Up Health was designed to empower you to manage all of your health data, including your lab test results, in one secure location. You can learn more on our homepage or by clicking below to create your account and start building your own centralized health portfolio. The Fasting Insulin Test We said it last time, and it’s worth repeating: A fasting insulin test is the most important test your doctor probably isn’t ordering. The reason it’s so important to track insulin is that in many cases, fasting glucose and A1c remain normal due to chronically elevated insulin—that is, sky-high insulin is keeping the glucose “in check.” Fasting glucose and HbA1c are often the last things to rise, and they become elevated only after one of two things has happened: The pancreas can no longer pump out the inordinate amounts of insulin required to keep blood glucose within a safe range (sometimes called “beta cell burnout”). This is relatively rare, except in typ Continue reading >>

The Insulin Resistance Diet Protocol

The Insulin Resistance Diet Protocol

Understanding the cellular mechanisms of insulin resistance helps us choose more effective therapeutic interventions for the treatment and prevention of prediabetes and type 2 diabetes. Insulin resistance is present in individuals who are obese and those with diabetes mellitus. Several studies have found that an insulin resistance diet protocol and exercise can alter insulin signaling pathways and delay the onset of insulin resistance. It’s estimated that the number of diabetes sufferers in the world will double from about 190 million to 325 million during the next 25 years. (1) It’s obvious that we need to pay more attention to our lifestyle habits and make some changes. An insulin resistance diet, similar to a diabetic diet plan, helps you lose excess weight and regulate your insulin and blood glucose levels in order to reduce your risk of developing prediabetes and diabetes. Insulin Resistance Diet Research suggests that the primary cause of insulin resistance is excess weight, especially excess fat around the waist. Fortunately, weight loss can help the body respond better to insulin. The Diabetes Prevention Program and other large studies indicate that people with insulin resistance and prediabetes can often prevent or delay developing diabetes by changing their diets to follow an insulin resistance diet, along with losing weight. Here are seven ways to start eating an insulin resistance diet. 1. Limit Carbohydrates Research published in Diabetes, Metabolic Syndrome and Obesity suggests that monitoring carbohydrate intake, whether by carbohydrate counting or experience-based estimation, remains a key strategy in achieving glycemic control. Although all carbohydrates can be incorporated into carbohydrate counting, for good health, carbohydrates from vegetables, Continue reading >>

A Case Of Insulinoma Presenting With Low Serum Insulin Levels

A Case Of Insulinoma Presenting With Low Serum Insulin Levels

Insulinoma is a rare but potentially treatable cause of hypoglycaemia. We present a case where achieving a diagnosis of insulinoma was complicated by evidence of low serum insulin levels during documented biochemical hypoglycaemia. A 58 year old lady presented with weight gain and daily episodes of shaking, hot flushes and disorientation that were relieved by the ingestion of food. During symptomatic episodes home capillary blood glucose measurements suggested hypoglycaemia. Baseline biochemistry and a urinary sulphonylurea screen were negative. A 72 h fast was undertaken. Eight hours into the fast the patient became confused, aggressive and shaky. A laboratory serum glucose taken during the episode was low (2.1 mmol/l (NR=3.5–6.0)). Serum insulin and C-peptide levels were also low. (Insulin=3.3 mIU/l (NR=2.6–24.9) and C-peptide =0.7 mcg/l (NR=1.15–4.5). A spiral contrast CT showed a 1 cm hypodense nodule in the proximal body of the pancreas. A subsequent test carried out on the serum obtained during hypoglycaemia revealed an elevated pro-insulin level (32.7 pmol/l (NR 6.4–9.4)) A medial pancreatectomy was performed and the histology on the tumour resected showed a well-differentiated pancreatic endocrine neoplasm consistent with a diagnosis of insulinoma. The patient made an excellent recovery and is now asymptomatic. Pro-insulin is often the dominant hormone produced by insulinomas but pro-insulin levels are not always measured during hypoglycaemia. Older insulin assays demonstrate cross-reactivity, inadvertently measuring a combination of insulin and pro-insulin. However, newer insulin assays are more specific. This case therefore highlights the importance of routinely measuring pro-insulin levels in all patients during hypoglycaemia. There is a risk of missi Continue reading >>

You And Your Hormones

You And Your Hormones

What is insulin? Insulin is a hormone made by an organ located behind the stomach called the pancreas. Here, insulin is released into the bloodstream by specialised cells called beta cells found in areas of the pancreas called islets of langerhans (the term insulin comes from the Latin insula meaning island). Insulin can also be given as a medicine for patients with diabetes because they do not make enough of their own. It is usually given in the form of an injection. Insulin is released from the pancreas into the bloodstream. It is a hormone essential for us to live and has many effects on the whole body, mainly in controlling how the body uses carbohydrate and fat found in food. Insulin allows cells in the muscles, liver and fat (adipose tissue) to take up sugar (glucose) that has been absorbed into the bloodstream from food. This provides energy to the cells. This glucose can also be converted into fat to provide energy when glucose levels are too low. In addition, insulin has several other metabolic effects (such as stopping the breakdown of protein and fat). How is insulin controlled? When we eat food, glucose is absorbed from our gut into the bloodstream. This rise in blood glucose causes insulin to be released from the pancreas. Proteins in food and other hormones produced by the gut in response to food also stimulate insulin release. However, once the blood glucose levels return to normal, insulin release slows down. In addition, hormones released in times of acute stress, such as adrenaline, stop the release of insulin, leading to higher blood glucose levels. The release of insulin is tightly regulated in healthy people in order to balance food intake and the metabolic needs of the body. Insulin works in tandem with glucagon, another hormone produced by the pan Continue reading >>

How To Lower Insulin Levels

How To Lower Insulin Levels

Having high blood insulin levels, also called hyperinsulinemia, is a risk factor for developing type 2 diabetes and cardiovascular disease. Regulation of insulin levels is complex and has many influences. Following a healthy lifestyle that includes good nutrition practices, regular exercise and weight management is important for controlling your insulin levels. Some prescription medications may also lower your diabetes risk. Video of the Day High Blood Insulin Levels Your pancreas secretes the hormone insulin in response to eating. Insulin plays important roles in carbohydrate, protein and fat metabolism and storage of the excess calories you eat. Being overweight commonly causes a condition called insulin resistance -- or reduced tissue sensitivity to the effects of insulin. Increased fat in the blood and abdominal region often occur with insulin resistance. Your pancreas produces and releases more insulin to overcome reduced tissue sensitivity, resulting in high blood levels of the hormone. Insulin resistance may progress to development of type 2 diabetes. The U.S. Department of Health and Human Services' dietary guidelines suggest eating more dark green vegetables and fiber-rich, whole-grain foods and consuming less alcohol and foods containing trans fats and added sugars. The relationship between adhering to these guidelines and blood insulin levels was evaluated in a report published in the April 2007 issue of "Diabetes Care." More than 3,000 men and women without diabetes were included in the study. Strict adherence to U.S. dietary guidelines was associated with lower fasting insulin levels and estimates of insulin resistance in women. The study results also suggest that decreasing waist circumference may be more important for lowering blood insulin levels and ins Continue reading >>

Physiologic Effects Of Insulin

Physiologic Effects Of Insulin

Stand on a streetcorner and ask people if they know what insulin is, and many will reply, "Doesn't it have something to do with blood sugar?" Indeed, that is correct, but such a response is a bit like saying "Mozart? Wasn't he some kind of a musician?" Insulin is a key player in the control of intermediary metabolism, and the big picture is that it organizes the use of fuels for either storage or oxidation. Through these activities, insulin has profound effects on both carbohydrate and lipid metabolism, and significant influences on protein and mineral metabolism. Consequently, derangements in insulin signalling have widespread and devastating effects on many organs and tissues. The Insulin Receptor and Mechanism of Action Like the receptors for other protein hormones, the receptor for insulin is embedded in the plasma membrane. The insulin receptor is composed of two alpha subunits and two beta subunits linked by disulfide bonds. The alpha chains are entirely extracellular and house insulin binding domains, while the linked beta chains penetrate through the plasma membrane. The insulin receptor is a tyrosine kinase. In other words, it functions as an enzyme that transfers phosphate groups from ATP to tyrosine residues on intracellular target proteins. Binding of insulin to the alpha subunits causes the beta subunits to phosphorylate themselves (autophosphorylation), thus activating the catalytic activity of the receptor. The activated receptor then phosphorylates a number of intracellular proteins, which in turn alters their activity, thereby generating a biological response. Several intracellular proteins have been identified as phosphorylation substrates for the insulin receptor, the best-studied of which is insulin receptor substrate 1 or IRS-1. When IRS-1 is activa Continue reading >>

The Ketogenic Diet And Insulin Resistance

The Ketogenic Diet And Insulin Resistance

We recently touched on how you can use the ketogenic diet to control symptoms of diabetes such as elevated glucose and triglycerides. In this article, we examine research showing the impact that the ketogenic diet has on levels of the hormone insulin, a key regulator of blood sugar in the body. What is Insulin’s Role in the Body? Before we look at the research, we need to know our main players. Insulin is a protein-based hormone produced by beta-cells located in the pancreas. The pancreas, which is located under the stomach, also produces enzymes that aid with digestion. Insulin’s primary purpose is to regulate the metabolism of fats and carbohydrates. The digestive system breaks down carbohydrates, such as sugars and starches, into a molecule called glucose. This compound can be used by cells to produce energy through a process called cellular respiration. Insulin allows cells in the body absorb glucose, ultimately lowering levels of glucose in the blood stream. After a meal is consumed, blood glucose levels increase and the pancreas responds by releasing insulin into the blood. Insulin assists fat, liver, and muscle cells absorb glucose from the blood, resulting in lower levels of blood glucose. Insulin stimulates liver and muscle tissues to store excess glucose as a molecule called glycogen and also reduces glucose production by the liver. When blood sugar is low, the hormone glucagon (produced by alpha-cells in the pancreas) stimulate cells to break down glycogen into glucose that is subsequently released into the blood stream. In healthy people who do not have type II diabetes, these functions allow levels of blood glucose and insulin to stay in a normal range. What Is Insulin Resistance and Why Is It a Problem? Unfortunately, for many Americans and other peopl Continue reading >>

Four Steps To Reducing Insulin Levels

Four Steps To Reducing Insulin Levels

Metabolic Syndrome, a leading cause of weight gain and obesity, occurs when the body loses its ability to control insulin levels. Left untreated, glucose and insulin levels can become chronically elevated, resulting in obesity, diabetes and increasing the incidence of heart attack, strokes, cataracts and cancer. According to the Journal of the American Medical Association, over 80 million adults in the United States suffer from Metabolic Syndrome – and most don’t even know that such a condition exists – or that they have it. Obesity and “Poisoned” Food Supply In a paper recently published in Nature Clinical Practice: Endocrinology and Metabolism, nationally renowned obesity expert Dr. Robert Lustig observed that hyperinsulinemia – elevated insulin – does not result from being obese, but is the primary culprit in causing obesity. According to Lustig, much of the problem can be linked to a “poisoned” food supply that alters people’s biochemistry, causing them to eat more and move less. The processed foods most readily available in America – potato chips, cookies, yogurt and white bread – are loaded with sugars that cause the body to believe that it is hungry, which compels the body to consume more calories and conserve energy. Additionally, sugar makes the body produce more insulin, which then blocks hormones that would normally tell the brain to stop eating. This insulin floods the brain, and in particular the hypothalamus, which regulates energy use in the body. As a result, leptin, a hormone that tells the brain when the body needs more or less energy, can’t get its signal to the hypothalamus because the insulin is blocking the way. A New Approach to Healthy Weight Control Angered by the simplistic argument that obesity is caused by eating too Continue reading >>

Hypoglycaemia With Low Insulin Levels: What Insulin Tests Do Not Measure

Hypoglycaemia With Low Insulin Levels: What Insulin Tests Do Not Measure

This supplementary information is presented as submitted by the corresponding author. It has not been copy-edited by NTvG. Introduction Hypoglycaemia can be a diagnostic challenge. Besides glucose, measurements of insulin and C-peptide levels are recommended. Increased insulin levels may indicate the presence of an insulinoma or exogenous cause. The C-peptide concentration may help to differentiate between an endogenous or exogenous hyperinsulinism. We describe 2 patients in whom diagnostics proved difficult because of pitfalls in these diagnostics. Case description Patient A, a 45 year old woman with diabetes mellitus type 1, complained about ‘attacks’ of hypoglycaemia. Insulin glargine and insulin aspart were adapted. Nonetheless, in the following years, these hypoglycaemic periods became more frequent. Biochemical analyses during hypoglycaemia showed low glucose, insulin, pro-insulin and C-peptide concentrations. Therefore, factitia or an insulinoma were excluded. No evidence for insufficient counter regulation, adrenal insufficiency, celiac disease, insulin- or insulin receptor antibodies and IGF or BIG-IGFII overproduction was found. Without an appropriate explanation for these hypoglycaemias, glargine was tentatively discontinued. Unfortunately, a diabetic keto-acidosis arose. In a tertiary referral hospital glargine was replaced by insulin isofaan (NPH) and aspart by fast acting human insulin (actrapid). The patient was referred back without new insights. A few weeks later, she was presented again with hypoglycaemia. This time, we found low levels of glucose and C-peptide and high levels of insulin, suggesting factitia. We presumed a detection problem and previously missed exogenous insulin with our commercial insulin assay. The previous samples were tested a Continue reading >>

Calorie Restriction Not Key To Increasing Life, Lowering Insulin Level Is

Calorie Restriction Not Key To Increasing Life, Lowering Insulin Level Is

Numerous studies have shown that lowering your caloric intake may slow down aging, reduce age-related chronic diseases and extend lifespan. The effects have been observed in a variety of species from worms and yeast to rats and fish, and there’s evidence that it has a similar effect on the human lifespan. However, when digging deeper, it seems clear that the underlying factor that makes calorie restriction beneficial in the first place, is the lowering of insulin levels. What we now know about calorie restriction is that it reduces metabolic rate and oxidative stress, and alters neuroendocrine and sympathetic nervous system function in animals, as noted in a 2003 review in the American Journal of Clinical Nutrition. It also improves insulin sensitivity, and this factor may explain much of the longevity phenomenon, as again evidenced by the results in this latest study. This all makes perfect sense since we also know that high insulin levels speeds up the aging process. Reducing Sugar Consumption Can Add Years to Your Life I do believe that eating less is likely to be healthier for most people in the long run, but even more important is eating foods and drinking beverages that do not excessively raise your insulin levels. Eating sugar and grains, for example, increase your insulin level and is a sure way to accelerate the aging process. Beverages play a paramount role here, as high fructose corn syrup from soda is the number one source of calories in the US. and devastates your insulin resistance. Diets high in sugar and grains are also the primary culprit of obesity, and leanness, more so than food restriction in general, is also a key contributor to a long life, as evidenced by another 2003 study published in the journal Science. This elegant study from Harvard also Continue reading >>

Low Insulin Linked To Depression

Low Insulin Linked To Depression

Diabetes risk factors may increase odds of depressive symptoms…. Research has shown links between diabetes and depression. Now, it looks like people with early signs of diabetes may have a risk for depressive symptoms. According to a recent study, women who produce little insulin may have a higher risk of developing depressive symptoms, Results showed that women who produced the least amount of insulin had more than twice the odds of having symptoms of depression, compared to those who produced higher levels of insulin. Tasnime N. Akbaraly, PhD, of University of College London, and colleagues wanted to see if blood sugar and insulin levels were associated with the development of new symptoms of depression. They found that women with the lowest levels of insulin secretion had 2.18 times higher odds of developing depressive symptoms than those with higher insulin secretion. The researchers also found that fasting insulin levels (insulin levels before eating) were not associated with the development of depressive symptoms in men. In addition, fasting glucose levels (blood sugar levels before eating) were not associated with the development of depressive symptoms in either sex. Dr. Akbaraly and colleagues concluded that, the study suggests that low insulin secretion may put middle-aged women at risk for depressive symptoms. However, more research is needed to confirm this finding, The study included 3,145 adults, 23.5 percent of whom were women. Patients ranged in age from about 53 years to 68 years. Continue reading >>

C-peptide

C-peptide

A C-peptide test measures the level of this peptide in the blood. It is generally found in amounts equal to insulin because insulin and C-peptide are linked when first made by the pancreas. Insulin helps the body use and control the amount of sugar (glucose) in the blood. Insulin allows glucose to enter body cells where it is used for energy. The level of C-peptide in the blood can show how much insulin is being made by the pancreas . C-peptide does not affect the blood sugar level in the body. A C-peptide test can be done when diabetes has just been found and it is not clear whether type 1 diabetes or type 2 diabetes is present. A person whose pancreas does not make any insulin (type 1 diabetes) has a low level of insulin and C-peptide. A person with type 2 diabetes can have a normal or high level of C-peptide. A C-peptide test can also help find the cause of low blood sugar (hypoglycemia), such as excessive use of medicine to treat diabetes or a noncancerous growth (tumor) in the pancreas (insulinoma). Because man-made (synthetic) insulin does not have C-peptide, a person with a low blood sugar level from taking too much insulin will have a low C-peptide level but a high level of insulin. An insulinoma causes the pancreas to release too much insulin, which causes blood sugar levels to drop (hypoglycemia). A person with an insulinoma will have a high level of C-peptide in the blood when they have a high level of insulin. A C-peptide test is done to: Help tell the difference between type 1 diabetes and type 2 diabetes. Find the cause of low blood sugar (hypoglycemia). Check to see whether a tumor of the pancreas (insulinoma) was completely removed. You may be asked to stop eating and drinking for 8 hours before having this blood test. Insulin and some oral medicines use Continue reading >>

Insulin And Fat Storage

Insulin And Fat Storage

We left off last week with the question, “What prevents fat from leaving the fat cell?” If you missed out on it, you may want to read The Futility of Low-Calorie Diets. To quickly recap, we talked about the fact that your body has two main fuels: glucose (sugar) or fat. The preferred source of fuel is fat, but under certain circumstances, we can shift the body to using more sugar rather than fat. At times, such as being chased by a rabid dog, this is a good thing. However, it’s not a good thing if sugar remains the main fuel for most of the day. Relying on sugar means you’re not burning fat. Many people make lifestyle choices and nutrition decisions that have basically locked up their extra stored fat in their fat cells, making it useless for energy. The only way you can lose fat is if you use fat. You’ll be unsuccessful at losing fat if you don’t burn fat, even if you eat fewer calories and burn more through exercise. You can lose weight, but most of the loss will come from lean body mass, or muscle tissue, not fat. Fat Storage and Insulin The most significant factor in fat storage is the level of insulin in the blood. Insulin has many effects on the body. With respect to fat storage, insulin increases the storage of fat in fat cells and prevents fat cells from releasing fat for energy. This is such a key point for people to understand that I’ll repeat it: Insulin increases the storage of fat in fat cells and prevents the cells from releasing it for energy. Eight hormones stimulate fat utilization: epinephrine, norepinephrine, adrenocorticotrophic hormone (ACTH), glucagon, thyroid-stimulating hormone, melanocyte-stimulating hormone, vasopressin and growth hormone. One hormone prevents fat utilization: insulin. The pancreas releases insulin when blood suga Continue reading >>

2017 The Nemours Foundation. All Rights Reserved.

2017 The Nemours Foundation. All Rights Reserved.

This test measures the amount of insulin, the hormone that lets cells take in glucose. Glucose, a sugar that comes from food, is the body's main source of energy. Our bodies break down foods we eat into glucose and other nutrients, which are then absorbed into the bloodstream from the gastrointestinal tract. Glucose levels in the blood rise after meals and trigger the pancreas to make insulin and release it into the blood. Insulin works like a key that opens the doors to cells and allows the glucose in. Without insulin, glucose can't get into the cells and it stays in the bloodstream. For good health, the body must be able to keep insulin and glucose levels in balance. With too little insulin, blood sugar remains higher than normal (a condition known as hyperglycemia) and cells can't get the energy they need. With too much insulin, blood sugar decreases (hypoglycemia), causing symptoms such as sweating, trembling, lightheadedness, and in extreme cases, shock. The most common cause of abnormal fluctuations in blood sugar is diabetes. This test is often used to evaluate the cause of hypoglycemia (low blood sugar) or any other conditions related to abnormal insulin production. It's often used to diagnose and monitor insulin resistance, a condition in which the tissues become less sensitive to the effects of insulin, causing the pancreas to overcompensate and produce more insulin. Insulin resistance is common among obese people who may go on to develop type 2 diabetes and also in women with polycystic ovarian syndrome. Insulin levels are very low — despite the presence of high blood sugar levels — in children who have type 1 diabetes. Your doctor will let you know if any special preparations are needed for this test. Sometimes a child will need to avoid eating and drink Continue reading >>

Fasting Physiology – Part Ii

Fasting Physiology – Part Ii

There are many misconceptions about fasting. It is useful to review the physiology of what happens to our body when we eat nothing. Physiology Glucose and fat are the body’s main sources of energy. If glucose is not available, then the body will adjust by using fat, without any detrimental health effects. This is simply a natural part of life. Periods of low food availability have always been a part of human history. Mechanisms have evolved to adapt to this fact of Paleolithic life. The transition from the fed state to the fasted state occurs in several stages. Feeding – During meals, insulin levels are raised. This allows uptake of glucose into tissues such as the muscle or brain to be used directly for energy. Excess glucose is stored as glycogen in the liver. The post-absorptive phase – 6-24 hours after beginning fasting. Insulin levels start to fall. Breakdown of glycogen releases glucose for energy. Glycogen stores last for roughly 24 hours. Gluconeogenesis – 24 hours to 2 days – The liver manufactures new glucose from amino acids in a process called “gluconeogenesis”. Literally, this is translated as “making new glucose”. In non-diabetic persons, glucose levels fall but stay within the normal range. Ketosis – 2-3 days after beginning fasting – The low levels of insulin reached during fasting stimulate lipolysis, the breakdown of fat for energy. The storage form of fat, known as triglycerides, is broken into the glycerol backbone and three fatty acid chains. Glycerol is used for gluconeogenesis. Fatty acids may be used for directly for energy by many tissues in the body, but not the brain. Ketone bodies, capable of crossing the blood-brain barrier, are produced from fatty acids for use by the brain. After four days of fasting, approximately 75 Continue reading >>

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