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HbA1c and fasting insulin

Discussion in 'Optimal Labs' started by Souldanzer, May 4, 2012.

  1. Souldanzer

    Souldanzer Banned

    I got my new hbA1c back today... 5.4 that's exactly 0.1 less than November last year (when it was 5.5). I was hoping it would have improved a little more :(

    My fasting insulin was 3. That doesn't sound terribly high? I think optimal is
     
  2. shilohman

    shilohman New Member

    Souldanzer;21608 wrote: I got my new hbA1c back today... 5.4 that's exactly 0.1 less than November last year (when it was 5.5). I was hoping it would have improved a little more :(

    My fasting insulin was 3. That doesn't sound terribly high? I think optimal is
     
  3. mambo

    mambo New Member

    You want to compare your fasting insulin with fasting blood glucose, not HbA1c, which is a 3 month moving average. How high was your "fasting" blood sugar? That should be there as part of your Comprehensive Metabolic Panel.
     
  4. Souldanzer

    Souldanzer Banned

    Thanks, guys.



    Didn't get the comprehensive panel b/c this was a follow up for elevated hbA1c. They didn't do the fasting glucose for whatever reason. It can be all over the place... from 80ies to 110. Don't remember that particular day's number. I think I have dawn syndrome, too.



    An average of 115 over three months of almost zero carb is too high. I'm happy it moved down as opposed to up but it's been almost six months...



    I got the fasting insulin b/c I don't know what's going on with my pancreas... is it still making insulin or have my beta cells gone byebye. I thought high hba1c equals IR and usually goes along with high insulin levels. But my insulin level isn't that high.
     
  5. mambo

    mambo New Member

    5.8 A1c is high and some endos would consider that to be prediabetic; some, even diabetic. However, most will think your IR is reversible at this stage. Fasting insulin under
     
  6. mambo

    mambo New Member

    I misread the post. I thought u said the A1c was 5.8/5.9, not 5.4/5.5. At that level, the IR could be mostly PSIR than prediabetes.



     
  7. Souldanzer

    Souldanzer Banned

    Thanks, mambo. PSIR is physiological insulin resistance?



    I don't want to do the OGTT b/c I don't feel comfortable with dowsing myself with carbs for a few days for such a test. I had been feeling unwell and suspecting elevated blood sugar for a few years by the time I actually got tested. At that point I already had been low carb for months. But was still dealing with junk food binges due to my eating disorder.



    I'm pretty sure at some point I was a T2D unless I have undiagnosed T1D developing. Unfortunately, I do think there is a chance my beta cells have burnt out.



    Not really sure where to go from here :confused: Request a non-fasting insulin with non-fasting BG? But that would still be a low-carb result. My BG was 121 an hour or so after eating the other day :eek: almost zero carb meal.
     
  8. mambo

    mambo New Member

    Yup, just do the OGTT test yourself but with yams or sweet potatoes. Get the equivalent of 75g net carbs, check after 1 and 2hs. If you're low-carbing, your BG will seem normal even if you may be insulin resistant. That's why 5.5 is deceptive: are you in fact prediabetc/diabetic but normal due to your VLC diet? Or are you in fact PLIR and will return to normal when eating moderate carbs? Most people who experience PLIR while being ketogenic, however, are a bit lower than 5.5 in A1c. That's why I think you could be either and may be mixed.



    Even if you're zero-carbing, your BG will rise after a carb-less meal. Proteins will definitely raise your BG, albeit slowly. 121 after a carbless meal but with plenty of proteins isn't unusual. The only way to check if you're IR is to see how you fare with moderate carbs (150/200g+)



     
  9. Destiny

    Destiny New Member

    Souldanzer;21608 wrote: I got my new hbA1c back today... 5.4 that's exactly 0.1 less than November last year (when it was 5.5). I was hoping it would have improved a little more :(

    My fasting insulin was 3. That doesn't sound terribly high? I think optimal is
     
  10. Souldanzer

    Souldanzer Banned

    @ Destiny: Thanks for the input. I am due to re-test... my last result was low progesterone with normal estrogen which throws off the ratio and technically makes me E dominant. Have been waiting to get labs again b/c of CT.



    @mambo: Thanks for explaining. I'm pretty sure my BG was too high before I ever started low carb. I intuitively started lowering carbs b/c I could tell they were making me feel real bad. I'm not sure I want to douse myself with that many carbs right now due to other health issues that are going on - but I really appreciate the input.



    Will discuss the result with my doc this week as I have to see him anyways. He is a paleo fan (and hates grains) and usually is happy to listen and learn. Maybe we'll repeat the tests with fasting BG included to get a more complete picture. My BG readings have been ranging from 70ies to 125 over the last few weeks so I'm not consistently too high.
     
  11. Valorie33

    Valorie33 New Member

    mambo;21623 wrote: 5.8 A1c is high and some endos would consider that to be prediabetic; some, even diabetic. However, most will think your IR is reversible at this stage. Fasting insulin under
     
  12. Souldanzer

    Souldanzer Banned

    If you've been low carb for that long this test will not necessarily give you any result, I think. You'd have to eat at a "normal" carb level for a few days to get an accurate reading, iirc.
     
  13. Valorie33

    Valorie33 New Member


    I think you are right !! I am reading everything I can find and I found this on a site about PCOS:

    Preparing for Your Oral Glucose Tolerance Test





    "Do I need to eat anything special before the test?

    3 DAYS BEFORE THE OGTT

    Plan on eating three healthy meals and snacks for 3 days before the test. You do not need to buy anything special, but you do need to make sure you have healthy foods to eat. Your meals should be balanced with plenty of carbohydrates."



    I know this will put me in a really bad place, and I will be weeks getting myself back to where I need to be, however I don't want the test showing something that isn't true. My Naturopath says I probably have been PCOS for years, but my doctor will not even look at hormones or anything like that. He just believes I eat too much fat and don't exercise enough.
     
  14. Destiny

    Destiny New Member


    The stuff is horrid, I still remember when pregnant. I question the whole test - drinking pure glucose? How does that fit with mimicking the day to day life of my glucose response?
     
  15. mambo

    mambo New Member

    I wouldn't take the test since it has little therapeutic value. All I would do is test myself with 75g net carbs with something benign like yams or sweet potatoes. All you need is a meter and a food scale. PLIR: all that means is you've become somewhat insulin resistant due to lack of carbs. Do 150g carbs daily for 3 days before taking the test; else you might fail due to PLIR, not actual IR. You should be fully insulin sensitive, then ... that is, if you do not have prediabetes/diabetes.



     
  16. Souldanzer

    Souldanzer Banned




    This actually could be dawn syndrome. I assume you got tested at the clinic later after waking up than usual. My FBG goes higher when I don't eat right away in the AM.
     
  17. Destiny

    Destiny New Member


    That makes a lot of sense, mambo!
     
  18. donkjellberg

    donkjellberg Silver

    Yeah, don't take that test. Exposing yourself to a toxic level of sugar just to find out something that can be done in a healthier way.



    Modern medicine makes less and less sense the more it is critically examined . . .
     
  19. Destiny

    Destiny New Member

    I got violently sick last night after CT. This was my second time like that. Really bad.



    I could not eat anything at all this morning so I made sure that I was drinking a lot to replenish the lost fluids.

    I measured my FBS this morning, it was 106 which is high. I have been between 86-96 since February.

    I just measured my sugar again. I was curious how it will look after 21 hrs of fasting. It was 128.



    Is it because I was so sick? I normally do not fast that long so I have no idea what my reading under regular fasting would be.
     
  20. Jack Kruse

    Jack Kruse Administrator

    Think of it like a insulin/glucose stress test......it is measuring dynamic reserve and function. Not day to day activity.
     

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