Who Should Be Tested For Insulin Resistance
Insulin resistance tests may be ordered for people with certain genetic and lifestyle risk factors. According to the National Institute of Diabetes and Digestive and Kidney Diseases , the following factors can make people more likely to develop insulin resistance and possibly prediabetes:
- Being overweight or obese.
- Having a history of polycystic ovary syndrome , gestational diabetes, heart disease, or stroke.
- Health issues like high blood pressure and/or abnormal cholesterol levels.
- Physical inactivity.
- A history of diabetes in the immediate family.
- Ethnicities such as African American, Alaska Native, American Indian, Asian American, Hispanic/Latino, Native Hawaiian, or Pacific Islander American.
- Hormonal disorders like Cushings syndrome or acromegaly.
- Taking certain medications like glucocorticoids, certain antipsychotics, and certain HIV medications.
- Sleep problems, such as sleep apnea.
The NIDDK also notes that excess fat in the abdomen and around the organs can be a cause of insulin resistance. A waist measurement of 40 inches or more for men and 35 inches or more for women is linked to insulin resistance, even if their body mass index is within a normal range.
If weight loss goals are not currently a realistic option, there are still ways to improve your blood sugar levels through diet and activity. Consult with your doctor to learn about the best options for your health.
> Signs That You Have May Insulin Resistance
Having several of the following may also be indicators of insulin resistance :
- You are middle-aged or older and overweight
- Increased abdominal circumference with a waist measurement of 35 inches or greater for a woman and 40 inches or greater for a man
- Increased Waist-Hip Circumference Ratio is associated with abdominal obesity and insulin resistance. This test is even more accurate than the waist measurement alone. A diagnosis of abdominal obesity is made if the waist-hip ratio is equal to or higher than 0.8 in females, and equal to or higher than 1.0 in males. For example, if your waist is 32 and your hips are 35 -> 32 divided by 35 = .91. This would indicate abdominal obesity. This can be helpful test that you can do on your own. And even if you are lean, high WHR levels are associated with insulin resistance markers.
- Waist to height ratio . < 42 very slim> 50 increased risk for insulin resistance and type 2 diabetes
- Acanthosis nigricans
- Skin tags
- Meeting 3 out of the 5 criteria as noted above
How To Test Insulin Resistance
The Gold Standard of insulin sensitivity/resistance testing is with something called a Hyperinsulinemia Euglycemic Clamp. It is an invasive procedure where insulin and glucose are infused into your veins and someone measures how much insulin is needed to keep your glucose levels in a certain range for an extended period of time. While definitely interesting, I wouldnt recommend this and other than a research lab I wouldnt know how to even try to attempt this technique.
No need for long lab drawing just a short one!
Luckily there is a calculation based off of your fasting glucose and insulin levels that predicts your insulin resistance very closely to the clamp method above. It is called the HOMA-IR Short for Homeostatic Model Assessment Insulin Resistance. The model was based off of young lean individuals using the clamp method so it isnt 100% accurate for the entire population but it definitely has a good correlation and can be calculated quite easily.
Here is how to calculate it using either the US Formula or International Formula
US Formula fasting Glucose x fasting Insulin / 405
International Formula fasting Glucose x fasting Insulin / 22.5
For example, my fasting Glucose was 90 mg/dL and my fasting insulin was 5 µU/mL so /405 = 1.11
There have been many proposed cutoff values depending on your age and race, but in general you can use this guideline:
You can get a pretty cheap one at Walmart!
1. Convince your doctor to order the test
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P Stands For Pressure
Your blood pressure is a measurement of the effort it takes for your heart to circulate blood throughout your cardiovascular system. The higher your blood pressure, the harder your heart must work to push blood throughout your body.
In most cases, hypertension is caused by the hardening of blood vessels, which creates resistance against your heart. Over time, hypertension can become life-threatening, because it increases your risk for a heart attack or stroke .
Most doctors prescribe medication to treat hypertension, unaware that simple dietary changes are more powerful and free of dangerous side effects .
The evidence-based research shows that hypertension is an independent risk factor for insulin resistance . Reducing your blood pressure to less than 120/80 without medication is essential in helping you reverse insulin resistance.
Recommended Blood Pressure RangeDiastolic pressure = 60-80 mmHg
How Does Insulin Resistance Happen
The obesity or weight-related spectrum of conditions has varied labels.
- Insulin Resistance.
Insulin Resistance isnt just for some people. It holds no prejudice. It develops in every body.
So then, how does insulin resistance happen?
The body, over time, grows resistant to insulin to some degree because insulin has been signaling your cells throughout your entire lifetime every time you eat and every time you experience an emotional rise or feel stressed. Insulin becomes especially overly present in a body that has been over-fueled, burdened, or over-loaded with glucose. Glucose is the sugar that foods break down into during digestion.
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How To Test For Insulin Resistance In Horses
How To Test For Insulin Resistance In Horses? Collect blood samples for glucose at 1, 5, 15, 25, 35, 45, 60, 75, 90, 105, 120, 135, and 150 minutes. Collect a blood sample for insulin at 45 minutes. A normal response is a glucose concentration back to baseline by 45 minutes and an insulin concentration < 100iu/ml at 45 minutes.
Is there a way to test for insulin resistance? There is no single test that can directly diagnose insulin resistance. Instead, your healthcare practitioner will consider several factors, including medical history, physical exam, signs and symptoms as well as test results.
How do they test for EMS in horses? To diagnose EMS in horses, insulin and glucose concentrations can be measured in a blood test. Horses are starved for 6 hours over night and a blood test taken in the morning. Stress raises insulin concentrations in horses so it is important not to take a blood sample whilst the horse is suffering from laminitis.
How do you diagnose EMS? A blood test can determine whether a horse has EMS. When a horse becomes insulin- resistant, the body produces more insulin to try to counteract it. A blood test that shows high insulin levels can be enough to diagnose EMS. Also, some signs of EMS are very similar to Equine Cushings Disease.
What Are Clinical Trials And Are They Right For You
Clinical trials are part of clinical research and at the heart of all medical advances. Clinical trials look at new ways to prevent, detect, or treat disease. Researchers also use clinical trials to look at other aspects of care, such as improving the quality of life for people with chronic illnesses. Find out if clinical trials are right for you.
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The 1800 Rule And Calculation
People who use this type of pump can use a calculation to find out how much rapid-acting insulin they need to reduce blood sugar by a certain amount.
The ADA give full instructions for deciding how much insulin a person needs when using an insulin pump. The individual should calculate this with the help of their healthcare provider.
Adjusting a dose incorrectly could be dangerous.
Recap: What You Need To Know About The Fasting Insulin Test
- Blood sugar conditions take years to develop, and most standard tests fail to detect the signs of pre-pre-diabetes.
- The fasting insulin test can help you detect insulin resistance early.
- Optimal insulin levels are below 8.
- You want optimal levels, not just normal or high-normal levels.
- While genetics can play a role, lifestyle changes can often prevent insulin problems.
- Diet, exercise, sleep, and stress management all play key roles in keeping insulin levels balanced.
- Studies have shown that working with a Health Coach like those at Knew significantly helped people manage chronic conditions, like blood sugar issues.
Do you need help with a blood sugar issue? Or do you suspect you may be at risk for developing such a condition? If so, we encourage you to reach out to your healthcare provider.
Visit our Services page to learn more about how Knew Health can empower you to be more proactive with your health. We provide you with the resources you need to reach and maintain your optimal, individual wellness, and we have your back when unexpected accidents and illnesses happen.
Knew Health is only available in the US, excluding Vermont , Alaska, Washington. Please contact us with any questions.
Evexia provides comprehensive, cutting-edge lab services at convenient locations nationwide. Knew Health members have access to free and discounted tests, panels, and specialty kits with no prior approval needed.
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Back To The Basics One More Test For Insulin Resistance
- Waist to Height Ratio
A completely free yet accurate marker of insulin resistance is the waist to height ratio. This is incredibly simple to calculate as it is the waist circumference divided by height in the same units. A 2010 study following 11,000 subjects for 8 years found that WHtR was a better measure of the risk of heart attack, stroke or death. Another study in 2016 followed 754 reproductive age women found that Waist to Height Ratio was a good predictor of Insulin Resistance and metabolic syndrome in women with and without PCOS.
Waist to height ratios over 0.5 are considered to be exceptionally risky when it comes to metabolic health. We encourage all patients to measure this ratio, as it is completely non-invasive and can be done at home.
I hope that this guide has been helpful for you in clarifying the difference between testing for insulin resistance and diabetes, two conditions that although are linked, require different testing to be done to detect. Have you ever been told that you were not insulin resistant even though you have clear signs and which tests have you had done so far?
Please share your experiences and cases below in the comments!
What To Limit Or Avoid
Try your best to stay away from:
Processed foods, which often have added sugar, fat, and salt. If it comes in cans, boxes, wrappers, and other packaging, itâs probably processed.
Saturated and trans fats, which can boost insulin resistance. These come mainly from animal sources, such as meats and cheese, as well as foods fried in partially hydrogenated oils.
Sweetened drinks, like soda, fruit drinks, iced teas, and vitamin water, which can make you gain weight.
U.S. National Library of Medicine: âEvidence-based diabetes nutrition therapy recommendations are effective: the key is individualization,â âThe DASH Diet and Insulin Sensitivity,â âNutrition therapy recommendations for the management of adults with diabetes,â âDiet and risk of Type II diabetes: the role of types of fat and carbohydrate,â âDairy Products and Prevention of Type 2 Diabetes: Implications for Research and Practice.â
National Institute of Diabetes and Digestive and Kidney Diseases: âPrediabetes and Insulin Resistance.â
Ohio State University: ââIn study, skipping meals is linked to abdominal weight gain.â
American Diabetes Association: âDiabetes Meal Plans and a Healthy Diet,â âDiabetes Superfoods,â âNon-Starchy Vegetables,â âFruits,â âProtein Foods,â âDairy,â âCreate Your Plate.â
American Heart Association: âPolyunsaturated Fat,â âMonounsaturated Fat.â
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How To Accurately Assess Your Level Of Insulin Resistance
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Understanding insulin resistance can be somewhat challenging, but it doesnt have to be.
At Mastering Diabetes, our mission is to provide you with a clear understanding of what causes insulin resistance, and provide you with the tools to reverse it using your food as medicine, so that you can maximize your metabolic health safely and effectively.
Our team hears the following statement all the time: My A1c is now in the non-diabetic range. Does that mean that I reversed insulin resistance completely? If not, what am I supposed to do now?
The what now? part of the question is important, because if youve fully adopted a low-fat, plant-based, whole-food lifestyle, then your habits will continue to improve your insulin sensitivity over time.
How To Reverse Insulin Resistance
If you have insulin resistance, you want to become the oppositemore insulin sensitive .
Physical activity makes you more sensitive to insulin, one reason why its a cornerstone of diabetes management . Dont wait until youre diagnosed with diabetes to start moving more. The earlier you take action , the better off youll be.
Weight loss is important too, as is avoiding high blood sugar, reducing stress, and getting enough sleep .
These lifestyle changes really work. Talk with your health care provider about how to get started.
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What Are The Symptoms Of Insulin Resistance
The following are common symptoms of insulin resistance:
- Weight gain, especially belly fat
- Fatigue after eating
- Needing to eat frequently for energy
- Hormone imbalances, including PCOS and infertility in women
- Craving carbohydrate foods
As a precautionary measure, we recommend getting fasting insulin tests done even if you dont have the above symptoms.
Favorite Resource For Diabetes Education
If insulin resistance has led you to be diagnosed with diabetes or you want to be educated if that day comes, enroll in a program led by Joslin Diabetes Center experts. The 12-week Why Wait program is designed to help you meet your weight goals, which could improve your bodys sensitivity to insulin.
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Is Fasting Good For Insulin Resistance
Interestingly, intermittent fasting has been shown to have major benefits for insulin resistance and to lead to an impressive reduction in blood sugar levels . In human studies on intermittent fasting, fasting blood sugar has been reduced by 36% over the course of 812 weeks in people with prediabetes.
F Stands For Fasting Blood Glucose
Your fasting blood glucose value is a key indicator of your level of insulin resistance, and is important to monitor daily when living with any form of diabetes. As you become more insulin sensitive, your fasting blood glucose is likely to decrease.
Monitoring your daily fasting blood glucose is a simple way to measure how your diet is affecting your glycemic control. The goal is to achieve a consistent fasting blood glucose between 80-100 mg/dL.
As you transition to a low-fat, plant-based, whole-food diet, you are likely to experience fluctuations in your fasting blood glucose, but an overall downward trend is a great indicator of increased insulin sensitivity.
Fasting Blood Glucose Target: 80-100 mg/dL
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Choosing The Best Assessment Technique
The hyperinsulinemic-euglycemic clamp technique is the most scientifically sound technique for measuring insulin sensitivity, and it’s against this standard that all other tests are usually compared. Because this and similar “clamp” techniques are expensive, time consuming, and labor intensive, they are not very practical in an office setting.
To overcome these obstacles, alternative tests have been developed, including the frequently sampled IV glucose tolerance test , insulin tolerance test , insulin sensitivity test , and continuous infusion of glucose with model assessment . Unfortunately, all of these methods require IV access and multiple venipunctures, making them relatively impractical for office assessment. The oral glucose tolerance test does not require IV access but does involve several venipunctures and 2 to 4 hours of patient and technician time. Each of these tests has been shown to correlate reasonably well with dynamic clamp techniques.
Clamp Techniques & Insulin Infusion Tests
A variation of this technique, the hyperinsulinemic-hyperglycemic clamp provides a better measurement of pancreatic beta cell function but is less physiologic than the euglycemic technique.
Taking The Minimalist Approach
Fasting Methods For Assessing Insulin Sensitivity
I0 x G0__________
ISI = exp
ISI = exp
Identify Ir And Take Action To Change Its Course
Patients whose risk factors for IR may not be as evident may benefit from testing. These include:
- Patients with normal glucose and HbA1c who may be at risk3
- Individuals with clinical features associated with IR
Relevance of insulin resistance score, even in lean patients3
What actions might you consider?5-10
- Counsel patients on lifestyle changes, such as increasing physical activity, losing weight, and adhering to a healthy diet
- Employ pharmaceutical interventions that increase insulin sensitivity or induce weight loss
Risk score report: the Cardio IQ® Insulin Resistance Panel with Score gives you an effective counseling tool for patients who need to make lifestyle changes.
*The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.
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