Why Hasn’t My Doctor Talked to Me About Insulin Resistance?

Can labs and blood tests show if I am insulin resistant?

In most cases, your doctor compares your lab results to the ranges provided by the testing site. Lab ranges from blood tests show what is “normal” or average.  The normal fasting glucose is 65-99 mg/dL (optimal is 75-86). The normal triglyceride is 0-150mg/dL (optimal is 70-80). Normal A1C is 0-5.7% (optimal is 4.6-5.3%). We know that retinal damage is shown to occur at levels as low as 5.6, and in some studies early indicators are detected at 5.4.  Explain that!  Our labs are being compared to “normal.” According to Georgetown University, “Three-quarters of those age 50 to 64 use prescription drugs, compared to 91 percent of those age 80 and older.” The “normal” person over the age of 50 in the U.S. is on 4 prescriptions and is overweight. I don’t want to be “normal.” I want optimal health.  If your doctor is not aware of the difference, they may not know that you are already at risk.

Blood tests that can be used to determine insulin resistance are Hemoglobin A1C, Triglycerides, Fasting Glucose, and Fasting Insulin. Insulin resistance is NOT a diagnosis and just 1 lab result does NOT mean that someone has it, but if all or most of these are out of range, I would make some lifestyle changes to get them to improve.   If any of these markers are above normal, there is an increased risk of cardiovascular disease, kidney disease, diabetes, and Alzheimer’s.

Hemoglobin A1C is a blood test that you may have to request your doctor to run for you.  They usually do not run it unless your fasting glucose is too high (high on the “normal” range, but I think it should be a part of the annual lab tests or even more often if elevated.  If you wait until fasting glucose is too high, there could already be nerve damage in the eyes and the peripheral nerves.  Find out before it’s too late!  Hemoglobin A1C measures how many blood sugars are attached to a red blood cell. Since red blood cells live 120 days, it shows you the average blood sugar for the past 3 months. (Checking every month would not give it enough time to change).  A normal A1C is 0-5.7, but an optimal A1C is 4.8-5.0.  Retinal damage can occur before 5.7!

Triglycerides are in your reports if you get an annual physical and is usually covered by insurance.  The triglycerides are a measure of sugar in your diet.  Triglycerides are fats that are created from excess carbohydrates. So many people tell me they don’t eat sugar or drink soft drinks, but their triglycerides are still high.  When we dive into their diet, I usually discover that they are having trouble getting rid of processed carbs which act like sugar in the body. Foods like boxed cold cereal, sandwich bread and wraps, and that roll at dinner or crackers with that soup.  Those don’t look like sugar, but to your body, it is sugar. A normal triglyceride is 0-150. (Look at how wide that range is?! but optimal is a much tighter range of 70-80.

Fasting glucose is another test that insurance companies usually cover in your annual physical.  I recommend that everyone have a physical once a year at least for their blood work.  Insurance usually pays for this.  Be sure to fast before this appointment. Schedule it for first thing in the morning and wait to have breakfast (and coffee!) until after the blood work. Drink plenty of water.  You doctor or nurse may tell you that coffee is okay, but it can affect your blood sugar response and other blood markers.  For me, coffee brings my blood sugar down, which is great for numbers but not if I want to see what is actually happening.  I want to know the truth!  Fasting glucose is not only affected by food but by sleep and stress, too. Sleep well the night before and arrive early enough to relax after arriving. This will help your blood pressure reading, too.  A normal fasting glucose is 65- but optimal is 75-86.

Fasting insulin is not on a regular blood test, so you do have to request it.  Fasting insulin refers to the level of insulin in the blood after an overnight fast, typically for 8-12 hours. Insulin is a hormone produced by the pancreas that helps regulate glucose levels in the blood. When we eat, insulin is released to signal the body’s cells to take up glucose from the bloodstream and use it for energy or store it for later use. However, when insulin levels are consistently high, it can lead to insulin resistance, a condition where the body’s cells become less responsive to insulin’s signals. This can lead to high blood sugar levels, which can eventually result in type 2 diabetes. Measuring fasting insulin levels can provide important information about insulin resistance and diabetes risk. The normal range is 1-19.6 ulU/ml, but optimal is a much tighter range of 2-5 ul/ml.

Once again, 1 test is not going to tell much of anything.  Be sure to look at all of your markers and compare them each year.  Are your numbers improving or getting worse?  What steps are you taking now to get your numbers into the optimal range and where can you get help to improve them?  Ask your doctor to explain your results to you, and question medications.  Ask to read the small print.  Ask what is in this medication, what can I do to go off of this medication? DO NOT GO OFF ANY PRESCRIPTIONS WITHOUT CONSULTING YOUR MEDICAL PROVIDER. Are there some alternatives?  What are the side effects?  If your doctor doesn’t have time to discuss your questions, find a new one.  If you doctor says there’s nothing you can do to go off of your medications, find another one.

Know your numbers!  This is so important to prevent not only insulin resistance but to protect your health and longevity.  You can have peace of mind know that you are in control of your health.

If you would like help understanding your labs or getting your health under control, please contact me.  I would love to help!  For more information about my programs, click here.



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