10

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Insulin sensitivity and healthy metabolism... how to tell?

Answered on September 12, 2014
Created June 27, 2010 at 10:30 AM

Are there any tell-tale signs that your body is adequately insulin sensitive (as opposed to insulin resistant)? And more generally, that you have the much-touted "healthy metabolism" (whatever that may be)?

Some ideas I've heard: you're insulin sensitive if you can eat reasonable amounts fruit and tubers and not have a hypoglycaemic crash a few hours later, or if you can eat some fruit daily and not gain fat, or if you have stable energy levels through the day, being able to fast quite easily, etc.

70d9359a2086e890a4c3bccb2ba8a8cb

(2254)

on June 28, 2010
at 10:20 PM

@Jae, you did specify that they are POSSIBLE markers plus you explained about the crappy diet confounding factor in your answer, so I think it's OK. In the end the topic of insulin resistance is bound to be a bit on the speculative side, as it's incredibly complex and so many things are still not understood.

77732bf6bf2b8a360f523ef87c3b7523

(6157)

on June 28, 2010
at 02:35 PM

Hm. Should I delete the list? I don't want to confuse people. I do think fat around the middle IS a reliable indicator of insulin resistance, but the other items may be more indicative of a crappy diet than anything else.

6426d61a13689f8f651164b10f121d64

(11478)

on June 27, 2010
at 06:09 PM

The most reliable clinical indicator, if present, of insulin resistance, is a skin rash called "acanthosis nigricans," which is a thickened, dark area of skin, usually on the neck or armpits. However, if you don't have the rash, it does not mean that you are not insulin resistant.

590987831dd6f6542829e69bb9ea6a48

(508)

on June 27, 2010
at 06:05 PM

http://www.phlaunt.com/diabetes/14046889.php Some good info here about testing your own blood sugar and what the numbers mean.

4b97e3bb2ee4a9588783f5d56d687da1

(22913)

on June 27, 2010
at 04:44 PM

Yes inversely, thanks for the link Chris

1a8020e101199de55c1b3b726f342321

(1973)

on June 27, 2010
at 04:26 PM

http://ajpendo.physiology.org/cgi/content/abstract/273/4/E708

1a8020e101199de55c1b3b726f342321

(1973)

on June 27, 2010
at 04:23 PM

None of these are reliable markers of insulin resistance

70d9359a2086e890a4c3bccb2ba8a8cb

(2254)

on June 27, 2010
at 04:03 PM

What did you get tested for in order to find out that you were insulin resistant?

A727956fa3f943057c4edb08ad9e864e

(4183)

on June 27, 2010
at 01:41 PM

75g glucose, not 75g sugar as sugar is half glucose, half fructose and fructose does not affect blood sugar, though it is harmful in other ways. I used glucose syrup mixed with water, it's pretty horrible, especially if you've retrained your sweet tooth.

7df8f3cc7f1475c3ecbbd4a4feb87d04

(514)

on June 27, 2010
at 01:15 PM

Maybe this should be obvious, but do you mean that you just ate about 75g of sugar for the test? I'm thinking about testing myself, so I want to be sure I understand the mechanics of it.

70d9359a2086e890a4c3bccb2ba8a8cb

(2254)

on June 27, 2010
at 01:02 PM

That's interesting (though not surprising)! Do you have a link/reference for it? Presumably you mean they correlate inversely, i.e. the lower the trigs the higher (better) the insulin sensitivity (I hope so - I have low trigs)

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7 Answers

best answer

3
77877f762c40637911396daa19b53094

(78467)

on June 27, 2010
at 04:28 PM

Best way to know? Next time you get a complete blood panel, ask if insulin will be measured (your blood glucose will). after looking at the reference ranges, THEN test your blood sugar after meals (15 min, 1 hour, 2 hour, 3 hour -- YES 3 hours). It's a lot of testing, but if you really want to know, you need to know how much insulin is actually circulating in your body, then you need to know what it is actually doing, and when.

Depending on what you eat, you may see a BG spike, or a more gradual rise, but a rise nonetheless (most likely to happen if you eat pasta - either with fat or not).

The OGTT (oral glucose tolerance test) is an effective way of knowing how your body responds to pure glucose (as a consumer, you can buy this as "dextrose"; WFM and medical supply stores and pharmacies carry it). It is only somewhat effective in letting you know how well your body processes carbohydrate of varying form.

You have to eat and test to know. Is all of this worth it, or might it be more effective to base your meals on high quality vegetables, moderate protein, and optimal fats, and just move forward?

If you have diabetes or diabetes runs in your family, I suggest that going through the testing is very valuable. You'll know if you can "tolerate" sweet potatoes after a strenuous workout, or if you're taking in too much protein (excess protein can have a deleterious effect on BG).

Let us know what you decide to do.

3
77732bf6bf2b8a360f523ef87c3b7523

(6157)

on June 27, 2010
at 02:04 PM

Possible (not perfect) markers of insulin resistance:

  • Can't go for 4-6 hours between meals without excessive, gnawing hunger.

  • Excess body fat, especially around the waist.

  • Fat loss seems difficult even on high-fat low-carb Paleo-type diet.

  • Seem to gain fat even on calorie-restricted diet.

  • "Crashes" within 30-60 mins after meals. Fatigue, mental fogginess, lethargy.

  • Acne. (?)

  • Frequent colds. (?)

  • Allergies. (?)

  • Difficulty sleeping. (?)

It occurs to me that some of the above may be indicators of a crappy diet rather than actual insulin resistance. Of course, a crappy diet will often lead to insulin resistance, which will further encourage a crappy diet, etc. But I can't say for sure that acne, for example, is a marker of insulin resistance. It may only be a sign of inflammation. I'll edit this list if people give me feedback. Or we can turn it into a community wiki.

1a8020e101199de55c1b3b726f342321

(1973)

on June 27, 2010
at 04:23 PM

None of these are reliable markers of insulin resistance

70d9359a2086e890a4c3bccb2ba8a8cb

(2254)

on June 28, 2010
at 10:20 PM

@Jae, you did specify that they are POSSIBLE markers plus you explained about the crappy diet confounding factor in your answer, so I think it's OK. In the end the topic of insulin resistance is bound to be a bit on the speculative side, as it's incredibly complex and so many things are still not understood.

6426d61a13689f8f651164b10f121d64

(11478)

on June 27, 2010
at 06:09 PM

The most reliable clinical indicator, if present, of insulin resistance, is a skin rash called "acanthosis nigricans," which is a thickened, dark area of skin, usually on the neck or armpits. However, if you don't have the rash, it does not mean that you are not insulin resistant.

77732bf6bf2b8a360f523ef87c3b7523

(6157)

on June 28, 2010
at 02:35 PM

Hm. Should I delete the list? I don't want to confuse people. I do think fat around the middle IS a reliable indicator of insulin resistance, but the other items may be more indicative of a crappy diet than anything else.

2
4b97e3bb2ee4a9588783f5d56d687da1

on June 27, 2010
at 12:27 PM

Triglyceride levels correlate to insulin sensitivity

70d9359a2086e890a4c3bccb2ba8a8cb

(2254)

on June 27, 2010
at 01:02 PM

That's interesting (though not surprising)! Do you have a link/reference for it? Presumably you mean they correlate inversely, i.e. the lower the trigs the higher (better) the insulin sensitivity (I hope so - I have low trigs)

4b97e3bb2ee4a9588783f5d56d687da1

(22913)

on June 27, 2010
at 04:44 PM

Yes inversely, thanks for the link Chris

1a8020e101199de55c1b3b726f342321

(1973)

on June 27, 2010
at 04:26 PM

http://ajpendo.physiology.org/cgi/content/abstract/273/4/E708

1
A89f9751a97c3082802dc0bcbe4e9208

(13978)

on June 27, 2010
at 06:28 PM

Robb Wolf suggests getting A1c levels tested.

Here's the link to the abstract of a paper that talks about it.

0
A727956fa3f943057c4edb08ad9e864e

on June 27, 2010
at 12:44 PM

Get a blood glucose meter and check. I did my own oral glucose tolerance test by administering 75g glucose and measuring blood sugar after 1 and 2 hours. You have to eat high carb a few days beforehand if you are eating low carb in order to get an accurate result.

590987831dd6f6542829e69bb9ea6a48

(508)

on June 27, 2010
at 06:05 PM

http://www.phlaunt.com/diabetes/14046889.php Some good info here about testing your own blood sugar and what the numbers mean.

A727956fa3f943057c4edb08ad9e864e

(4183)

on June 27, 2010
at 01:41 PM

75g glucose, not 75g sugar as sugar is half glucose, half fructose and fructose does not affect blood sugar, though it is harmful in other ways. I used glucose syrup mixed with water, it's pretty horrible, especially if you've retrained your sweet tooth.

7df8f3cc7f1475c3ecbbd4a4feb87d04

(514)

on June 27, 2010
at 01:15 PM

Maybe this should be obvious, but do you mean that you just ate about 75g of sugar for the test? I'm thinking about testing myself, so I want to be sure I understand the mechanics of it.

0
D5db204527668aa712504995c0f8f96f

(551)

on June 27, 2010
at 12:37 PM

You are insulin sensitive if you are gaining muscle easily (like art devanny), burning body fat easily for fuel and if you don't have energy drops (sugar crash). Those are three ways of knowing it that don't require blood tests. (at least, in my experience).

-2
0fb8b3d6dcfb279b0f7e050d2d22510f

(4645)

on June 27, 2010
at 03:04 PM

It is really not that easy. You need to be tested beyond the routine morning fasting test the doctors office gives. I am resistant but can fast for several days and have none of what Jae listed although the list is a good baseline of what to expect. Diabetes and insulin are very tough to pin down and a good doctor is need to see where you are at.

70d9359a2086e890a4c3bccb2ba8a8cb

(2254)

on June 27, 2010
at 04:03 PM

What did you get tested for in order to find out that you were insulin resistant?

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