9 Comments

This is a great reminder of ways to assess for insulin resistance. I read (and wrote) about this recently, and the importance of moving/walking after eating - an underutilized hack against insulin resistance:

There is truth in the saying: “Eat breakfast like a king, lunch like a prince, and dinner like a pauper.” Research has shown that our cells become more insulin resistant as the day goes on, and our pancreases more sluggish. Less insulin sensitivity, combined with less circulating insulin, combined with dinner being the largest meal of the day can all add up to metabolic dysfunction and high blood sugars.

Fortunately, muscles are like big sinks for glucose. About 80% of the glucose that is taken up from the blood goes into muscle, especially when we are moving. That’s also why movement after eating is important. At least 181 studies have investigated this, with most finding health benefits.

https://mccormickmd.substack.com/p/a-walk-after-dinner-in-philadelphia

Expand full comment
Aug 16, 2023Liked by Dr Paddy Barrett

"Let’s put it in plain sight and get to work reversing it." Indeed. Speaking as someone who has gone from an A1C of 8.4 down to a 6.2, I look forward to hearing more about how to reverse it.

Expand full comment

I forgot to mention, the reduction came about by exercise and diet. No drugs.

Expand full comment

Great review Dr. B. It's troubling how many people fall into the trouble zones. It would be nice if there was a cheap CGM that could be used BEFORE patients get into greater difficulty. We did a video on the G7 and having worn one myself, it was very valuable to see what my sugar was doing. time for me to go for my lunch bike ride!

JJ Rybacki, Pharm.D.

Host The Essential Guide to Medical News

Expand full comment
author

They can provide valuable information but I believe mostly as a psychological tool. Enjoy the bike ride.

Expand full comment
Aug 16, 2023·edited Aug 16, 2023

Hi Doctor,

Luckily here in France I was able to request a HOMA IR without prescription at my local lab, for like 40 euros.

Other tests that are often mentioned in regards to insulin resistance :

- oral glucose tolerance test (OGTT).

- Kraft insulin survey. Basically an OGTT where they also measure insulin.

What do you think of these tests?

Cheers,

Ryan

Expand full comment
author

That’s great. The Kraft test is similar to the Matsuda index. Same principle.

Expand full comment

Apologize if this is slightly off topic. In the July 26th 2023 newsletter it was stated that you would discuss the CTCA test in the following week's newsletter. I cannot find that discussion. I'm really interested because I think it's 70 years old I should probably have one of these tests. Thanks so very much for this newsletter, Dr. Paddy!

Expand full comment