Hi Paddy, great read , but can an overhaul of diet for example keto/ paleo etc not have a very positive and in some cases reversing effect in insulin resistance and type 2 diabetes. The research seems to show this and along with good quality exercise you can reduce another major risk factors like weight and blood pressure .
Great information once again Paddy. And so refreshing to see the clinical reasoning for exercise to be further underlined. We have a number of patients on insulin pumps who have seen changes to lower basal rates over time once they started (**and sustained) a prescribed exercise programme. Well done Paddy for highlighting this important info once again
Fasted yes. Test is 'Insulin'. But before all of this, I would chat with your doctor first to see if they are comfortable requesting and interpreting it. Best is to also measure glucose at the same time so as to work out the HOMA-IR score. I try to have this done on most of my patients but getting it done in the community can be a really big challenge for a variety of reasons.
What is known about the molecular basis of why many have carbohydrate intolerance (insulin resistance) given the standard American diet, yet others can be over 400 pounds, have no exercise, have poor diet, and not be diabetic or even pre-diabetic?
Having had Gestational Diabetes, I am at higher risk for Insulin resistance and T2D. I have a finger prick blood glucose monitor that I used for fasting and post meal levels. Is this something I can use now I no longer have GD, in order to keep an eye on insulin resistance? If so, is this something more people could do as the test kits are not expensive to buy. Thanks.
Technically yes but an assessment of serum insulin, glucose and HBA1c on a yearly or 6 monthly basis would likely be more useful. The finger prick testing can be interesting for experimenting but you need to be very clear what you are testing for. You want to avoid repeatedly finger sticking if no actionable info.
Hi Paddy, great read , but can an overhaul of diet for example keto/ paleo etc not have a very positive and in some cases reversing effect in insulin resistance and type 2 diabetes. The research seems to show this and along with good quality exercise you can reduce another major risk factors like weight and blood pressure .
It absolutely can, but as you mentioned, it is only one side of the equation.
Nutrition + Exercise = Solution
"You cannot outrun a bad diet, and you cannot out diet not exercising."
Play golf with a few cardiologists they are all on statins
What’s your opinion
I think golf is ok. But just not my game ;). Re statins - the answer is always it depends. Can't give personal medical advice online.
Great information once again Paddy. And so refreshing to see the clinical reasoning for exercise to be further underlined. We have a number of patients on insulin pumps who have seen changes to lower basal rates over time once they started (**and sustained) a prescribed exercise programme. Well done Paddy for highlighting this important info once again
Thanks Andy. The type 1 patients are very interesting significant changes in insulin use which is great.
Which begs the question why it’s not tested more routinely? I had a Kraft test done recently which turned out well for nearly 59!
Well done. I ask myself the question most days.
Dr. Barrett; That was an excellent synopsis of the problem.
I have two logistical questions for you:
1. When asking a physician for an insulin level blood draw, what is the exact name of the test to ask for?
2. Does it need to be drawn while fasted?
Thank you.
Bill Ennis
Fasted yes. Test is 'Insulin'. But before all of this, I would chat with your doctor first to see if they are comfortable requesting and interpreting it. Best is to also measure glucose at the same time so as to work out the HOMA-IR score. I try to have this done on most of my patients but getting it done in the community can be a really big challenge for a variety of reasons.
Thank you for your answer.
Bill
What is known about the molecular basis of why many have carbohydrate intolerance (insulin resistance) given the standard American diet, yet others can be over 400 pounds, have no exercise, have poor diet, and not be diabetic or even pre-diabetic?
Personal Fat Thresholds. More here: https://paddybarrett.substack.com/p/not-all-fat-is-created-equal?utm_source=publication-search
Having had Gestational Diabetes, I am at higher risk for Insulin resistance and T2D. I have a finger prick blood glucose monitor that I used for fasting and post meal levels. Is this something I can use now I no longer have GD, in order to keep an eye on insulin resistance? If so, is this something more people could do as the test kits are not expensive to buy. Thanks.
Technically yes but an assessment of serum insulin, glucose and HBA1c on a yearly or 6 monthly basis would likely be more useful. The finger prick testing can be interesting for experimenting but you need to be very clear what you are testing for. You want to avoid repeatedly finger sticking if no actionable info.
Carbohydrates. Hard to navigate but we are getting better.
Not asking for advice
Just Mybe some not notes on pros and cons
I would have a read through these two articles I have written for some context. Hopefully they help address your question.
https://paddybarrett.substack.com/p/reversing-coronary-artery-disease
https://paddybarrett.substack.com/p/cholesterol-lowering-tools