For those of you who have already seen the video on the regulation of blood sugar, there are some redundancies with this video here. My apologies for that. I decided to repeat some of the essential information because it's critical to be clear that insulin resistance is not the same as glucose intolerance, i.e., it is very much possible to have normal blood glucose levels but still be very insulin resistant. As always, don't hesitate to post questions or requests for future content in the comment section. Cheers Mario
@malikaamir6412
Жыл бұрын
dear doctor, what is the importance of C-peptide test ( fasting + stimulated) for checking insulin resistance or diabetes ?
@surefire07
Жыл бұрын
Why my doc order lipid test report does not have majority of the discussed test parameter but have other items which are not looked at even by my doctor? Did AMA ever thought about it?
@brothernorb8586
Жыл бұрын
You are doing a great job
@georgwabraham7236
4 ай бұрын
@lq😊lee
@lily5952
Жыл бұрын
My father, who suffered from type 2 diabetes for most of his adult life, passed away recently. Officially, it was from multi organ failure, but it all came as a result of diabetes. He also had both legs amputated some years before his death. My dad didn't really take his condition seriously and he paid a dear price for it. I'm really happy that more researchers and doctors are paying more attention to this "silent pandemic" of insulin resistance. So many people are walking around thinking that they are healthy but they aren't. Another thing to add is that my dad was never fat. Thinness doesn't equate to health either. That's why it is so important to go for your checkups and do the blood tests too. Better safe than sorry.
@nourishedbyscience
Жыл бұрын
So sorry to hear of your loss. My dad also recently passed away, and he also had T2DM. His diabetes was better controlled, but he loved his white bread with syrup, his sweets, cakes, and baked goods, and didn't really want to make a more substantive change to his diet. He died of metastatic pancreatic cancer, which may or may not have been related to his diabetes. Diabetes clearly is a major risk factor, and I do keep wondering whether he may have had a few more years with us if he had taken his diabetes more seriously ... I'll try to do my best to help those people who are motivated to make a change avoid the types of long-term health issues that come with diabetes. Pancreatic cancer, amputated legs, dialysis from chronic kidney disease, blindness, heart attacks and strokes, there are no guarantees that any of this can be 100% prevented, but I do think the risks can be lowered substantially if we take this seriously and adopt a healthy diet and lifestyle. Thank you for sharing, and again, my deepest sympathies. Best, Mario
@Jimfrenchde
Жыл бұрын
Professor Tim Noakes who is a marathon runner and very slim had type 2 diabetes. So yes. You can be slender and have diabetes.
@craigfisher1062
11 ай бұрын
Slim people are more prone to t2d. They have less fat cells to store energy so will present with lipid disregulation earlier
@AndyLambg
11 ай бұрын
Yes i hv been lean all my life, I recently discovered tat my bg always 6ish even after I woke up fr 10hrs of fast. Not sure I'm already prediabetic or insulin resistant coz the place I stay has no doctor checking for insulin. I'm lost what to do to improve myself besides low carb diet. 😢
@johnstewartvet
11 ай бұрын
Agreed. Well said
@JesseOsby
11 ай бұрын
FYI for those in the U.S., it is possible to find your HOMA-IR pretty cheaply without a doctor or insurance. There are labs online where you can order a fasting glucose and insulin test. They send you to a local lab for the blood draw. I was just able to order one for only $37 with no prescription or insurance. From the results, I calculated my score to be 5.8, so I definitely have some work to do. Your videos on reducing IR will be extremely valuable to me, Dr. Kratz, as all your others have been.
@nourishedbyscience
11 ай бұрын
Good suggestion. Thank you for sharing! Cheers Mario
@emilyshan4835
2 ай бұрын
which website did you use? Thank you
@leandrobecker123
Жыл бұрын
I am cardiologist in Brazil. And after I read Dr. Krafts book i started to use insulin and glucose curve in many patients in risk for IR. I also did it in me (normal!). My HOMA IR is 1. Great videos! Very well done. Congratulations for the chanell. I will keep seeing.
@nourishedbyscience
Жыл бұрын
You are doing your patients a great favor. It is now sufficiently clear that insulin resistance and hyperinsulinemia can lead to major health problems long-term, and it doesn't make sense to me that many physicians are resistant to even measure a fasting insulin in their high-risk patients. Considering the burden of associated disease, and costs related to these, we should be intervening way earlier in the development of diabetes. Thank you for your kind feedback. Cheers Mario
@leandrobecker123
Жыл бұрын
@@nourishedbyscience maybe you know the book from Ben Bickman - Why we get sick. He approaches a lot about hyperinsulinemia.
@rabbitgirlz4380
Жыл бұрын
How is homa IR calculated
@mamafoodlivelaughlove9746
Жыл бұрын
Thanks to all Dr. Who care about their patients educated provide guidance not just insist medication. I am struggling for 20yrs was searching for help because I was not informed or tested by my doctor 😢 I am on two metformin my dr. Said i have no other choice is to keep increasing medication
@fansberat8583
7 ай бұрын
And what is your HOMA B doctor? Mine is 54% and HOMA IR 2.1
@zinnia20207
Жыл бұрын
My Dr. Said A1C is only a 10th of a % over into pre diabetes. Not concerned, see ya for your yearly in October. Said nothing about nutrition/diet. I'm so glad I found you.
@tamaraharrison8776
4 ай бұрын
Yes he is diabetic
@anitahamlin2411
Жыл бұрын
You are doing those who listen a great service. It is amazing how humans go through a great deal of trouble to avoid a minimal discomfort in the immediate when that slight discomfort would avoid major discomfort for the long run. I hope your videos help many to decide to do the work.
@johnstewartvet
11 ай бұрын
Agreed
@supreetaarya3731
Жыл бұрын
I think the best content on blood sugar regulation on youtube is on this channel - thanks Dr Mario for sharing evidence based knowledge translatable into practice with us !
@stevenlench7331
Жыл бұрын
What an amazing, timely series.Time and time again I tell friends to get their insulin tested only to have their doctors refuse !
@wmp3346
Жыл бұрын
Some don’t even know there is a homa ir test?
@jpotter2086
Жыл бұрын
Tell me about it. It's bizarre how the 'normal' range for insulin is so ridiculously vast, and nothing is done about it. Then one day the dam breaks and your glucose sky rockets. As if insulin hadn't been creeping up, and up, and up for *years*. What's considered normal should be cranked way down, and it should be monitored at least annually.
@zag221
Жыл бұрын
My GP doesn't even think prediabetes is an issue! I managed to get rid of it with the low carb diet and other lifestyle changes. However, now I got a diagnosis of osteoarthritis and a higher fibre intake for example with legumes is suggested to improve gut bacteria. I am wondering what happens with my next HbA1C in a years time. Unfortunately I am not able to afford a HOMAR IR. Can I win?
@johnstewartvet
11 ай бұрын
Dr Joseph Kraft showed in the 1970 s there was a 10-year period where glucose stayed normal in the face of rising insulin levels. This is a strong argument for doctors to add fasting insulin to the laboratory request form. ( this will cost the Australian government about $47) Early recognition of insulin resistance saves lives. If your doctor does not understand this basic preventative medicine, get him or her to watch this video. I have had about 90% success rate getting GPs and oncologists to put fasting insulin on the laboratory request form once the patient tells them about the research of Dr Joseph Kraft. Only 1% of GPs know of the Joseph Kraft research . New Zealander Dr Catherine Croft did her PhD on Insulin resistance re analysing Kraft's data
@maplenook
9 ай бұрын
They can order it themselves
@Joelina456
Жыл бұрын
I´ve never clicked on a video so fast! 🙂 So helpful and insightful! Dankeschön! :)
@afonsodealbuquerque4115
Жыл бұрын
Me too!
@Kandybarbrown
Жыл бұрын
Me too!
@dannyweiss9701
Жыл бұрын
and Me Three...thx Mario..:-)))
@mukundaks9515
6 ай бұрын
Your plain speaking and presentation is excellent Kindly be doing what you are doing It will help a great many of the population
@Maak19
Жыл бұрын
Your fastidious care and rigor to your research are evident. It is a pleasure to bask in the knowledge that you spread. More power to you, Super Mario !
@ZohaEnglishLab
8 ай бұрын
As a Nutritionist , one of the best videos I came across, information so well talked and explained with thorough research , much needed for we Indians to understand this concept Of Insulin Resistance.
@suphesizdogru
Жыл бұрын
This is my favourite channel. Over the time I've learnt tones of information. A big thank you. I always looking forward to your videos.
@jackonsville
Жыл бұрын
Great series of videos. Had a blood test last week, which included a HbA1C test, but if I had seen this video I would of asked for a Homa IR test. Thank you - you have a very balanced style of presentation with excellent information.
@rabbitgirlz4380
Жыл бұрын
Is that test available in the usa
@Tyrannocaster
Жыл бұрын
If you had fasting insulin and glucose levels done you can calculate your HOMA IR result yourself; it's not a blood test, just a calculation based on those two values, and there are many online calculators which will do it for you.
@trend0000
Жыл бұрын
Great video, without hype, promoting, or blame, just straight truth! Amazing! I listen this post twice and I’ll do more in the future…Thank you very, very much! Some confession to make: I already “bing watched”trough all your previous videos!
@PeterJames468
Жыл бұрын
Thank you for giving us these videos. Your straight forward explanations make it easy to understand for us lay persons. You are doing a fantastic job!.
@praguecr
10 ай бұрын
excellent video. well presented and not directly or indirectly pushing a million products and services. Very impressed with this doctor.
@barbarama
Жыл бұрын
I've recently discovered your channel and enjoy the well balanced and researched content as well as your calm delivery. Greetings from Austria 🇦🇹.
@nourishedbyscience
Жыл бұрын
Thank you for your kind feedback!
@blumingwellness
Жыл бұрын
Just discovered your channel through your interview on Sigma Nutrition. I've been looking for a video like this for years! So clear, concise, precise and MUCH NEEDED! Thank you so much! I will support you and tell my clients about you. ~ Marian Blum
@karolina8367
Жыл бұрын
Yesss, I was impatiently waiting for another video!
@nourishedbyscience
Жыл бұрын
Sorry. I am very slow, I know …
@karolina8367
Жыл бұрын
@@nourishedbyscience Do not worry one bit, its absolutely worth waiting.
@tesfayegebre7706
6 күн бұрын
Great information and presentation. I have been wearing a CGM to see how much and why my glucose levels vary. I now understand from your videos, the CGM will not tell the whole story and that also need to look at my insulin levels. I wish there was a continuous insulin monitor also. Thank you Dr. Mario.
@nourishedbyscience
6 күн бұрын
Yes, agree. However, you can get a sense of your insulin levels throughout the day by looking at your glucose levels under consideration of your HOMA-IR. The more your HOMA is elevated, the more your insulin levels will tend to rise with any given rise in blood glucose.
@cathyellington7599
Жыл бұрын
Thank you Mario, my daughter is struggling and not getting the help she needs from her Dr. How is it that a Dr. gets himself so busy as to mot be able to see his patients in a timely manner. The PA or NP in office aren't helping her and told her Dr. booked into next year. I have told her to find another physician but in meantime to start looking at your videos. She has every indication of having metabolic syndrome and insulin resistance. I really think your videos are going to benefit her. You have helped me so much. Everything is reversing for me. Now my b/p for first time is low. Weight maintained and feeling good. Thank you.
@YeshuaKingMessiah
Жыл бұрын
Her dr or any dr isn’t going to do anything She needs to take it on herself to go lowcarb/keto.
@cathyellington7599
Жыл бұрын
@@YeshuaKingMessiah you really should read a little more before giving your advice. Metabolic syndrome, NAFLD and others require life long changes. KETO diet is not recommended to be on for more than few months. I see a hepatology Dr. for NAFLD and metabolic syndrome. The diet requires life change and that is for sugar. Sugar is the real danger. The Mediterranean diet is what is recommended and to start with very low calorie like 800 a day to start reversing the fat stored in the liver. She knows she has to do it on her own. Until someone knows the problem they don’t really know where to start. That’s where the Drs come in.
@YeshuaKingMessiah
Жыл бұрын
@@cathyellington7599 epileptics and others live on keto for life. Keto is very healthy. Besides the many many ppl who live on it more “by choice”.
@YeshuaKingMessiah
Жыл бұрын
@@cathyellington7599 undereating is the worst thing to do for any issue. Fasting IS another avenue that can work to move out glycogen from liver. It is hard to do and some ppl have a lot of issues arise at first also. Fasting is very diff from starving. Your body responds very differently. The worst thing you can do for a metabolic condition is undereat/starve. It sets ur metabolic rate very low too. IF is a great middle ground or practice whereby u are eating enough, just in a daily window of several hrs. When u eat highfat, lowcarb u also don’t suffer in ur off-eating hrs. Endocrinologists of any ilk (hepatologists incl) are clueless. Look up nephrologist Jason Fung, he’s on YT also. He got tired of ineffective protocols for the diabetics losing their kidneys. IR, fatty liver, obesity, metabolic syndrome, diabetes all are the same thing. Diff names - they’re all related thru hyperinsulinemia. THAT takes time and lowcarb/keto to resolve. Then u must stay aware still of any creep backs, for life. There’s prob a genetic component but it’s majority a lifestyle choice and once you’re damaged, it never completely resolves. Ppl THRIVE on keto.
@cathyellington7599
Жыл бұрын
@@YeshuaKingMessiah yes, you are right about the epilepsy. I was a dialysis nurse for 32 years and RN for 38. Any diet carried to extremes can cause harm. My daughter is pre renal. Told to limit protein. You limit carbs, you limit protein then your body starts to get what it needs from itself. A balanced diet is what is recommended by AHA. Glad you are a fan of KETO. Sure it works but would recommend before anyone stays on it for extended period they get accurate information from non bias sources.
@Straightdeal
Жыл бұрын
Why HOMA-IR is not a standard test is crazy. This measurement is the gold standard for health. Anything below 1 is super.
@SidMalipatil
4 ай бұрын
Agree… HOMA-IR is a must go test for all routinely
@estellesstories7467
Жыл бұрын
Excellent, informative video. Thank you for making this information widely available and accessible. Delighted to subscribe to your channel.
@veraison777
Жыл бұрын
I love your videos and I appreciate your adherence to science based data.
@marynguyen6417
Жыл бұрын
Finnaly this video has come, thank you! This is the topic of my biggest interest, and I cannot wait to see the rest of this series.
@rafaelgelpi2718
Жыл бұрын
I miss your videos, only so many times that I can re watch the old videos
@nourishedbyscience
Жыл бұрын
Really sorry, lots going on recently, and currently, I am on vacation. It's my goal to post more regularly. Best, Mario
@user-pg6xs9sp6l
Жыл бұрын
So glad I found this channel - great presentation, thanks.
@MeHere650
Жыл бұрын
Thank you so much for this content, very informative.
@pamstaub5403
Жыл бұрын
I am loving your content. I was able to calculate my Homa IR at 2.6 to 2.9 (depending upon using my fasting blood sugar or my average bs of 120 from my A1c). Now to work on improving my sensitivity. I only have 1/2 a pancreas and I am committed to preserving what pancreatic function I have left.
@nourishedbyscience
Жыл бұрын
HOMA-IR is based on fasting glucose only, so your HOMA-IR is 2.6. Cheers Mario
@pamstaub5403
Жыл бұрын
@@nourishedbyscience unfortunately 2.9.
@mjgrant1515
9 ай бұрын
thank you for all the excellent information. this is my favourite channel for learning about insulin resistance.
@suzysandiego6478
6 ай бұрын
You are awesome Mario! Bless you for helping us all keep healthier😊
@abjkl
11 ай бұрын
Great video -- lots of quality information. Very well done. Thank you.
@N330AA
Жыл бұрын
They should teach this stuff at school.
@Sparkling-Cyanide
Жыл бұрын
Another awesome, informative video! I’ll be anxiously waiting for more information on how to become more insulin sensitive. Right now, at 2.75, I know I’m insulin resistant. I was only able to get my fasting insulin down to 2 when I really backed off on the grains and starchy carbs. It’ll be interesting to see how your upcoming information aligns with my own experience with diet changes!
@jimandallysongomolka998
Жыл бұрын
There is data from Dr. Bozworth that the ratio of the glucose to the ketones mirrors insulin. This is easy to test and might be a good practical test with good data
@nourishedbyscience
Жыл бұрын
For people consuming low-carb diets, this may work reasonably well. Not so for the general population eating a mixed diet, however.
@theresaotoole9141
Жыл бұрын
Another great presentation - learnt so much.
@MohdKl24
Жыл бұрын
I benefited from this chanel. When u plan to eat big amount of carbo eat little carbo before that meal
@elmeric7086
Жыл бұрын
Excellent explanation. It matches my observation of 18 months of glucose testing.
@jolantawozniak2132
9 ай бұрын
Thank you so much, Mario. I watched your two videos and can tell that I can save a lot of time and stop watching other health related videos. You are so right and to the point that I have literally tears in my eyes…I had to figure out myself a lot, including HOMA -IR. As a child I was accidentally poisoned by Death Cup mushroom and I think that I am paying for this all my life. My body never responded typically, many gut issues, immune system overreacted in strange way. Finally, when I am a senior I start to understand my body…. Hope to learn a lot from your channel. Thank you.
@nourishedbyscience
8 ай бұрын
Sorry to hear about your death cap mushroom experience, but glad to hear you made it through alive! Thank you for your kind feedback. Cheers Mario
@scottjackson163
6 ай бұрын
I obtained a HOMA-IR of 1.1 based on my 3/18/24 lab report: Fasting insulin = 4.7 and glucose level = 95. 😊
@ursulabecker730
Жыл бұрын
I’ve had diabetes for the last 15yrs. After watching your video I brought my HbA1c levels down by ,5 on just one month!! Another question : do you these videos in a German version for German speaking people? English is perfect for me. Thank you very much for these videos. They are extremely helpful.
@nourishedbyscience
Жыл бұрын
Sorry, as much as I wish I were able to also make these videos in German, I don’t have the time to do that. As the number of people who can follow this in English is at least 20-fold larger, I decided to make them in English, at least initially.
@ursulabecker730
Жыл бұрын
I thought as much. I went for my regular check up this week and my doctor asked me for your u tube details to pass onto other patients. 👍🏼👍🏼
@maplenook
9 ай бұрын
Most Germans speak English
@dr.samierasadoonalhassani2669
11 ай бұрын
Thanks.This lecture to my ears like classic music to those love music .
@thisoneT
11 ай бұрын
Always excellent content 👍🏼
@Heilungshilfe
Жыл бұрын
Danke für ein weiteres, sehr informatives Video!!
@florincoman6564
Жыл бұрын
Love it, love it, love it❤, can’t wait to see your next videos and some of your CGMs results/data etc
@NomadicNine
Жыл бұрын
Thanks!
@nourishedbyscience
Жыл бұрын
Thank you!
@hefeweizen9475
Жыл бұрын
As Mario explained, insulin resistance does not tell the whole story regarding a person's ability to maintain healthy blood glucose levels. The ability of the pancreatic beta cells to produce insulin is also crucial. If the beta cells are capable of producing a lot of insulin, then insulin resistance can go very high before a person gets into trouble with glycemic control. On the other hand, if the beta cells are impaired, then glycemic control will begin to suffer at a lower level of insulin resistance. All of this to say that while measuring insulin resistance is crucial, we can get a fuller picture of metabolic health by also measuring beta cell function. I went looking for an inexpensive test of beta cell function and found that the HOMA model itself provides an indicator called HOMA-B (or HOMA-ß) that serves this purpose. Better still, it requires only the same two inputs that go into the HOMA-IR calculation: fasting glucose and fasting insulin. Higher HOMA-B numbers indicate a greater ability to produce insulin. I also discovered that there is an improved, more accurate version of the HOMA model called HOMA2. The HOMA2 model is considerably more complicated, so you need to use a HOMA2 calculator rather than trying to do the calculations by hand. I got mine from the Radcliffe Department of Medicine at the University of Oxford. Google 'oxford homa2' and you'll find it. Normal ranges vary by population, so you need to be careful in interpreting the results, but I found these ranges in one particular study: HOMA2-IR in non-diabetics: mean 1.16, standard deviation 0.31 HOMA2-IR in diabetics: mean 2.61, standard deviation 1.06 HOMA2-B in non-diabetics: mean 113.10, standard deviation 30.56 HOMA2-B in diabetics: mean 47.10, standard deviation 24.67
@YeshuaKingMessiah
Жыл бұрын
This is why normal just means common Not OPTIMAL (optimal is currently at no more than 1 on standard HOMA-IR) Getting a T2 “good enough” isn’t good enough! They can actually eliminate the T2 *and* NAFL (fatty liver) if they go keto. It takes a lot of patience and strict adherence but after months of it, change will be visible (fat loss), not just slowly internally healing. Thx for the calculator info, wish u had incl a link.😮
@bipindeshpande2043
Жыл бұрын
Good informative podcast. Examples are perfect. Dr. Bipin Deshpande, INDIA.
@danielbarbour3501
Жыл бұрын
I think there is an issue with how Type 2 Diabetes is defined (I say this in 'reaction' to the standard medical statement that Insulin Resistance is a Risk Factor for Type 2 Diabetes). The definition of Type 2 Diabetes per a description I found from a Mayo Clinic article is: "..Type 2 diabetes is a condition that happens because of a problem in the way the body regulates and uses sugar as a fuel. That sugar also is called glucose. This long-term condition results in too much sugar circulating in the blood. Eventually, high blood sugar levels can lead to disorders of the circulatory, nervous and immune systems..." Starting with THIS definition of Type 2 Diabetes, then yes - Insulin Resistance is a 'Risk Factor'. However - I would argue that the difficulty with regulating blood sugar is a side-effect of the primary disease factor which is Insulin Resistance. I would suggest that public health would be better served by measuring Fasting Insulin levels and Insulin Response Coupled With routine Blood Glucose and HbA1c tests. Type 2 Diabetes diagnosis under my suggested approach would be based on excessive levels of Insulin in the blood OR high HbA1c/blood glucose levels. Conversely, Type 1 Diabetes is a symptom of Low Blood Insulin levels AND high HbA1c/blood glucose levels. Only Type 1 Diabetes should (IMO) be treated with Insulin. In this regard - I must push back on the assertion made at 7:05 in regard to "Fred" where you Imply that he has low insulin sensitivity (i.e. high Insulin Resistance) because his PRODUCTION of insulin is too LOW and THUS has Type 2 Diabetes. There may be those that fall in that category but I believe there are sufficient studies to show that many diagnosed with Type 2 Diabetes are still producing very high amounts of insulin (in absolute mcU/ml terms). Though High, for those diagnosed with Type 2 Diabetes the amount is insufficient to overcome Insulin Resistance (despite the high Insulin level cells can no longer be stimulated to absorb/use blood glucose and the Liver thus converts the sugar to fat). This is, in fact, MY situation. I am not 'Fred', if anything my production might be HIGHER than Ben's. I am sensitive about this issue because my father passed away in large part because of High Insulin levels that contributed to Non Alcoholic Fatty Liver Disease and he was prescribed Insulin for Type 2 Diabetes rather than treated to LOWER his Insulin Resistance. The prescribed insulin just made his NAFLD worse, the insulin might have lowered his blood sugar but at the cost of destroying his liver and causing other health issues. He would have been better served by dietary changes (types of food he ate, eating frequency, ...) but his Doctors then followed the 'Standard of Practice' as do most today.
@nourishedbyscience
Жыл бұрын
Appreciate your comment. However, note that the diagrams simply mean to illustrate principles, and the axes don't have units of measurement. Fred could be anywhere on the left side of the green shaded area, and you are correct to assert that many people with type 2 diabetes (at least among Caucasian or African race) tend to have quite high insulin levels. Note, however, that many Asians with type 2 diabetes tend to develop diabetes at fairly low insulin levels (because often their problem is more an inability to produce more insulin). About the definition of diabetes, given that it's focused on glucose levels, I am fine with the current definitions, but absolutely agree with you that much more emphasis in clinical practice should be on insulin and insulin resistance. Cheers Mario P.S.:Sorry to hear about your dad. Mine also had diabetes, and recently passed away from pancreatic cancer.
@DawidRoos-y7g
7 ай бұрын
The pharmaceutical industry do not want you to get an early warning of metabolic disease.
@SuzanaMantovaniCerqueira
Жыл бұрын
I agree , that can exist high insulin resistant and chronic diseases ….
@stephendspringer
Жыл бұрын
I'd love to hear about how/whether age impacts insulin sensitivity and glucose tolerance and about reactive hypoglycemia. Thanks!
@nourishedbyscience
Жыл бұрын
This video here covers reactive hypoglycemia: kzitem.info/news/bejne/zK6LtmSws3R2dnY Age definitely affects insulin sensitivity and glucose tolerance, and age is the second most important risk factor for type 2 diabetes, behind body fat mass. As we will discuss in the very next video, this is because the ability of the subcutaneous fat tissue (=the only safe place to store fat in the body) to expand and store fat effectively declines with age. Cheers Mario
@heloisaportela1226
Жыл бұрын
Thank you for your videos. They are so informative and helpful! ❤
@kostar500
Ай бұрын
Fasting insulin is such an important parameter…
@n2daair23
Жыл бұрын
It has absolutely blown my mind to learn about how EXTREMELY IMPORTANT it is to control insulin. Insulin management is probably the most important aspect of one’s health. Everything ties back to insulin somehow!
@nourishedbyscience
Жыл бұрын
I shy away from making strong statements, and always want to be open to new data to change my mind, but I agree that insulin resistance and hyperinsulinemia (and the issues causing them) are very much underappreciated in preventive medicine. Cheers Mario
@sweetsushanna-ahh
7 ай бұрын
Thank you doctor for your video, I will see if I can get this test.
@augustinalawson6373
Жыл бұрын
Dr. Mario, thank you for your wonderful information. It's so comforting to have things explained the way you do. God bless you.
@IndianSrMan
Жыл бұрын
Very informative for lay person to understand and get the Homa ir test done. How does hba1c fit here? In India the test is very common to decide if you are prediabetic or diabetic.
@nourishedbyscience
Жыл бұрын
Fasting glucose and HbA1c (and potentially the 2-hour value in an OGTT) are still the measurements used to diagnose diabetes, or pre-diabetes. HOMA-IR is not relevant for the diagnosis of any disease (which is why it's not commonly done). Think of fasting glucose, 2-h glucose in an OGTT, and HbA1c as diagnostic criteria of a disease, whereas HOMA-IR is a risk factor for disease (more similar to LDL-cholesterol). If someone has type 2 diabetes, they are almost always at least somewhat insulin resistant, but HOMA-IR can also be elevated in people without diabetes or pre-diabetes, so that's where it really has value because then you can intervene early to reverse the insulin resistance and prevent the progression to pre-diabetes and diabetes. Cheers Mario
@KoiRun50
Жыл бұрын
@@nourishedbyscience Just call it PPD test. Pre-pre-diabetic test and it would make sense.
@nourishedbyscience
Жыл бұрын
@@KoiRun50 The problem is that even if someone has elevated fasting insulin/HOMA-IR, suggesting that they are at increased risk, on an individual basis it is still thought of as a poor marker of diabetes risk (because you never know how much insulin a specific patient will be able to make, i.e., they may never become glucose intolerant even if they are already very insulin resistant). I think this is inconsistent thinking. Similarly, one could argue that not all patients with hypertension and elevated apo B develop CVD. That is true, but still no reason to ignore these risk factors. Cheers Mario
@IndianSrMan
Жыл бұрын
@@nourishedbyscience Good explanation. Thank you. I think our government and doctors should give more publicity to homa ir considering India has large population of diabetics and prediabetics. An ounce of prevention is better than a tonne of cure.
@atsaivan
8 ай бұрын
Thank you for the very interesting, well produced and informative videos! May be the link between stress (and the other factors) and IR could be explored by you in a separate video(s).
@hanumm9938
Жыл бұрын
information.. should need to be known everybody whether above 45 or below 45 .. to be his own health care guy🐸🐸
@adrianmihailescu5255
Жыл бұрын
Simple and clear👍
@emese-tundetorok1135
Жыл бұрын
I would like a video about control of blood sugar (type 2 diabetic) + breast cancer.
@nourishedbyscience
Жыл бұрын
Added to the list! Thank you for the suggestion. Cheers Mario
@emese-tundetorok1135
Жыл бұрын
@@nourishedbyscience thanks it would be very helpful. My mom is going through this and I want to help as much as I can.
@mplt6151
Жыл бұрын
Excellent video, thank you so much
@AdiasAdventure
Ай бұрын
Thank you for this information! It has been eye-opening to say the least. I have a question though… Why has no doctor or company put out an insulin monitoring device? Is it that difficult to measure? Could it not be programmed for a home kit?
@nourishedbyscience
Ай бұрын
Insulin is a protein, and circulates in blood as one of thousands of other proteins. To measure its concentration well, we need a test that so far no one has been able to put into a small point-of-care device. Would be cool to have for sure. Cheers Mario
@mastandstars5869
Жыл бұрын
It would be wonderful to see what research you are familiar with for people living with T1D. We tend to be forgotten in favor of info pertaining to T2. I use both a CGM & an insulin pump. Thank you for your videos.
@nourishedbyscience
Жыл бұрын
I do intend to have some videos for T1DM as well, but my primary expertise is on T2DM and related metabolic disease, as I have studied this professionally for ~20 years. Cheers Mario
@berkshiregirl6810
Жыл бұрын
There is a channel called "Type 1 Talks" He shares a ton of information with his personal 30+ years of being Type 1. Tons of great info
@garync3810
8 ай бұрын
Wonderful content Vielen dank! A suggestion though: possibly make a numerical reference to each video so one can easily follow the videos in order of production? I enjoy all of them though!
@nourishedbyscience
8 ай бұрын
Thank you! Good idea. As an alternative, you can go to my channel page and look up my 'playlists'. These are in order. Cheers Mario
@MM-fy4bw
Жыл бұрын
Amazing and informative video thank you!
@YEK888
Жыл бұрын
Hey Doc' Another great video - well explained. Since you encouraged us to post questions, here's one you might like to help explain. For some time I've been wondering if using blood ketone strips (to measure Blood BHB) might be a simple way of estimating the approximate level or variability of insulin at home? I suggest this for those, like me, who have been unable to get the Doctor to do an appropriate insulin check and/or find it too expensive - including transport costs to a Lab' etc. I thought of this when I heard Professor Ben Bikman say in one of his lectures, "the liver wont produce ketones unless insulin is low". No doubt the situation is much more complicated than I seem to think.......hence me asking the question. Would be great if you could mention something on the subject in a future Video. Kind Regards, Y
@nourishedbyscience
Жыл бұрын
I don't think this would be very useful. Dr. Bikman is correct when he says that high insulin levels prevent ketosis; however, that is mostly related to the very high insulin levels after meals. So even if you were insulin resistant, your elevated fasting insulin levels would still be low enough to allow you to enter ketosis. Therefore, whether your fasting insulin levels are indicative of good or poor insulin sensitivity, I don't think you can measure well by looking at ketones. Best, Mario
@Tpry
Жыл бұрын
Insulin resistance is a risk factor for type 2 diabetes, and all chronic metabolic diseases. . Insulin resistance risk factors : 1. 45 years and older 2. Overweight or obese , with excess fat/weight around the waist. 3. Sedentary lifestyle 4. High blood pressure 5. High stress lifestyle 6. Fasting triglycerides more than 150 mg/dl 7. Chronic inflammatory condition 8. Medications: cortecostetoids, antiretrovirals, antipsychotics. To measure insulin resistance - HOMA-IR blood test HOMA-IR: blood test in AM, after overnight fast ( only water) of 12 hrs , under no stress, no tooth extraction, no infection, no inflammation ( ex. Joint inflammation/ arthritis), no meds ( of cortecostetoids, antiretrovirals, anti psychotics )no vaccinations Formula: a) if Glucose data in mg/dl: Fasting Insulin ( microunits/ml)X fasting glucose ( mg/dl) divided by 405 b) if Glucose data in millimoles/L Fasting Insulin ( micromoles/ml) X fasting glucose ( millimoles/Liter) divided by 22.5 Interpretation: 1 is normal Less than 2.5 - insulin sensitive Greater than 2.5 - insulin resistant Or: Under 1.5 ideal or perfect Between 1.5 to 2.5 - mild insulin resistance. Between 2.5 to 7 - insulin resistant
@donrad
7 ай бұрын
Please do a video about hyperinsulinemia. When a person has chronic insulin resistance it means they also have chronic high levels of blood insulin. High levels of this powerful hormone circulating in the blood all the time has terrible health consequences; the number one of which is it makes it impossible for the person to burn body fat. So the person has to rely on frequent meals of carbs, sugar, or alcohol - which further increase the insulin resistance and hyperinsulinemia. A vicious cycle disease plaguing the majority of humans on earth. Symptoms of hyperinsulinemia include: Weight gain.. Cravings for sugar. Intense hunger. Feeling frequently hungry. Difficulty concentrating. Feeling anxious or panicky. Lacking focus or motivation. Fatigue. A number of complications may occur as a result of having hyperinsulinemia, including: Increased uric acid level Raised triglycerides Atherosclerosis Weight gain Hypertension Type 2 diabetes. The earlier a person with hyperinsulinemia is diagnosed, the more likely it is that the above complications can be prevented or the extent of these complications can be reduced. Thank you kindly
@patriciahoke4722
Жыл бұрын
This is a very accessible channel. Still - it seems to have synthesized the works of people I've been following for years if not decades - Lustig, Ludwig, Attia, Fung, Diet Doctor, and on and on. I'm always wondering how much these youtube experts are cribbing from each other!
@nourishedbyscience
Жыл бұрын
Ha, always good to be skeptical. I am certainly not claiming to be perfect, but I do not watch other people's content when making these videos. Instead, it's all based on my own research. In many cases literally my own research in my own lab (I was an academic clinical researcher for about 25 years), and otherwise by studying the scientific literature. I invite you to click on the links to my blog post that you'll find in the description box underneath each video, and that will show you all of the scientific publications that were considered for each video. Best, Mario
@patriciahoke4722
Жыл бұрын
@@nourishedbyscience Thank you, good to know.
@gregassan
9 ай бұрын
Thanks Mario very interesting
@minativishwakarma3985
9 ай бұрын
Useful information!!👍
@okritsky
Жыл бұрын
why do you think infla... triggers IR but not vice versa? I have the opposite information: only when I had reduced my IR I got rid of my arthritis, not earlier... and nothing could help.
@nourishedbyscience
Жыл бұрын
Did I say somewhere that IR does not cause inflammation? If so, I appologize. I have myself published that elevated insulin levels may play a role in activating the immune system, so this is something I am very familiar with. However, it's not the main point of the video, so that's why I didn't want to get into that specifically here. Cheers Mario
@okritsky
Жыл бұрын
@@nourishedbysciencewow!thank you for the response and so fast! I was triggered for the comment at 13:05 of the video. Because I expected to hear "because inflammation can be an indicator of existing IR, or can be caused by IR..." And it's ok, as you have just explained. I was just amazed maybe you really meant that an inflammation can lead to IR too?
@nourishedbyscience
Жыл бұрын
@@okritsky Ah, I see what you mean. I put this list at 13:05 together to help people assess whether they may be at risk of insulin resistance, so that's why I only talked about inflammation as a cause of IR. You are correct though that it can go both ways, and potentially lead to a viscious cycle over time. There is always so much to talk about. I try to be systematic when i make these videos, and stick with the main theme. Otherwise, it becomes confusing and too long (even though know I am already guilty of that ...;-). Cheers Mario
@okritsky
Жыл бұрын
@@nourishedbysciencecool! thank you! and I think 20 minutes (+-5 min) is the best or optimal video length in this area of knowledge (even watching other channels - this length is like a "golden standard"). so, you have good videos: quite clear, optimal length, and yes, you are really well systematic)
@wishingb5859
5 ай бұрын
Thank you for this video. I was recently diagnosed as Diabetic and I have immediately changed my diet to Whole Food Plant Based very-low fat and no refined carbs. I have not gone on meds yet as I asked for 3 months to try to reverse it with diet. I lost 13 pounds in my first month. Two to go. But I want to know if I am changing my insulin resistance and you just gave me a way to do it. I also need to take the C-Peptide test (according to Mastering Diabetes) to figure out if my body produces enough insulin to reverse it with diet alone.
@JacquiQ
11 ай бұрын
people say oatmeal is so healthy yet every time I eat it it makes me hungry and crave sweets. I also put on weight with it.
@nourishedbyscience
11 ай бұрын
I hear this a lot with oatmeal. I think it's good to pair with some protein, or stay away from it if it clearly gives you issues. Cheers Mario
@hernancoronel
Жыл бұрын
Thank you for the video! It would be interesting if you could make a video on leptin resistance.
@nourishedbyscience
Жыл бұрын
For sure. At some point, there will be a similar series about body weight regulation. It's going to be a while, though, because I have a lot of plans for more videos about blood sugar. Cheers Mario
@sranney1
Жыл бұрын
Insulin resistance is a big problem, cancer risks
@MJYouAreNotAlone1
Жыл бұрын
I would like you to do a video on your opinion of the keto lifestyle. I had an A1c of 5.8. I have been doing the keto diet for a year now my A1c is 5.5. But my glucose monitor the numbers are usually somewhere between 101 and 115. That would suggest I am still prediabetic. Please help me with this. Thank you and God bless you!🙏❤️
@anomarnamloh7444
Жыл бұрын
You are more then likely in an Adaptive Glucose Sparing state in your Keto Lifestyle.. Meaning: Your muscles are preferring fat as a fuel and saving your glucose to use for functions that require glucose. This stste is not a problem. I have the same Adaptive Glucose Sparing state. If you want to know more "clap back" to me and I'll give you the Science link(s)
@MJYouAreNotAlone1
Жыл бұрын
@@anomarnamloh7444 please send me that information. Thank you so much for responding to me. God bless you!🙏❤️
@Tyrannocaster
Жыл бұрын
Lol, sock puppet
@aspiresk8boarding
11 ай бұрын
Avoiding carbs increases insulin resistance. We would pass out from hypoglycemia of this weren’t the case
@maplenook
9 ай бұрын
Fast and carnivore
@rajg7037
10 ай бұрын
This video series has been incredibly helpful and informative. Please keep making content, the quality of the information is excellent. Thank you!
@cauwenberghsroeland8607
Жыл бұрын
I did notice that loosing weight with prediabetes ( sugar 1,12 g/l ) does provoke very high triglycerides, the high insulinaemia provoking to low lipoproteinelipase. The risk is that unsaturated fatty acids will peroxydate in the body and get transformed into VLDL. Attention too : even avoiding sugarpeaks consuming full of fibre, still carbs, but allso proteines, will be tranformed in glucose, and push the insulinaemia..., I think that this will allways slow down the production of lipoproteinelipase, and is the reason why "for a nothing" lost weight comes so easily back...Not only there will remain the risk of have again insulinemia to high, provoking that fatty acids will be rather stored than burned... diet and movement will remain permanently necessary...That is how i do understand... Is this correct?
@marilyncurtis5011
7 ай бұрын
Thank You!
@jackolantern7342
Жыл бұрын
Thank you for this video and upcoming series. This is tremendously informative. I have a question on insulin on storage -hopefully, I didn't miss it from a prior video. Does insulin trigger a simultaneous storage of glucose into muscles, liver, and fat cells? If so, does that mean that glucose just ends up in fat cells only because the former stores become full/saturated first?
@nourishedbyscience
Жыл бұрын
Excellent question, but a straightforward and short answer would be difficult. However, this will be covered in future videos, including in the very next one in which we'll discuss the causes of insulin resistance (because what happens when all of the target tissues for insulin are 'full'?). Cheers Mario
@jackolantern7342
Жыл бұрын
@@nourishedbyscience Excellent. Thank you!
@anara5570
8 ай бұрын
I no longer bother going to doctors and begging for tests, I do all tests on my own🔴. Quest-on-demand offers many tests, although i still haven't seen them offering insulin resistance test. Will shop around and see which lab does it offer. 🍎🍎🍎 By the way, the lab prices are so discounted (when buy on your own) that it's cheaper to buy my own test than do it through insurance + doctor's fees.
@jensbjorkkvist
2 ай бұрын
Is there a way to calculate this whit fasting Glucose and C-peptide value??
@nourishedbyscience
2 ай бұрын
Yes, and that's even better because c-peptide tends to be less volatile than insulin. However, the interpretation is not as straightforward, as we have fewer data linking c-peptide-based HOMA to health outcomes. Still, you can probably google the formula (depends on your units of measurement as well, so pay attention to that). Cheers Mario
@Makinghumanlifebetter
7 ай бұрын
It is very unfortunate that the whole medical world is corrupt. As a diabetic for past 18 years, not even one doctor has suggested HOMA IR until recently. I reduced my A1C from 12.4 to 6.0 in about 30 days just by changing diet and exercise. HOMA IR came out at 4.2. Imagine, if any Doctor would have tested this and asked me to make lifestyle changes earlier. The world is just too corrupt. Fortunately, I signed up for a remission program that has already resulted in lower LDL, Pressure and Diabetes medications. Hoping to get to A1C under 6. Looking for help on Insulin Resistance reduction back to under 2
@lovrodujmovic1223
Жыл бұрын
Are the effects of stress on fasting insulin that you mentioned strong? I was on a whole food diet for a year when I wanted to check my insulin resistance. I have a really good lipid profile, very low inflammation markers, no chronic illness, phisically active daily, bmi 18.7, very good CGM results (eating lots of whole food carbs daily), hba1c is 5.0, i'm 37 yrs old. But still my fasting insulin is the only thing that is higher than I would expect, around 8-10. The only thing that i suspect is that I seem to have quite high stress/anxiety before and during the blood draw. Could that have such a strongh effect on fasting insulin?
@nourishedbyscience
Жыл бұрын
It depends on how stressed someone is. If you are stressed enough to feel stressed and anxious when the blood is drawn, this alone could explain an increase in fasting insulin. Here, for example, is a scientific paper on 'stress-induced diabetes': www.ncbi.nlm.nih.gov/pmc/articles/PMC9561544/ Now, this is obviously if someone is chronically stressed. Considering your HbA1c, this doesn't seem the case for you, for sure, but it may explain slightly elevated fasting insulin levels when you have your blood drawn. Hard to know for sure though. Cheers Mario
@lovrodujmovic1223
Жыл бұрын
Thank you so much for the reply! Great video, as always
@KoiRun50
Жыл бұрын
Sounds like me except I'm 57. I would imagine, just like blood pressures , insulin levels could be very dynamic. My blood pressure readings tend to be higher at the doctor's office; "white coat syndrome." At the time of blood draw, I'm pretty sure there are blood markers that are more dynamic than other when faced with 'acute' 'perceived' stress levels. This would be an interesting topic for Mario to cover. I think he did cover this a bit here.
@eugeniebreida1583
Жыл бұрын
@@nourishedbyscienceThank you for that important link to Review on Stress and Insulin/resistance if chronic.
@YeshuaKingMessiah
Жыл бұрын
Lots of carbs daily is why ur IR is high Ur body isn’t politically correct. Carbs are carbs to it. Dr Wm Davis (cardiologist) speaks about BG not moving from food ingestion. When u eat this way, ur IR will come down, definitely. (Yes, this means keto/very lowcarb)
@suzannecase6170
Жыл бұрын
My A1C was 6% to 6.1% I lost 55 lbs on a low carb diet and my A1C dropped to 5.4%. BUT my fast insulin only dropped from 15 to 13 to 12.4. Over about 1 yr. How long does it take for fasting insulin to drop to a healthy level (
@nourishedbyscience
Жыл бұрын
Losing this much weight should have an effect, and it did, but please be clear that insulin resistance can be caused by a lot of different things. I'll cover most of the main causes and contributing factors in the next two videos, so maybe this information will provide some clues to you about what is going on. Cheers Mario
@suzannecase6170
Жыл бұрын
@@nourishedbyscience thank you for your message I’ll be watching.
@chrisk8978
Жыл бұрын
I’ve been battling IR for a year now with good, but not great, results using mostly NMR lipid profiles. I focused on Whole Foods plus low carb/low sat fat. But I’ve recently learned about high fat intake (even M/PUFA’s) creating IR by blocking the insulin receptors inside of the muscle cells. Do you agree that this contributes to IR and that dietary fats of all kinds should be limited? Thanks!
@YeshuaKingMessiah
Жыл бұрын
SAT fats don’t do this, stay away from seed oils (ur M/PUFAs). Eat animal fats.
@aspiresk8boarding
11 ай бұрын
High carb low fat is effective for gaining insulin sensitivity. Avoiding carbs is counterproductive, it increases stress hormones which increases lipolysis. More fat circulating in the blood the more it impedes glucose uptake. Avoiding carbs increases insulin reactance
@YeshuaKingMessiah
11 ай бұрын
@@aspiresk8boarding flat out lies Besides the word salad
@aspiresk8boarding
11 ай бұрын
@@YeshuaKingMessiah Where’s the lie Yeshua? Check out Kempner’s rice diet. Or other low fat high carb diets treating IR. It’s usually high stress hormones or body fat creating high blood lipids which blocks glucose uptake via randle cycle. Avoiding carbs does not get to the root of IR
@aspiresk8boarding
11 ай бұрын
@@YeshuaKingMessiah Where’s the lie Yeshua? Check out Kempner’s rice diet. Or other low fat high carb diets treating IR. It’s usually high stress hormones or body fat creating high blood lipids which blocks glucose uptake via randle cycle. Avoiding carbs does not get to the root of IR
@SlapHappyRetirement
Жыл бұрын
Am I right in thinking that Insulin is the fat storage hormone and therefore more insulin > more fat > more insulin resistance > need more insulin and so on, A vicious cycle. How to interrupt that?
@nourishedbyscience
Жыл бұрын
Good question. Complex answer. This is a common narrative, particularly in the low-carb community, but the science isn't clear on how much this is a factor in weight gain and obesity. The body indeed needs insulin to store fat effectively. However, even if you consume a low-carb diet, you usually have a little bit of insulin in your body, and it isn't clear that having slightly higher insulin levels that result from eating carbohydrates makes it more likely that you'll gain weight. In fact, if we look at human intervention studies, people can lose weight similarly effectively on low-carb and high-carb diets. Much more to say about this, and I'll cover this in separate videos at some point. Whether or not elevated insulin plays a key role in weight gain or not, however, I'd say it's abundantly clear that we would benefit from maintaining good insulin sensitivity and avoiding chronically elevated insulin levels, simply because insulin resistance and hyperinsulinemia are risk factors for other medical conditions such as type 2 diabetes, heart disease, cancer, and kidney disease. Best, Mario
@Straightdeal
Жыл бұрын
You can calculate it yourself; easy peazy. You just need your fasting glucose and insulin readings.
@rajeshtanwar2445
Жыл бұрын
Very valuable, objective and scientific knowledge covering various aspects of Insulin resistance...
@fernandov5667
Жыл бұрын
great video!
@sheilam4964
Жыл бұрын
Thx.
@strath1960
Жыл бұрын
Is this information relevant for Type 1 diabetes?
@nourishedbyscience
Жыл бұрын
Great question. It's not entirely irrelevant for T1DM. However: as you probably know, Insulin resistance is not the primary problem in type 1 diabetes, but - maybe obviously - people with type 1 diabetes can also become insulin resistant on top of their diminished insulin production capacity. I personally would not use HOMA-IR in that case to determine how insulin sensitive/resistant I am, because IMO it's value is uncertain when most or all of the insulin in blood has been injected. However, given that the insulin doses needed to control blood sugar levels are dependent on the patients insulin sensitivity, a type 1 diabetic should have a pretty good sense anyways of their degree of insulin sensitivity. If this is unclear, maybe discuss your specific case and insulin dose relative to carb consumption with your doctor, and he/she should be able to give you a sense of whether insulin resistance seems to be a concern. By locking at basal and bolus insulin requirements relative to carb dose and the resulting blood glucose levels throughout the day, one should be able to get a better sense of insulin sensitivity than HOMA-IR could provide in a healthy person. Cheers Mario
@finnster5800
Ай бұрын
I have A1C of 5.7 so prediabetic. I also recently diagnosed with atrial fibrillation. Could this be caused by insulin resistance?
@nourishedbyscience
Ай бұрын
The glucose intolerance quite possibly yes. Atrial fibrillation not so likely. Either way though, it's good to know if you are insulin resistant, so that you can figure out why that is and address the cause.
@Jack_Schularick
Жыл бұрын
Exceptionally good video, thanks Mario! Is waist circumference not a good proxy for insulin resistance without all the trouble and loss of time?
@nourishedbyscience
Жыл бұрын
Thank you. Yes, waist circumference is reasonably good to detect obesity-associated insulin resistance, which accounts for most cases these days. However, there are many other causes of insulin resistance (as we'll discuss in the next video), such as certain medical conditions, certain medications, chronic stress or sleep deprivation, very low muscle mass/sarcopenia, etc., and none of these would necessarily be reflected in waist circumference. Cheers Mario
@Jack_Schularick
Жыл бұрын
@@nourishedbyscience Agreed! But even stress induced IR will probably have a big waist (cortisol). If anything, i'd say that if one has a big waist to start with and has a lab confirmed IR, then the dynamics of the waist mirrors the dynamic of IR. Would you agree?
@eugeniebreida1583
Жыл бұрын
@@Jack_SchularickI have chronic high stress, concerns about diabetes, and ZERO excess fat (perfect/narrow “waistline”, size 0 clothes), so I’m with our PhD here, that waistline IS useful for many - but other factors must also weigh in.
@Jack_Schularick
Жыл бұрын
@@eugeniebreida1583 Agreed. Yesterday i had a patient with a normal waist, a biologically young and fit 60 ys old lady, and already type 2 diabetes and breast cancer. Sad. Probably a very strong family disposition. But most insulin resistant do have big bellies.
@eugeniebreida1583
Жыл бұрын
@@Jack_Schularick That is very sad . . . yes, could be a disposition for eaither or both. In that you are an MD, may I ask which woul be teh best IR labs I could request of less enlightened GP in order to get the highest level data w/least strain on his/her ego? Much appreciated. (there is no concern as to lab cost). Thanks, if you would be so kind. (and thank you, as well, for giving me hope that I am a pretty healthy skinny 64 yr old in terms of diabetes potential. I have an inflammatory issue, however, which leaves me nervous, and impatient to know IR status)
@Bakerqueen925
27 күн бұрын
Hi, Mario. All of my tests are normal. I’m 5’4” and recently lost 20 pounds and weigh 121. Bp is great. I’m an active tennis playing 65 year old female. Homa IR is 0.6. Trig are 67. HDL is 100. Total cholesterol is 307. I watch my carbs and use IF. My A1C is 5.4 down from 6.0. My fasting bg runs 92 to 110 depending on my carb intake. Here is my question. I SPIKE with ANY significant carbs. Any small dessert or extra carb serving. I don’t know why? As high as 200 to 230. Then it comes down within 3 hours. What’s wrong? Thank you!
@nourishedbyscience
25 күн бұрын
The fact that your blood sugar goes up so high could be due to a diminished first-phase insulin response, i.e., a reduction in the amount of insulin produced by your pancreas immediately after you consume carbs. To some degree, this can be genetic in nature, and is often seen in people with a family history of T2DM. However, there are some known factors that can contribute to a diminished first-phase insulin response: 1.) Excessive fat accumulation in the pancreas. This is commonly seen in people who carry extra weight. I explain this more here: kzitem.info/news/bejne/xIZrnaODcZ5zlIosi=03atoeDX4WFWVGYv This has been shown to be often reversible with a loss of the excess weight. 2.) A low-carb diet. People who ear few carbs store less and less insulin in their pancreatic beta-cells over time. And this stored insulin is what is secreted as part of the first-phase insulin response. Thus, one recommendation is to always eat similar amounts of carbs during each meal (always low-carb, or always medium-carb, or always high-carb). Again, if someone has a diminished first-phase insulin response due to being on a low-carb diet, or even just if they occasionally have low-carb meals, they would be expected to have a poor first-phase insulin response whenever they do eat carbs. Thus, if you have been low-carb for a while, re-introduce carbs slowly and in small amounts, and initially focused on low-glycemic index carbs. You also mention that your blood glucose takes about three hours to return to baseline. That is too long, and may indicate some insulin resistance. This is even though your HOMA-IR is low. From a HOMA-IR in the normal range, we can conclude that you are not insulin-resistant in that fasting state. Usually, fasting insulin resistance is strongly associated with insulin resistance in the postprandial state (i.e., after meals). However, there are exceptions to this. For example, someone who is lean may be insulin sensitive in the fasting state because they have no fatty liver (the liver is the main insulin-sensitive tissue in the fasting state), but maybe they have a lot of stress during the day, or they have very little muscle mass, or they are physically inactive. All of these factors could make them insulin-resistant throughout the day and also after all of their meals. I talk about all of the different factors that can cause insulin resistance in this video here: kzitem.info/news/bejne/qY-q1KCIfKNpZqgsi=O0StX0aMOxj-vKGm So, again, because I know this can be confusing: while in most people, HOMA-IR provides a good estimate of overall insulin resistance, this may not be the case in some people, depending on their specific circumstances. The fact that your blood glucose frequently goes to over 180 mg/dL (10 mmol/L) and stays elevated for an extended period of time does suggest some degree of glucose intolerance, and even though your HbA1c is now in the normal range, I would encourage you to try to get to the bottom of whatever it is that is making you glucose intolerant. I have a few videos about this that may help, but more will be coming on this subject soon. Best, Mario
@Bakerqueen925
25 күн бұрын
@@nourishedbyscience thank you so much for this. I hope to have good news about it one day.
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