A topic of interest for me when talking about health is insulin resistance. My initial dive into the subject came after reading Max Lugavere’s “Genius Foods“, where I learned about Alzheimer’s sometimes being called type 3 diabetes – or insulin resistance in the brain.
Having seen more of my peers be diagnosed as diabetic or pre-diabetic has gotten me to really open my eyes to the diabesity epidemic in America. I finished up the book “Obesity Code” by Dr Jason Fung last year and am now reading “Diabetes Code” by the same author.
As many of you know, I’m currently tracking my blood sugar with a CGM. I do not have diabetes, but am very interested in the data so I can personalize the most optimal routines in my life.
First off, what is Diabetes?
Diabetes is a disease that occurs when your blood glucose is too high. According to the CDC:
- 34 million US adults have diabetes
- Diabetes is the 7th leading cause of death
- In the last 20 years, the number of adults diagnosed with diabetes has doubled
- More than 1 in 3 adults have pre-diabetes, and more than 84% of people don’t know that they have pre-diabetes
To explain diabetes, I first have to explain both the hormone insulin and blood glucose (i.e blood sugar). When you eat, carbohydrates are broken down into glucose (fat gets broken down into ketones during lipolysis when carbohydrates are not present), which serves as a source of energy for your cells. This is where insulin comes into play.
I like to use the “lock and key” analogy to explain insulin. Think of your cells as being locked and insulin as being the key to allow glucose to enter your cells and provide you with energy. Diabetes is when blood glucose raises too high, which causes a number of problems.
There are three main types of diabetes:
- Type 1 Diabetes: Type 1 diabetics cannot produce insulin. In this scenario, blood glucose rises but there is no insulin to transport the blood glucose into cells. The body is depleted of energy and rushes to burn fat into ketones, which can lead to ketoacidosis (more on that below).
- Type 2 Diabetes: This was once known as adult-onset diabetes but is now frequently occurring in children as they eat more and more processed foods with added sugar. Type 2 diabetes occurs when your cells and filled with glucose, and more and more of it is consumed. The effect is that the insulin has nowhere to transport blood glucose and becomes less effective, leading to insulin resistance.
- Type 2 diabetes can lead to kidney failure, lower-limb amputations, and adult blindness (source: CDC)
- Alzheimer’s is known as Type 3 diabetes, or insulin resistance in the brain. Alzheimer’s begins developing 30 years before the first symptom shows.
- The typical treatment is to inject more insulin into a patient. However, that doesn’t address the root cause of the issue. It’s like having a water leakage and putting more and more buckets to catch the water spilling. The better solution is to turn off the water and consume the water already out before turning it on again!
- Gestational diabetes: Gestational diabetes develops in pregnant women.
Diabetes is diagnosed either with a fasted blood glucose reading of over >120 or a hemoglobin A1C reading of >6.5 (5.7-6.5 = -0.8 pre-diabetes). As many of you have seen from my CGM (continuous blood glucose) experiment, I’m not tracking my blood glucose levels at all times of the day to see where it trends, and how my blood sugar responds to stress, diet, training, and lifestyle.
How To Measure:
Fasted Blood Glucose and Hemoglobin A1c are taken during your routine blood tests. Hemoglobin A1c numbers are typically the standard of diagnosing diabetes, as fasted blood glucose can be inaccurate as a measure during one particular point in time. A1c, on the other hand, measures the glucose that binds to your red blood cells. As red blood cells’ average lifespan is 3 months, the hemoglobin A1c measures average blood glucose over that time period.
Additional tests:
HOMA-IR: What I’m learning now, is that HOMA-IR is a more accurate measure of insulin resistance, but is not commonly tested. This test considers both blood glucose and insulin and measures the relationship between the two metrics, showing how efficiently insulin can transport glucose into your body’s cells. I request this test in addition to my routine bloodwork.
LP-IR: Another test that is frequently shown on my results is an LP-IR score. This comes with an NMR test, which is one that I will explain in a separate post about Cholesterol (that I will write in the next week or so). LP-IR measures insulin resistance in combination with 6 lipoprotein metrics and has a high correlation with HOMA-IR.
