If we can find insulin resistance, we can prevent diabetes!

Most physical exam “preventive lab profiles” check fasting glucose for diabetes screening. Did you know that the body has several mechanisms for maintaining blood sugar balance and that by the time the blood sugar is increased, insulin resistance is well under way?

There are 13 markers that my lab utilizes to detect early and late insulin resistance but I will only look at a few of them for the sake of mental space and time.

HbA1C-Hemoglobin A1C is a traditional diagnostic criteria for pre-diabetes and type 2 diabetes. It is usually ordered after someone is showing higher fasting glucose levels and then to monitor diabetes status and compliance with meds and diet. It measures average blood sugar over a 2-3 month period. Chronic high blood sugar shown in high HgA1C is associated with premature aging and increased risk for microvascular damage and cardiovascular risk.

Insulin is a hormone made in the pancreas to regulate glucose levels by moving glucose into the tissues. Higher insulin levels indicate insulin resistance resulting from high glucose intake. It may cause cognitive decline, reduced bone strength, and cardiovascular disease risk.

C-peptide is produced in the pancreatic beta cells during insulin formation. It may be an earlier measure of insulin resistance than insulin because it isn’t cleared in the liver as quickly as insulin is. Elevated levels are associated with increased risk of cardiovascular disease.

Adiponectin is an anti-inflammatory hormone produced by fat (adipose tissue) that protects blood vessels, inhibits plaque formation and promotes insulin sensitivity. Low levels may contribute to type 2 diabetes but high levels are paradoxically associated with cardiovascular disease risk. Exercise, diet, weight loss, and insulin sensitizing herbs and medications can increase serum adiponectin and prevent diabetes and cardiovascular disease.

Body fat also determines sensitivity to insulin, which is also influenced by inflammation status. Leptin is another hormone produced by fat cells that normally suppresses appetite and enhances energy burning. It also helps regulate glucose and lipid balance, immune function, and bone building. When levels are chronically high (caused by obesity), the signal to decrease food intake or increase energy burning stops working or we develop leptin resistance. High levels indicate higher risk for diabetes and difficulty losing weight through exercise. Leptin resistance is also thought to promote cognitive decline and dementia.

I almost skipped the one value that I scored badly on! Was that denial?

Free fatty acids are the form of fat that is transported from the tissues in the blood to be used by other sites for fuel. When these are high they can impair the body’s response to insulin and cause glucose levels to rise. High levels of free fatty acids can also increase very low density lipoprotein (VLDL), which increases the risk for diabetes and cardiovascular disease.

All of these markers appear well before blood sugar levels alert us to developing diabetes and cardiovascular disease. We can respond to prevent these endpoints with the above lifestyle modifications, along with herbs like gymnema, milk thistle, prickly pear, devil’s club bark, and berberine.

If you would like your Complete Cardiometabolic Assessment done, give us a call!