We now have continuous glucose monitors – we can scan a person’s glucose all day long and view graphs. This is really cool stuff, I know, but it misses a really important piece. What is the thing that makes glucose correct after a meal? Pancreatic Insulin. (yeah, I have written about insulin before…)

People with type 2 diabetes or prediabetes have proven that cells within their body are resistant to the message of the hormone insulin to some degree. Insulin is the hormone that responds to what and how you eat and works to removes glucose from the bloodstream, storing it as glycogen and fats in the liver, muscle and fat cells.

As some of you know – I am from a family with a strong family history of type 2 diabetes onset. And I wrote about this in The Blood Code, that our type of diabetes is a low/normal insulin type. Meaning we are leaner people. We don’t gain weight prior to the diabetes or prediabetes onset. But not so fast to judge here, thin type 2 diabetics die of heart disease sooner than heavier people given all the same blood sugar numbers. This surprises a lot of people, that the thinner type 2’s have GREATER risk of early death (if not treated and dealt with properly).

What happens when you have high insulin: But this note is about the high insulin folks. They gain central body fat for years but keep their blood sugar in good ranges. On lab tests, I will see the fasting lipid panel show a triglyceride (TG) that is higher than 100 mg/dL. The glucose is normal! The HgbAic is normal and below 5.7%! So their doctor does not look further. The plan is to blame the person for gaining weight and wait until the prediabetes symptoms start to appear:

• Gradual onset of high blood pressure

• Excessive central weight gain

• Dyslipidemia – a disturbance of the cholesterols and triglycerides on a fasting lipid panel involving a lower HDL (good) cholesterol as TG goes up

• Elevation of liver enzymes especially the one called ALT – this is called fatty liver disease

Why Wait? What is going on in medicine that higher insulin people are blamed for “poor food choices” as they gain weight with their high insulin output. It’s because everything in medicine is revolving around the GLUCOSE. If the glucose is OK, there must not be a problem – no diabetes, it must just be bad choices. Back ten years ago when I was mid-prediabetic with my blood sugars, a physician friend of mine profiled me and said simply, “Wow, that is clearly genetic”. No shaming about food choices – of course because I was not overweight.

If you are a person with higher insulin, you will typically be bigger than someone with low insulin, but the insulin resistance game could still be happening. You produce more insulin so you will keep glucose normal for longer in your life.

What do you do? What am I asking you to do? If you have problems with cholesterol – blood pressure – weight gain and your glucose is not above 100 mg/dL on a fasting blood test, don’t stop there. Your primary doctor will not typically test for insulin. SO you may need to take a deeper dive on your own. Since it is cardiovascular disease usually gets our attention, run the advanced cardiovascular study here. This includes all the fasting metabolic tests including insulin.

I really don’t like to miss the actual problem. I have seen patient in the office and at 55 years old…they are on a statin, tow blood pressure medication and a prescription for reflux. Auggh. Medical standards of practice are too often treating the smoke and ignoring the fire. I know that you will have plenty to work with once you see the more interesting lab panels on yourself like this one.