Fasting Insulin

A test for fasting insulin is one of the most important blood tests you can take; Dr. Joseph Mercola in fact believes that it’s the most important.

It’s important because it shows the degree of insulin resistance — the higher the number, the more insulin resistant. A really high number generally means type 2 diabetes. A number merely higher than normal means metabolic syndrome or pre-diabetes.

Insulin resistance is one of the main causes of chronic disease in the modern world, including heart disease, cancer, kidney disease, and of course diabetes. It either causes or is caused by obesity; the arrow of causation in that case is controversial. Being sedentary also leads to insulin resistance, and exercise can prevent it.

Insulin resistance is strongly associated with obesity, but normal weight people, especially those who are skinny-fat, can have it too.

My fasting insulin test

Doctors don’t routinely test for fasting insulin; they normally do so only if they suspect diabetes.

I’ve had a few tests of fasting blood glucose that were high, in the range of 100 to 110. That’s an odd result, because I eat a low-carbohydrate diet and lift weights, and have a body fat percentage that i don’t know exactly but is no doubt <15%.

It’s probably due to the so-called dawn phenomenon, or physiological insulin resistance, which is normal. When on a low-carbohydrate diet, the liver can become insulin resitant in order to make glucose for the rest of the body. To be honest, the causes of the dawn phenomenon are not fully elucidated, and experts give varying explanations. But the fact is that many people who eat low-carb report it.

Not being clear on whether I should be concerned about my high fasting glucose, I decided to get a fasting insulin test from Life Extension.

Result: 2.9 µIU/ml. Normal range is 2.6 to 24.9. (On this scale, 1 µIU/ml = 6.9 pmol/L.)  Ideal, according to Dr. Mercola and others I’ve read, is <3. The odds ratio for prediabetes rises sharply with increased fasting insulin.

My result was about as perfect as one could want. I think I’m going to live another few years.

Should I remain concerned about my fasting glucose test? Probably not; my non-fasting glucose is actually lower than my fasting glucose, which would seem to indicate, together with my insulin test, that I have no risk of diabetes. It would indeed be strange if I did have increased risk, for the reasons mentioned above: low-carb diet, weight lifting, low body fat, plenty of muscle too.

If you do have a high fasting insulin, then you need to get to work. Below are relative risks of hypertension, high triglycerides, and diabetes based on fasting insulin levels. (Source.)

Image result for fasting insulin

You can order a fasting insulin test through Life Extension; blood is drawn at no extra charge at LabCorp.

PS: Read my book, Stop the Clock, for why insulin sensitivity is important. Read my other books too.

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Leave a Comment:

Murray says January 13, 2017

I had the same thing in my most recent blood test, good cholesterol figures, rock-bottom triglycerides (45.6 mg/dL), but a blood-glucose reading of 99 mg/dL, which is borderline high. I’m not skinny-fat (waist/height ratio of 0.45, low body fat), so it was a bit concerning.

My doctor told me not to worry about it, and the Dawn Phenomenon makes some sense, but I’ll ask for an insulin test next time I get my bloodwork done. Still, I’m thinking that the combination of optimal cholesterol, low TG, and low body fat indicates there’s nothing amiss.

David Johnson says January 13, 2017

Worth checking your Glucagon levels.
Rare pancreatic and GI tumours releasing glucagon can cause these abberrant high Blood sugars.

Fasting Insulin says January 14, 2017

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Ted says January 14, 2017

PD have you looked into IGF1? In my understanding it has a similar role to insulin, and controls fasting glucose. E.g. when pituitary gland releases HGH during sleep, it raises blood glucose, and IGF1 is released to drive it into cells.

I read that certain B vitamins are needed for liver to produce IGF1 which will control blood glucose between meals. I will post some links below with summaries.

ted says January 14, 2017 – Vitamin B12 deficiency common among T1D and T2D patients. – page 10: in rats optimum vitamin B1 requirement to ensure normal carbohydrate metabolism is many times the ordinary protective dose. – Plasma Concentration of IGF-I Is Independently Associated With Insulin Sensitivity in Subjects With Different Degrees of Glucose Tolerance. IGF-I has the characteristics to be a marker for the insulin resistance syndrome. This suggests that low IGF-I levels may be a useful marker for identifying subjects at risk for cardiovascular disease. – Multiple studies (in vitro and in vivo) demonstrate the association between IGF-1 deficit and deregulated lipid metabolism, cardiovascular disease, diabetes, and an altered metabolic profile of diabetic patients. – IGF-I administration increased total IGF-I serum levels 5.3-fold above control. During the control period mean fasting glucose, insulin, C-peptide, and total triglyceride levels were 11.0 mmol/l, 108 pmol/l, 793 pmol/l, and 3.1 mmol/l, respectively; and decreased during IGF-1 treatment to 6.6 mmol/l, 47 pmol/l, 311 pmol/l, and 1.6 mmol/l, respectively. Postprandial areas under the glucose, insulin, and C-peptide curve decreased to 77, 52, and 60% of control, respectively. – diabetics have 2-3x higher growth hormone secretion. In T1D insulin does not reach liver to stimulate IGF1 production, which may explain why GH secretion is not controlled (as IGF1 is important in controlling pituitary GH secretion). – Vitamin B12 deficiency decreases Taurine production. Taurine induces GH-dependent IGF1 synthesis in the liver. Therefore, low B12 leads to low Taurine and low IGF-1 and retarded growth. – Vitamin B6 treatment of gestational diabetes mellitus (pregnancy diabetes); statistically significant improvement in the glucose tolerance curve after the vitamin B6 treatment, with a lowering of blood glucose levels, despite an unchanged or lowered plasma insulin level. Thus a relative deficiency in vitamin B6 is associated with some cases of gestational diabetes mellitus and that the replacement of B6 improves the metabolic state. – Dr Darren Schmidt lactic acid cycle. Insulin like growth factor IGF-1 more important than insulin for blood sugar, IGF-1 controls blood sugar between meals, insulin controls blood sugar right after meals. Insulin comes from pancreas, IGF-1 comes from liver. Liver converts lactic acid back to sugar (75%) while rest of lactic acid stays in blood and dilutes arteries and capilaries. Need to maintain 24 B Vitamins (e.g. nutritional yeast or rice bran for full Vitamin B-complex) levels for healthy liver and detox it from metals etc, which will likely affect IGF-1 production.
From comments:
“Diabetics typically have elevated lactate, which shows that glucose doesn’t have a problem getting into their cells, just getting oxidized.” -Ray Peat, PhD. “Diabetics are relatively unable to oxidize glucose, they produce lactate in the presence of O2, and may synthesize fat inappropriately. Diabetes is relevant to cancer exactly because of their shared inability to oxidize sugar and lactic acid.” -Ray Peat, PhD. “The presence of lactic acid in our tissues is very meaningful, but it is normally treated as only an indicator, rather than as a cause, of biological problems. Its presence in rosacea, arthritis, heart disease, diabetes, neurological diseases and cancer has been recognized, and recently it is being recognized that suppressing it can be curative, after fifty years of denial. Lactate contributes to diabetes, inhibiting the ability to oxidize glucose.

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