a simple (at home) diagnosis of prediabetes
“I wish you would have come to me two years ago—even five years ago, when this was still prediabetes. You could have reversed this with diet and exercise. I’m sorry to say this, but you now have type II diabetes.”
It’s hard to know what’s harder to hear. That you have diabetes or that it could have been prevented.
But although doctors often give us these “I wish you would have come to me sooner” kind of explanations for their own failings, the truth of the matter is that even if you had shown up five years earlier, your doctor likely would not have tested you for prediabetic insulin resistance ( except if you presented with obvious symptoms).
Frustrated with a broken medical model, individuals everywhere are taking the prevention of diabetes into their own hands and putting the health back in healthcare. Today there is a growing number of at home lab tests that are available for undoctored, self-managed healthcare consumers and quantified selfies like us to track and monitor insulin resistance and prediabetic blood levels.
The HOMA test is the most accurate gauge of insulin resistance and the best test to gauge one’s likelihood of developing diabetes that your doctor is not doing. But you easily can, at home, without a doctor’s prescription.
What is the HOMA-IR?
The HOMA-IR is a diagnostic tool called the homeostasis model assessment of insulin resistance or the blood code calculation, and it is a highly accurate formula proven to accurately detect insulin resistance before prediabetes or diabetes occurs.
It’s a simple calculation and multiple diabetes websites have handy calculators online to calculate the HOMA-IR score. You need only plug in the results of two simple, affordable blood tests, a fasting insulin test and a fasting glucose test, and you can chart your level of insulin sensitivity or lack of it on a handy scale.
What’s astounding is that The HOMA-IR can detect blood markers for type II diabetes 10 to 15 years in advance – when it’s not even diabetes yet—heck when it’s not even reached a stage of prediabetes yet . . . When diabetes is still in a state of infancy called insulin resistance – a stage that’s easily and completely reversible with simple lifestyle changes.(i)
Today, Self-Managed Healthcare is Preventative Healthcare
So, why aren’t doctors testing for insulin resistance when today, 1 in 3 people aged 20 or older already have prediabetes?(ii)
Clearly such statistics indicate a need for using tests that can predict prediabetes well in advance.
We can ask such questions all day long but what it comes down to is they’re not testing for IR. They’ll test for diabetes later, when you show symptoms, but not before.
See, we have a medical model that’s more about treating symptoms than the root causes of those symptoms. It’s not about strategizing preventative solutions.
For example, the way the diabetes medical model works is you present with symptoms of diabetes, like frequent urination or thirst, and then they order glucose tests.
But if you’re suffering with symptoms like these, your blood sugar is already toxic and you’re already far past insulin resistance and into diabetes territory.
That’s not preventative healthcare. That’s simply diagnosing a disease that could have been prevented.
As Dr. Shawna Darou contends, “if testing for insulin resistance began as part of a standard physical examination, we could catch people who are at high risk of developing diabetes at a stage where it is reversible.”(iii)
Frustrated with a broken medical model, individuals everywhere are taking the prevention of diabetes into their own hands and putting the health back in healthcare.
Today, companies like True Health Labs and ZRT Labs are making preventative healthcare available to everyone, offering innovative blood, urine, and saliva tests you can order yourself that can save you from deadly diseases and conditions of all kinds, from diabetes, to neurotransmitter tests that predict conditions like Alzheimer’s, to tests for hormonal imbalance, and dangerously skewed Omega-6 to Omega-3 ratios.
Science is progressing in ways that are changing the face of healthcare, enabling us to prevent and not just treat disease.
If your doctors aren’t keeping up with the range of options out there to effectively prevent disease—you can.
And these tests are more affordable than a doctor’s visit with labs.
Let’s talk about what insulin resistance is, how widespread the problem is, and how you can chart your own insulin resistance, so neither you or your loved ones ever have to get a diabetes diagnosis.
Insulin Resistance: A Whole World at Risk
In 2014, a whopping 422 million people were diagnosed with diabetes.(iv)
Type II diabetes, also called “impaired glucose metabolism,” is the most prevalent form of diabetes in the world, making up 90 to 95% of all diabetes cases.(v)
Type II diabetes is acquired diabetes—acquired through unhealthy life factors such as being overweight, carrying a lot of belly fat, poor eating habits, a diet overly rich in refined carbohydrates and fat, a high waist circumference, a high fat to muscle ratio (BMI), an overly sedentary lifestyle, a genetic predisposition to diabetes, and other factors.(vi)
The unhealthier the lifestyle and the more of these at-risk factors you have from the list above, the higher the likelihood that you will develop diabetes at some point in your lifetime.
A major study published in 2014 in The Lancet, revealed alarming statistics about how pervasive insulin resistance and prediabetes is becoming, projects that by 2030, more that “470 million people will have prediabetes.”(vii)
By the age of 45, in fact, your risk of developing prediabetes is 48.7% and there’s a 74% likelihood that this will develop into type II diabetes.(viii)
So nearly half of all people over 45 are going to get prediabetes caused by insulin resistance (which could have been prevented had they known they were becoming insulin resistant) and 3/4ths of them will acquire diabetes because they didn’t catch it in time to reverse it.
But here’s the capper -- they could have saved their lives for $88.
For less than $100 then, you can order an insulin test and a glucose test, calculate your IR yourself and know where you stand. So, keep reading – you do not have to be one of the 470 million or more that will be diagnosed with diabetes by 2030—or before.
What are the Consequences of Diabetes?
Diabetes is a deadly condition that often leads to kidney failure, metabolic syndrome, heart failure, cardiovascular disease, organ failure, amputations, blindness, glaucoma, and several cancers including prostate, breast, kidney, and liver cancers.(ix),(x)
The best preventative against diabetes today, given the state of our food supply is to take a highly proactive approach by
- testing the glucose and insulin levels of ourselves and our family members
- charting our degree of insulin sensitivity now and throughout life via the HOMA-IR tool
- tracking our blood sugar responses to everything we eat—not just “junk” foods
As you know, we live in a word with genetically engineered produce that is plumped up with sugar water and devoid of nutrients – how could we not be becoming insulin sensitive when even tomatoes are nothing but water, sugar, and pesticides?
Catching diabetes before it becomes diabetes should be the goal of the world public since it threatens all of us with death – but when it is still a fledgling condition called insulin resistance. This mild condition can be reversed through diet and moderate exercise and by monitoring one’s HOMA-IR score throughout life to make sure they don’t become insulin resistant again.
What is Insulin Resistance?
In the very, very early stages of diabetes—before you develop prediabetes even, there are signs in the body that there is a problem on the horizon. There are thunder clouds in the blood warning us of this approaching storm.
It’s called insulin resistance and although doctors do not know each and every mechanism which causes it, we do know that it comes from an excess of glucose staying in the bloodstream.
This excess glucose can happen for all kinds of reasons – constant and consistent overeating, lack of exercise which would help burn off the excess glucose, a lifetime of refined carbs and excess fatty acids, fat tissue on the body that confuses complex signaling mechanisms—there are all kinds of unhealthy behaviors and factors that contribute here.
In its simplest terms and shortest explanation, with insulin resistance, too much glucose is in the blood – so much there’s no room for it in the cells anymore. So the cells stop listening. Then this not listening becomes a habit (as it does in life as well).(xi)
Then we have a real problem.
What we want is insulin sensitivity. Insulin sensitivity is ideal. It’s a state of non-diabetic risk.
This means our cell receptors are still highly sensitive to glucose when it’s present in the blood –because it’s not always there as it is on a diet of refined carbs and sugar.
Insulin sensitivity is when everything in the body in terms of blood glucose (sugar) and insulin (the hormone that keeps blood sugar in check) is operating smoothly without a hitch.
Insulin sensitivity means that when you eat carbohydrate your body shuttles glucose everywhere it needs to go very easily and effectively, fueling your cells, tissues, muscles, and organs—with glucose energy.
This means your cells are opening up to take glucose inside them and sending a signal back to the pancreas, yelling at them with a big “A-O.K. Glucose received. Thank you. You can stop with the insulin now.”
When your cells let that glucose in through a little window on the cell called the insulin receptor, the amount of glucose left in the blood decreases, and pancreatic production of insulin slows because that excess glucose is now out of the blood and inside the cell.
It is that being in the blood that signals the pancreas to keep producing more insulin, see. When it is taken up by the cells, mind you, the pancreas gets that important signal to stop.
But, with insulin resistance, your cells are becoming deaf or “immune” to insulin—deaf to its signals. Glucose is knocking on the cell walls going “Hey, let me in there. But like a disobedient child, the cells are going – “I can’t hear you, I can’t hear you.”
So, these glucose molecules stay in the blood. They’re eventually shuttled into fat, but they stay in the blood so long that the pancreas makes far too much insulin.
This stage right here – the stage when our cells are putting their hands over their ears and down regulating their insulin receptors is called insulin resistance -- and it’s an early wake-up call we need to save ourselves and our loved ones from a diabetes diagnosis.
What are The Symptoms of Insulin Resistance?
One of the most common symptoms of insulin resistance is highly unbudge-able weight loss plateaus. These happen for a reason. See, fat burning is greatly enhanced when there is no insulin in the blood. This is why fat burning and muscle building chiefly happen at night, when we are sleeping, fasting, and not eating.
If you want to dip down into your fat stores, you need insulin out of the blood. With insulin resistance, you’re never burning fat. Even if you get all exercise-obsessive in some herculean effort to lose weight, you’ll burn muscle only because you’re running on glucose all the time, not your fat stores.
So you’ll notice a belly that won’t budge, a scale that stays right at the same weight every day, and some other common symptoms as well.
Other symptoms of insulin resistance are:
- Belly fat and the pendulous looking abdomen
- Thinning hair (chiefly women)
- Acne (chiefly women)
- Brain fog and forgetfulness
- Rapid weight gain (typically a gain of 10 to 15 pounds in a number of years)
- Intense cravings for carbohydrates or sweets
- Increased appetite
- Feeling sleepy after you eat
- High blood pressure
- High cholesterol
- Dark patches on the skin called acanthosis nigricans(xii)
But if we catch diabetes right at this stage, before prediabetes even develops, we can reverse insulin resistance and live long, healthy, diabetes-free lives.
We have to watch for these symptoms, some of which tend to manifest in adulthood, right at the time we’re approaching menopause and flagging hormones and might blame IR on these conditions of aging.
How Reversible is Insulin Resistance and Pre-Diabetes?
Both insulin resistance and prediabetes are stages that all type II diabetics pass through on their way to type II diabetes—and both are highly reversible with lifestyle modifications—simple changes in diet and moderate exercise – really, just moderate exercise. The goal is to get out of a sedentary lifestyle and get the metabolism revving again. It’s not like it takes HIIT everyday and deep, exhaustive cardio—don’t think that. It doesn’t.
In fact, in recent report published in The New England Journal of Medicine, Walter Willett, MD, and other researchers from the Harvard School of Public Health demonstrated that 91 percent of all Type 2 diabetes cases could be reversed through simple, easy improvements in lifestyle and diet.(xiii)
But you have to find out you have insulin resistant to fix it.
In fact, finding out one has insulin resistance is often all it takes to jolt someone into having a moment of clarity about their health that can save their lives.
So it’s like prediabetes but in its most reversible stage.
However, until doctors start making these tests a routine part of their exams for everyone 20 years old and up (and overweight, inactive children and teens too), it is up to us to take our health into our own hands – to save our own lives before it is too late.
Don’t Depend On a Doctor to Do This
The problem is—we need to order these tests ourselves, while mainstream medicine catches up with holistic medicine, which has been clamoring for more effective testing of insulin resistance since the HOMA-IR became more widely known about and its effectiveness proven, around 2010.
Dr. Mark Hyman reminds us in his article “The One Test Your Doctor’s Isn’t Doing That Could Save Your Life” that
Most [doctors] don’t express concern until results show blood sugar levels reaching 110 mg/dl. That’s when they start ‘watching it.’ Then, once your blood sugar reaches 126 mg/dl, your doctor will diagnose you with diabetes and put you on medication.
The important thing to note is that blood sugar is the last thing to increase…so for many people, a fasting glucose test detects diabetes too late. Long before your blood sugar rises, your insulin spikes. High insulin levels are the first sign that can precede type 2 diabetes by decades.”(xiv)
Thankfully, today, you can order your own lab tests from highly revered blood and saliva analysis medical laboratories like TrueHealthLabs.com and save decades of your life.
The way it works is that you order your own blood tests online or by phone from these online labs, who then send you to a lab location close to your area, where you can pop in for a quick blood test. You get your results in 24 hours—not weeks and they’re emailed to you, where you can process them calmly in the security of your own hoe.
Then, when you get the results of your insulin and glucose tests, you can plug those into a handy online HOMA IR calculator.
The HOMA-IR will calculate your risk for insulin resistance using the following calculation. For those of you who want to calculate your own, the HOMA formula is quite simple.
Using your lab scores, you simply multiply your glucose score times your insulin score and divide it by one of the following, depending upon which of the units your tests are measured in.
When glucose is expressed in mg/dl: HOMA-IR = (Glucose x Insulin) / 405
When glucose is expressed in mmol/L, divide by 22.5 instead of 405. (Glucose x Insulin)/22.5
Then, compare that figure to the table below to measure your degree of IR or, hopefully, IS.
|Normal range||.5 to 1.4|
|Mild insulin resistance||1.5- 3|
|Moderate insulin resistance||Between 3 and 5|
|Severe insulin resistance||>5|
How Glucose Monitors Can Become Preventative Health “Tools”
Accurate glucometers are another important investment for anyone today wanting to avoid diabetes and take their health firmly into their own hands.
Measuring post-prandial glucose is a highly useful way to strategize a diet that keeps your blood sugar at optimum levels and to see if you have impaired glucose tolerance to certain foods or just in general.
You can use this HOMA method below both to detect an impaired glucose response or insulin resistance (which you could confirm with a HOMA-IR) and to put together a diet that keeps your blood sugar in check, no matter what your status.
Steps for Testing Your Glucose Response to Food, Fasting, and Carbohydrate Rich Meals
- Get an accurate, affordable glucose monitor and strips (lots of strips for this initial period, as you’re going to be doing a lot of testing of your blood sugar response to all kinds of foods)
- Take your blood sugar in the morning after a complete 12 hour fast for a more reliable result.
- Test your blood sugar before a typical lunch.
- Test your blood sugar at the 1, 2, and 3 hr. marks after lunch.
- Record all results from the 12 hour fast, before and at all points you tested after lunch.
- Do this for two days with a different typical lunch meal you often have. This way, you’ll gather data for two days to chart how foods you like and typically eat affect your blood sugar.
- On the third day, see how you do with starchy carbohydrates. Eat one boiled white potato or one cup white rice, boiled. On this day, do not eat any fat with the meal—no butter, no cheese, no bacon—no meat, period. Combining fat with any carbohydrate will take down your normal blood sugar response because fat, by the way, is the only food that doesn’t spike blood sugar at all.(xv)
|Fasting blood glucose (mg/dL)||<86|
|Post Prandial glucose (mg/dL + 1 hr)||<140|
|PPG (mg/dL after 2 hours)||<120|
|PPG (mg/dL after 3 hours)||Return to baseline|
On all of your results, what you want is a fasting blood glucose less than 86. Blood sugar that doesn’t rise past 140 one hour after a meal and that returns to baseline within three hours afterward. That’s the ideal.
Of course, all glucometers have +/- 10% accuracy margins of error, so take this into consideration too. If you think you might have an issue, get your blood tested by a lab or see a doctor for a more thorough glucose panel.
One important thing to consider—if you typically eat Atkins, Paleo, Primal, ketogenic, or low carb, your response to the potato/rice meal will be abnormally exaggerated because your body is not used to that much carbohydrate.
The beauty of using the glucometer is that you can test your glucose responses with your favorite “splurge” foods—be it a latte, ice cream, or French toast. If your blood sugar goes beyond 140 and stays there over an hour afterward, you need to stay away from that particular food—period.
You can your blood sugar response to all kinds of foods this way, and put together a bespoke diet just for you that is blood sugar friendly.
Diabetes is Avoidable
Today, online labs are helping individuals take preventative healthcare into their own hands easily and affordably. You can have your glucose and insulin tested today, and have the results in 24 hours—results that will reassure you you’re safely insulin sensitive or giving you vital information you need to take action to reverse insulin resistance.
You don’t have to be one of the 470 million. Today, it’s easier than you think to save yourself and your family from a deadly disease that only becomes more pervasive and threatening with every year that passes.
[i] Darou, S. Dr. (2017). Why testing for insulin resistance should be part of every physical exam. http://drshawnadarou.com/2017/06/05/testing-insulin-resistance-part-every-physical-exam/
[ii] American Diabetes Association. American diabetes month: 2015: Messages and fact sheet. http://main.diabetes.org/dorg/adm/adm-2015-fact-sheet.pdf
[iii] Dr. S. Darou. Why testing for insulin resistance should be part of every physical exam. http://drshawnadarou.com/2017/06/05/testing-insulin-resistance-part-every-physical-exam/
[v] CDC. Diabetes: Working to reverse the epidemic at a glance, 2016. https://www.cdc.gov/chronicdisease/resources/publications/aag/diabetes.htm
[vi] NIDDK. Symptoms and causes of diabetes. https://www.niddk.nih.gov/health-information/diabetes/overview/symptoms-causes
[vii] Tabák, A. G. (2014). Prediabetes: A high-risk state for developing diabetes he Lancet, 379(9833): 2279–2290. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3891203/
[ix] Mayo Clinic. Diabetes: Complications. http://www.mayoclinic.org/diseases-conditions/diabetes/basics/complications/con-20033091
[x] NIH Medline plus: Preventing and managing diabetes complications. https://medlineplus.gov/magazine/issues/fall12/articles/fall12pg12.html
[xi] Guyenet, S. (2012). What causes insulin resistance?: Part I. http://wholehealthsource.blogspot.com/2011/11/what-causes-insulin-resistance-part-i.html
[xii] Dr. A Mandal. Insulin resistance symptoms. http://www.news-medical.net/health/Insulin-Resistance-Symptoms.aspx
[xiii] Willett, Dr. W., et. al. (2001). Diet, lifestyle, and the risk of type 2 diabetes mellitus in women. New England Journal of Medicine, 345:790-797. http://www.nejm.org/doi/full/10.1056/NEJMoa010492
[xiv] Dr. M. Hyman. The one test your doctor isn’t doing that could save your life. http://drhyman.com/blog/2014/08/18/one-test-doctor-isnt-save-life/
[xv] For more on this, see Chris Kresser’s How to prevent diabetes and heart disease for $16. https://chriskresser.com/how-to-prevent-diabetes-and-heart-disease-for-16/