Thursday, February 08, 2007

Are You Insulin Resistant? Get Pricked

If you've reached your mid 30s; are carrying a few extra pounds that can't be explained by breast augmentation or steroid-induced muscle build-up; had a brother, sister, mother, father, or childhood mail carrier ... the last of which was rumored to have spent a little extra time delivering your family's weekly editions of Life magazine in the months prior to your mother making her own special delivery of you, and which aging mail carrier happens to share your same lumpy schnoz, taste for black support hose, and appetite for Desperate Housewives reruns ... or any other first-degree relative known to have diabetes; or you're a woman who battled high blood sugars during a pregnancy - I offer this advice: get your blood glucose (BG) tested.

Ouch!The only way to determine if you are insulin resistant, or have full-blown diabetes, is through a blood test. You don't have to have vials of your valuable stuff drained, just a finger prick test can provide valuable feedback.

If that prick is done after an overnight fast and the number (mg/dl) on the meter reads:
  • 126 or more - See a doc for confirmation: 126 mg/dl is the cutoff for a diagnosis of diabetes.

  • 100 to 125 - You may have a prediabetes condition called Impaired Fasting Glucose (IFG) - your cells are likely becoming insulin resistant. IFG, by itself, raises the risk for heart attack, stroke, hypertension, atherosclerosis, polycystic ovary disease, some cancers, and more.
As your cells become resistant to insulin, more glucose (and insulin) roams the bloodstream. Those glucose molecules damage blood vessels over time. That's why insulin resistance, even without a diagnosis of diabetes, is harmful. The little vessels, the ones in the eye and kidney, are particularly vulnerable. In fact, the inability to metabolize glucose effectively, i.e. diabetes, is the leading cause of new-case blindness and kidney failure worldwide. It's also responsible for most lower extremity amputations, although with all the unexploded ordnance in the world, limb-loss cause has gotten pretty region specific.1

What Are Your Odds

A survey of US adults (20 and older) published last May revealed:
  • One-third of adults with diabetes didn't know they had it.
  • One in 4 adults (26%) had IFG. (The rate for adults 40 and older is higher.)
  • IFG and undiagnosed diabetes were 70% more common in men than in women.
You can find more trends in their report:
Prevalence of Diabetes and Impaired Fasting Glucose in Adults in the U.S. Population

Back to Testing

If screening for diabetes (or insulin resistance) was as easy as taking a body temperature or measuring blood pressure, there'd be a lot more people with a full-fledged diagnosis standing in pharmacy lines spending their way towards their Medicare Part D donut hole (that's not to say lifestyle treatments aren't effective, but drug companies have pull). But BG testing can be a pain in the ass (or finger). Ask anyone with diabetes, since daily pricking - preferably several times a day - is part of the therapy.

It amazes me how many people we find in a screening. People walking around with no overt symptoms whose sugars are in the 200s, 300s, 400s! Granted, they're not fasting, but if your body isn't getting your BG down to the low 100s several hours after a meal, those extra glucose molecules are wrecking havoc.

I wish there was an inexpensive, accessible, easy-to-administer test for measuring blood glucose. Aside from testing one's urine, which is a good indicator of urine glucose, but not a good indicator of blood glucose (or tasting urine for sweetness which was performed in the past), there isn't. A one-off test as part of a blood workup doesn't tell you what's going on daily, monthly, or yearly - given the frequency of those tests. (There is a time-lapse blood test, the glycosylated hemoglobin or HbA1c, but again, it fails to reveal daily peaks and valleys.)

For those with the financial means, and the proclivity, a blood glucose meter like the one shown (I make no endorsement of brand) can be had for under $100. Manufacturers often provide a coupon to cover the cost of the meter, which isn't the gift you might think after realizing the single-use test strips go for around $1.00 a pop ... or prick.

1 "In the aftermath of the 2006 Israel invasion of Lebanon, it is estimated that southern Lebanon is littered with one million undetonated cluster bombs - approximately 1 ½ bombs per Lebanese inhabitant of the region."
- Wikipedia, Unexploded Ordnance

Photo: Homegrown

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