Ben Bikman9: Answers Qs: insulin resistance; measure; SGLT inhibitors; Triglycerides to HDL ratio

doctorstotrust.com
presents episode 240

Question: If one has high glucose but normal insulin?
-could be stressful situation
-or a bad night of sleep
~these would push up glucose, not necessarily insulin
~not diet-related

Question: 2-hour post prandial insulin test
-better than fasting insulin test?
~yes...more data is better

"If, at 2 hours insulin is back to normal,
-good sign that you are insulin sensitive"

If able to get insulin sampled every 30 minutes...
-simplest measure is:
~highest point at 30 minute mark?
~if YES, that is a good sign you are
insulin sensitive
~otherwise, not so good

Question: SGLT Inhibitors...why on "bad list"?
-they effectively regulate blood pressure & glucose, but
-If we have high glucose...why not just limit its intake?

Question: Details on triglycerides to HDL ratio?
-insulin is always promoting the formation of triglycerides
~in VLDL & LDL
-hyperinsulinemia reduces HDL
-so: insulin alters these 2 variables, thus: the ratio for testing
-also, in humans, ratio data correlates very well with
~markers of insulin sensitivity:
-HOMA-IR &
-hyperinsulinemic-euglycemic clamps

Hyperinsulinemic-euglycemic clamps

Gold standard method to assess insulin sensitivity.
The euglycemic clamp is used to measure insulin's action
on glucose utilization in humans & animals for clinical &
basic research.

Triglycerides to HDL ratio cannot hold its fidelity...
-across all ethnicities
-study: not as valuable in African populations
-more broad lipid panel & lipid protein analysis
has a better predictive power

Triglycerides to HDL ratio cannot hold its fidelity...
-it is a growing research area:

"Blood lipids are more & more reliable marker of
insulin resistance"