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Better Tests to Determine if You Have Insulin Resistance or Diabetes

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  • #16
    Happy New Year - I’m interested in having my family (sisters and I) test for Kraft PreDiabetes Profile. We have a history of diabetes in the family on both sides of family. Not sure if contacting Meridian Labs is the only place that will administer the test. We live in San Diego and Denver. Thank you.

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    • Robin
      Robin commented
      Editing a comment
      Go to Quest Diagnostics in San Diego or Lab Corp.

  • #17
    Do Quest & LabCorp actually do a full Kraft Insulin Survey? I've tried ordering them, but couldn't. You could at least theoretically construct one, by asking them to:
    use 100 gm vs 75;
    get insulin fasting and at all testing periods; and
    do a full 4 hours, not 2 or 3.

    But that always confused the lab techs that I discussed this with. Labs can be a nightmare.

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    • #18
      El Paseo USA:

      You can obtain the Kraft Prediabetes Profile directly from Meridan Valley Labs near Seattle. They will mail you a bloodspot kit that you do yourself at home. As of a year ago the cost was $199 but it may have gone up since then. Here is their price list and phone number. http://meridianvalleylab.com/wp-cont...-List-2018.pdf. You do not need a doctor’s order to obtain it. Be very careful to follow their instructions exactly or they may not run your sample.

      https://www.meridianvalleylab.com/se...betes-profile/

      Quest does not offer the Kraft Test.

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      • mtbizzle
        mtbizzle commented
        Editing a comment
        Well shoot, I've been searching for a way to order the Kraft survey, only to find your link, and then find that the page is dead. I'm guessing that Meridian Valley doesn't offer the test direct to consumer anymore? Dang. I will try to call Meridian when I get a chance during business hours.

        As always, thanks for all the help & resources you provide, John.

    • #19
      By the way, I'm currently negotiating with David Vigerust of MyGenetix Labs to do the same as Meridian Valley labs. Since you're talking about a full 4 hour test, it's a lot easier to have this at home. And his technology would also use bloodspot technology ( fingerstick with drops of blood on the paper).

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      • mtbizzle
        mtbizzle commented
        Editing a comment
        Doc, that would be great. Please post on your youtube, or somewhere else, if you arrange this! I believe Meridian has stopped selling the Kraft test directly to consumers. So, I'm not sure there's any way to receive a Kraft survey aside from having a doc who buys into it.

    • #20
      I got the book called Eat Rich Live Long by Ivor Cummings and Jeffrey Gerber, M.D. It's about Low Carb and Keto for great health. To determine if someone has IR they suggest going to this website: Thebloodcode.com/homa-ir-calculator. Plug in your values and see the result. I have thought I had IR...because my A1c started at 4.9 Jan. 2018. Went to 5.8 by the end of the year...however two weeks after the 5.8 I had a routine physical and it was done again and my result was 5.3.....either way, it's higher and I made the diet change and was dedicated to it for the 11 months prior to the second test. ANYWAY....I went to that calculator and used the two sets of blood results from Jan. 2018 and Nov. 2018 and both times my HOMA-IR was 0.7. The book says if your results are below 1.0, you have low IR, Between 10-1.5 is marginal and may require some corrective action ... approaching 2.0 and certainly over indicates significant levels of IR. So, this along with the Naturopath I went to (who said I am not IR) makes me scratch my head. Is it just that the Cleveland Heart Lab or Health Lab just has the strictest markers on the planet or what the heck am I supposed to believe? It stresses me out when I take my FBG and getting values from 90-104....the other times of the day when I take my glucose it's always in a great place. OH also it says that Fasting Insulin below 8 is good and below 4-5 is great and my two tests were 2.9 and 3.0 U/L.

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      • #21
        Robin:

        As I see it, the HOMA IR test is a “static” test where you can plug in the values from your labs and draw an assumption from using the formula based on absolute cutoffs. I believe it may be useful for some people but, like any lab test, it’s not a perfect test. Example: A1c’s calculators have been shown to be +/- 20% of acrual value.

        Where the test falls short of expectations, mine at least, is that it does not look at “dynamic” values of glucose and insulin. That is why the Kraft Insulin Survey is so valuable. It looks at fasting and post-challenge dynamic insulin and glucose levels at over many hours.

        Here is a good analysis of the HOMA-IT Test. http://care.diabetesjournals.org/content/27/6/1487

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        • #22
          Ok thanks.

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          • #23
            Hey Robin,
            Just read your posts here! sorry to hear about the frustrating results, especially after youve put all this effort into making changes for exactly this sort of reason. I definitely can sympathize with how much of a letdown it can be when you put a lot of attention into lifestyle and the benefits don't seem to show up.

            Just two thoughts i figured i'd mention. before i do, though, it's worth noting that im not a doc, or certified in nutrition or any field like that. i'm studying to be a nurse and take a lot of interest in reading about and practicing prevention, but what follows is really just my take.

            the first thought ties into what dr brewer mentioned here re. skipping breakfast. i saw a recent metaanalysis (here: https://www.ncbi.nlm.nih.gov/pubmed/30418612 ) that found an association between skipping breakfast and diabetes. A short quote: "type 2 diabetes increased with every additional day of breakfast skipping, but the curve reached a plateau at 4-5 d/wk, showing an increased risk of 55% (summary RR: 1.55; 95% CI: 1.41, 1.71)." Perhaps the major mechanism here is what dr brewer mentioned. with this info, i figure that the question for someone like you becomes how to balance the benefits of fasting with the apparent risks of skipping breakfast. Of course i'm not sure and i don't have concrete answers, but maybe a different fasting pattern would help, eg, early dinner and no food between dinner and breakfast?

            second, i've also felt the pull of both vegan and low carb diets. there's so much information (and frankly, hysteria!) around diets these days. in short, my take at this point is that there is a lot going for both low carb diets and healthy plant based diets. both seem to me have some good research behind them, both seem to have been very helpful for some groups, and both seem very well suited to certain people. I tend to be skeptical of people who preach in effect that there is only one truly healthy diet pattern for all people. my suspicion is that low carb will tend to be a better diet pattern for older folks, as age often brings glucose metabolism issues (IR) and the onset of neurodegenerative issues which low carb seems well suited for. but perhaps something closer to your vegan diet just fits you better. I'm sure you've considered that; in short i just figured id mention that my sense is that some people respond exceptionally well to these diets, and some people seem to respond better to different diets. (full disclosure: i'm mostly vegan; i focus on lots of whole plants (veggies, fruits, nuts/seeds), tea/coffee & protein; some beans/intact grains; and try to limit refined carbs, added sugar, and liquid calories). it's also worth noting that a vegan diet doesn't have to be low fat, very high starch, like some proponents push -- I rarely eat refined carbs, and intact grains/root vegetables aren't staples of my diet.

            Best wishes, robin!!

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            • #24
              Thanks, mtbizzle. You have very good points. For many, skipping breakfast is not only not harmful, it's healthy. But long term, it's better to eat breakfast. I believe it's because of the dawn phenomenon. Cortisol peaks in the early AM. And yes, I'm very much aware of the concept & evidence behind Time Restricted Eating. I've done several vids on it. Here's what really needs to happen. 2 meals a day, with restriction on hours is good. But it would be far healthier to skip dinner than breakfast. Very few people will do that. I think long-term, the best combination will be to get into a later breakfast and eat a early dinner. And obviously no snacks before or after. And this still gets into the point that nothing works for every one of us. For that 20% with Dawn effect impacting blood sugar will probably need to have an earlier breakfast.

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              • #25
                This is my first post - here goes.

                Insulin resistance is the basic 'evil' of good health. And the Kraft GTT is the best method to diagnose IR.

                I haven't had an Kraft test yet, but I have had a lot of inflammation blood & urine work. And after a lot of work on diet & exercise, all my inflammation markers - hsCRP, Myeloperoxidase, PLA2, OxLDL, MACR and Homocysteine are at or below normal. And, for the record, my A1c varies from 5.2 to 5.6.

                I want to ask if the 'good' results of my inflammation tests essentially predict that I will not have IR? Turning this question around, does IR cause inflammation?

                Thanks

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                • #26
                  To kinda answer/elaborate on my question, here's an interesting piece of research: https://www.jci.org/articles/view/96139

                  The title to this trial article is: Insulin resistance causes inflammation in adipose tissue

                  The 'practical' answer to my first post -- IMHO -- would be:

                  1. Yes - low inflammation results would indicate strongly that you don't have IR.
                  2. However, science can't say for sure that lack of inflammation confirms lack of IR,
                  3. So go get a Kraft test! It's the gold standard for IR.

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