? about insulin resistance

macchiatto

How do you know for sure if you have IR PCOS? I was Dx'ed with PCOS 7 years ago and with prediabetes 3 years ago. I reversed the prediabetes a year later after going on a low carb diet and losing some weight.

I just had labs done again and my fasting glucose was 81, A1C was "normal," and my fasting insulin was "normal." The person who told me the results over the phone was not a nurse (I believe); I asked her to send me the full labs in the mail so I'll know all the exact numbers. Does having "normal" fasting insulin and glucose mean that I have non-IR PCOS? Or do I need to find out the exact number to know for sure? e.g. is this something where high-normal range could also mean insulin resistance? I honestly thought for sure I must be IR b/c of the PCOS, both parents are diabetic and the history of prediabetes.

Dragonwolf

I don't trust the lab's definition of "normal." My insulin is considered "normal" by the lab's definition, but I can't lose weight to save my life unless I get it down. Insulin resistance, no matter the cause, isn't a hard line. Like pretty much everything else in human biology, it's a spectrum. Putting hard lines on things often causes more harm than good, in my opinion.

That said, insulin resistance is in part heavily affected by lifestyle choices. So you can overcome it and regain normal insulin levels even with insulin-resistant PCOS. Having PCOS with IR just makes it more likely to have high insulin levels, higher risk of developing Diabetes, and reduces your threshold of tolerance for the underlying triggers (ie - you naturally don't deal quite as well with sugar as someone without PCOS). This makes lifestyle choices that much more important for us.

It is possible that your insulin resistance isn't from the PCOS. There's no real way of knowing that for sure, though, that I know of. Personally, I don't think it much matters. If you have insulin resistance, and a particular therapy works, then that's really all that matters. You have a family history of Diabetes and a personal history of insulin resistance and prediabetes. That, to me, is evidence enough that you have issues with glucose and should act accordingly.

A_Dabauer

Great advice from Dragonwolf (as always).

I second the lack of trust for lab's version of normal.

I think YOU know your body best, if you have a hard time maintaining your weight with carbs in your diet you'll have to reduce them. In my experience the level of carbs each person can "handle" is different. I'd play around with that particular macro, and see what your threshold is. I'd use that as your guide to whether you are Insulin Resistant more than a lab result.

macchiatto

That makes sense. Thanks, ladies. I wasn't sure if insulin resistance was reversible like the prediabetes is.

I had gotten to goal weight and while I'd gained about 5 lbs this fall that I want to get off, once I re-lose that I hope to be in maintenance long-term. I've been curious about how low-carb I need to go to be "safe," and also trying to figure out roughly how many calories I can eat to maintain. I have experimented for a while but don't have clear answers for sure yet so I thought info on whether I was IR or not might help me know if I can "relax" at around 100-120 gm carbs (which now seems to be the case; I needed to stay around 80-90 to lose weight) or if I need to be stricter than that at goal weight. I have the scale for feedback but wanted the blood work to complete the picture.

My sense is that at this point, I do have more wiggle room than I had in the past. I have been somewhat off-track since July in terms of both exercise and being lower-carb (I have been sporadic with it and had taken a break from tracking, and just overall eaten more carbs than usual). I was worried I might work myself back into prediabetes range; I'm relieved that my blood work was still good despite being off-track. I certainly plan to get back into a better routine now though. I don't want to take it for granted ... I try to be mostly LCHF but I tend to get frustrated/feel deprived over time and I think for long-term sustainability I'm trying to find that sweet spot where I'm eating for health but also not being stricter than I need to be, kwim?

A_Dabauer

Totally makes sense

In my opinion, when you get to maintenance, I'd keep your carbs low in the range you know you can lose at, and then up your calories gradually until you stop losing. This would be your calorie maximum. Then I'd increase your carbs while staying in that same calorie range and see how you respond. You may have to juggle lowering your calories a bit as you up your carbs. Obviously for long term maintenance you want something you don't feel deprived on. So finding that balance that works on both sides is very important

Best of luck!

macchiatto

That helps, A_Dabauer; thank you! I don't think I adjusted carefully enough in the past when shifting to maintenance mode (at times anyway).

You know what I just realized? I think a big part of the reason those 5 lbs crept up on me this fall (since school started) is that I've been in a rush to get my kindergarteners ready and to school so I stopped weighing myself most mornings. (I miss the later start of preschool!) I need to work that back into my routine because it does seem to help me stay on track.

Miss_1999

You've gotten some great advice! Here's a link with some info that I'd written as a "guide" scroll down past my little introduction, and it tells about symptoms of PCOS. If you aren't exhibiting any of those symptoms OTHER than the IR, then it is possible that you do not have PCOS, and they aren't exclusive. As it was mentioned above, it is entirely possible to have IR and NOT have PCOS. And, it's entirely possible to have PCOS and NOT have IR. Every woman, and every case of PCOS is unique, as are the treatments that will help each woman keep her personal symptoms under control.

community.myfitnesspal.com/en/discussion/1448249/diagnosed-living-with-pcos-read-me

macchiatto

Thanks, @Miss_1999. I know I have PCOS; I was just trying to figure out if I am insulin resistant or not. (I especially started wondering that after reading about how much lower the metabolisms of women with IR PCOS tended to be than women with non-IR PCOS.)