Over 40% of US Adults have Insulin Resistance

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kgeyser

Information about various diabetes testing methods and their strengths and limitations:

http://diabetes.niddk.nih.gov/dm/pubs/comparingtests/index.aspx

Scroll down to see a chart about each of the tests.

http://www.diabetes.org/diabetes-basics/diagnosis/

Guide to diagnosing diabetes.

http://care.diabetesjournals.org/content/34/Supplement_2/S184.full

Pros and cons of diagnosing diabetes with A1C.

http://care.diabetesjournals.org/content/34/2/518.full

A1C versus glucose testing. Perspective section discusses limitations for those not wishing to read the entire paper.

lindsey1979

Information about various diabetes testing methods and their strengths and limitations:

http://diabetes.niddk.nih.gov/dm/pubs/comparingtests/index.aspx

Scroll down to see a chart about each of the tests.

http://www.diabetes.org/diabetes-basics/diagnosis/

Guide to diagnosing diabetes.

http://care.diabetesjournals.org/content/34/Supplement_2/S184.full

Pros and cons of diagnosing diabetes with A1C.

http://care.diabetesjournals.org/content/34/2/518.full

A1C versus glucose testing. Perspective section discusses limitations for those not wishing to read the entire paper.

Once again, what's your point?

All this information only matters if you believe (and hopefully have some actual FACTS to support) that this results in significant error. Even if the error rate is 10%, then we're down to 39%. If it's 20%, we're down to 35%.

Unless you really believe the error rate is something like 97%, all this is just useless noise. And since we're talking over reporting, the error rate would have to be in the several hundreds -- like the percent is really 10% and the error rate is 400% yielding over 40%.

And if that is the case, we should never believe anything from the American Diabetes Association or the Center for Disease Control because they're WILDLY incompetent.

Is that really your argument? Or just throwing it out as a possibility? Because at this point, I think we should talk about the possibility of an asteroid hitting earth, or how this is just a conspiracy by some shadow group to scare Americans in to eating differently...or any other infinitesimal risk.

parkscs

I'm not of one those people who believes insulin resistance doesn't exist. I absolutely believe it exists, and I agree with you that how you set up your macros can impact your success with losing weight. I've never said anything to the contrary on that matter. However I have seen people claim that insulin resistance was the cause of their weight gain - some with actual medical conditions that cause insulin resistance and therefore would play a role in their weight gain, and others who have gained weight and want to believe that they are insulin resistant and it's the carbs, and not that they were overeating high calorie foods. I felt the link accurately covered both the lifestyle choices that lead to insulin resistance as well as factors that are out of our hands that cause it as well.

Now, concerning the statistics, it has been repeated several times in this thread that the purpose is to raise awareness of insulin resistance based on the 40% statistic and how that is a significant portion of the population. But when the surveys that statistic was extrapolated from have methodological errors and oversampling of populations who are predisposed to insulin resistance anyway, one has to question the validity of the estimate and whether this is really a significant issue that people need to be concerned about first and foremost.

Fair enough. Personally, I try not to get bogged down in the statistics on issues like this, in large part because I don't think it's relevant to the ultimate conclusions I tend to draw from this data. When I read those statistics, that says to me that "a lot" of obese people have some degree of insulin resistance. Is it 40%? 20%? 60%? I don't know, but either way it's a substantial number. And given that it's a substantial number, that says to me that people (not you specifically, but just speaking generally) should be more careful when broadly proclaiming there's no point in following a LCHF diet, as a substantial number of obese individuals may actually see much better results from such a diet. That's my big takeaway here and it applies regardless of how accurate those statistics are.

The other takeaway would be that, if someone does suffer from this condition, then the positive aspect is that it may improve as they lose weight and become more active. And that sort of cuts against the whole "if you can't eat low carb for the next 10 years, it's not sustainable!" advice I see repeated on these boards all the time. If someone can use it as a tool to reach a healthy body weight and improve their insulin sensitivity, they may be in a much better place to reintroduce carbohydrates into their diet than they were when they first restricted them. But you're absolutely right that obesity-induced insulin resistance didn't cause the initial obesity (how could it?) and it's still not an excuse for not losing the weight.

Ultimately, I think we agree and we're just looking at it from different perspectives. I see it as a relevant counter to a lot of the derpy anti-LCHF posts I see on boards every day. But to the extent anyone thinks OI insulin resistance is an excuse for why they aren't losing weight, I'm with you on calling BS.

sdelo7

If it wasn't for the diagnosis, I would have been exactly where I was 6 months ago. I *needed* an excuse to get healthier. The progress I'm making with myself goes beyond diabetes. The fact that I am doing something that is finally working keeps me motivated to keep going.

Wouldn't not having gained all the weight prevented you from developing diabetes?

Not necessarily. Getting fat didn't "give" me diabetes. I am genetically disposed to it. Otherwise, every fat person on the planet would have it. Otherwise there would be no thin people with Type II. I got fat because I was trying to lose weight the same way every one else was, and it didn't work for me. There was some complacency, and I convinced myself this was how my body was supposed to be.

Yes it may be in your genetics but you could have taken preventative measures against it. So saying diabetes was the best thing that ever happened to you when you could have done something to try being in this position to begin with.

Sometime you need a wake-up call to get things done.

kgeyser

Information about various diabetes testing methods and their strengths and limitations:

http://diabetes.niddk.nih.gov/dm/pubs/comparingtests/index.aspx

Scroll down to see a chart about each of the tests.

http://www.diabetes.org/diabetes-basics/diagnosis/

Guide to diagnosing diabetes.

http://care.diabetesjournals.org/content/34/Supplement_2/S184.full

Pros and cons of diagnosing diabetes with A1C.

http://care.diabetesjournals.org/content/34/2/518.full

A1C versus glucose testing. Perspective section discusses limitations for those not wishing to read the entire paper.

Once again, what's your point?

All this information only matters if you believe (and hopefully have some actual FACTS to support) that this results in significant error. Even if the error rate is 10%, then we're down to 39%. If it's 20%, we're down to 35%.

Unless you really believe the error rate is something like 97%, all this is just useless noise. And since we're talking over reporting, the error rate would have to be in the several hundreds -- like the percent is really 10% and the error rate is 400% yielding over 40%.

And if that is the case, we should never believe anything from the American Diabetes Association or the Center for Disease Control because they're WILDLY incompetent.

Is that really your argument? Or just throwing it out as a possibility? Because at this point, I think we should talk about the possibility of an asteroid hitting earth, or how this is just a conspiracy by some shadow group to scare Americans in to eating differently...or any other infinitesimal risk.

You said you had never seen any information that indicated any of these tests give false-positive results. I provided information about the tests, their pros and cons, and factors that can impact the test results.

This information supports my previous statements about how one time testing is not enough to diagnose an individual as insulin resistant and how other factors that the ADA would not be aware of when reviewing the report could impact the results.

I'm not the one who made the claim about the percentage - the burden of proof of its accuracy falls on you, not me or anyone else. What I have done is provided sufficient evidence that this number may not be as accurate as you claim and that the MFP community should treat this information, as well as the claim that this is a huge problem, with a bit of skepticism.

If you have any data or actual facts beyond an info sheet from the ADA supporting the accuracy of that figure, I'm sure the rest of us would like to see them so we can properly evaluate it.

sdelo7

If it wasn't for the diagnosis, I would have been exactly where I was 6 months ago. I *needed* an excuse to get healthier. The progress I'm making with myself goes beyond diabetes. The fact that I am doing something that is finally working keeps me motivated to keep going.

Wouldn't not having gained all the weight prevented you from developing diabetes?

Not necessarily. Getting fat didn't "give" me diabetes. I am genetically disposed to it. Otherwise, every fat person on the planet would have it. Otherwise there would be no thin people with Type II. I got fat because I was trying to lose weight the same way every one else was, and it didn't work for me. There was some complacency, and I convinced myself this was how my body was supposed to be.

Yes it may be in your genetics but you could have taken preventative measures against it. So saying diabetes was the best thing that ever happened to you when you could have done something to try being in this position to begin with.

I'm going to weigh in on this (pun intended) as someone who has both type 1 and type 2 diabetes (these are different diseases and should be called different things because of the consistent confusion, but that is a different discussion). I'm not a doctor, but I've had more training on type 1 diabetes than most GP's, and I have always closely followed new studies as they become available. Though I know more about both types of diabetes than most people simply because I've always paid close attention, I have much more expertise on type 1 diabetes than I do on type 2 diabetes.

Most type 2 diabetics are overweight. Not 100% are, but the percentage of overweight diabetics is much higher than the percentage of overweight people in the population as a whole. The reasons for that are much better understood scientifically than the reasons for why someone who is not overweight gets type 2 diabetes. Being overweight is a significant contributing factor, but is not the only factor. This is why some thin people have type 2 diabetes and why some fat people do not. I will add that some thin people who are diagnosed with type 2 diabetes are misdiagnosed - the ones who eventually find out that they have type 1, and got it later in life with a longer "honeymoon stage" (these people are considered to have type 1.5 or LADA). As of more recently, this shouldn't be happening any more (but it does) because there are now tests to see if one has the antibodies that cause type 1 diabetes.

As far as genetics, I would be interested in someone pointing to the genes that cause type 2 diabetes. There are specific haplogroups that have been traced to carryin the genes for type 1 diabetes, but again... that is a completely different disease. There has always been this assumption that type 2 diabetes is genetic because "someone in my family tree had it too." But I'm interested to know if there is more than circumstantial evidence to support that claim.

Research about this is interesting. I was diagnosed with gestational diabetes when pregnant with my daughter. My hospital - which also has a diabetes clinic - was doing a research on people with gestational diabetes over 10 years postpartum. The intent was to see if gestational diabetes may be an indication of a higher risk of diabetes later in life. I have been going every year for follow-up and full testing.
Last year, I tested as pre-diabetic. Oddly, about a year after my mom was also diagnosed with type 2 diabetes.
I am overweight, i get that, and at this point I am on a weight loss quest to attempt to avoid completely or at least delay full onset.

The upside of being part of this research is that I benefit from full testing and access to dieticians. I have also met with a naturopath as well as my doctor. I have noticed that calories are not the only thing for me, low GI is. I can eat the same amount of calories but need lower GI foods to lose weight. That's just me. So "calories in - calories out = net deficit for weight loss" is not that simple an equation for me. I control my calories, yes, but I need to be very careful on the type of carbs I eat.

Just my own personal experience.

kgeyser

I'm not of one those people who believes insulin resistance doesn't exist. I absolutely believe it exists, and I agree with you that how you set up your macros can impact your success with losing weight. I've never said anything to the contrary on that matter. However I have seen people claim that insulin resistance was the cause of their weight gain - some with actual medical conditions that cause insulin resistance and therefore would play a role in their weight gain, and others who have gained weight and want to believe that they are insulin resistant and it's the carbs, and not that they were overeating high calorie foods. I felt the link accurately covered both the lifestyle choices that lead to insulin resistance as well as factors that are out of our hands that cause it as well.

Now, concerning the statistics, it has been repeated several times in this thread that the purpose is to raise awareness of insulin resistance based on the 40% statistic and how that is a significant portion of the population. But when the surveys that statistic was extrapolated from have methodological errors and oversampling of populations who are predisposed to insulin resistance anyway, one has to question the validity of the estimate and whether this is really a significant issue that people need to be concerned about first and foremost.

Fair enough. Personally, I try not to get bogged down in the statistics on issues like this, in large part because I don't think it's relevant to the ultimate conclusions I tend to draw from this data. When I read those statistics, that says to me that "a lot" of obese people have some degree of insulin resistance. Is it 40%? 20%? 60%? I don't know, but either way it's a substantial number. And given that it's a substantial number, that says to me that people (not you specifically, but just speaking generally) should be more careful when broadly proclaiming there's no point in following a LCHF diet, as a substantial number of obese individuals may actually see much better results from such a diet. That's my big takeaway here and it applies regardless of how accurate those statistics are.

The other takeaway would be that, if someone does suffer from this condition, then the positive aspect is that it may improve as they lose weight and become more active. And that sort of cuts against the whole "if you can't eat low carb for the next 10 years, it's not sustainable!" advice I see repeated on these boards all the time. If someone can use it as a tool to reach a healthy body weight and improve their insulin sensitivity, they may be in a much better place to reintroduce carbohydrates into their diet than they were when they first restricted them. But you're absolutely right that obesity-induced insulin resistance didn't cause the initial obesity (how could it?) and it's still not an excuse for not losing the weight.

Ultimately, I think we agree and we're just looking at it from different perspectives. I see it as a relevant counter to a lot of the derpy anti-LCHF posts I see on boards every day. But to the extent anyone thinks OI insulin resistance is an excuse for why they aren't losing weight, I'm with you on calling BS.

I think you and I have basically the same viewpoint as well, just differing on the value of the statistic.

FWIW, I don't have an issue with LCHF diets. I think they can be very beneficial to those with health issues or who find the diet fits well into their lifestyle and encourages adherence. My only issue with LCHF is that it is often promoted on the boards as being a magical solution to weight loss, and generally by people who don't seem to know much about it. We see a lot of recommendations right off the bat to cut carbs, eliminate this food or that, and it's only when people like LadyMiseryAli* and hookilau* find the post that we actually get some information about the proper way to do a LCHF diet as far as macro settings, starting LC, what to expect, how to know if it's a good fit for you, etc.

*No offense to the other LCHF people on the boards, those two just pop into my head immediately as posters who I frequently see giving solid information and realistic advice about LCHF (I know LMA is also keto) without necessarily pushing the OP towards that dietary change, especially if it doesn't sound like it would be a good fit for that person.

lindsey1979

Information about various diabetes testing methods and their strengths and limitations:

http://diabetes.niddk.nih.gov/dm/pubs/comparingtests/index.aspx

Scroll down to see a chart about each of the tests.

http://www.diabetes.org/diabetes-basics/diagnosis/

Guide to diagnosing diabetes.

http://care.diabetesjournals.org/content/34/Supplement_2/S184.full

Pros and cons of diagnosing diabetes with A1C.

http://care.diabetesjournals.org/content/34/2/518.full

A1C versus glucose testing. Perspective section discusses limitations for those not wishing to read the entire paper.

Once again, what's your point?

All this information only matters if you believe (and hopefully have some actual FACTS to support) that this results in significant error. Even if the error rate is 10%, then we're down to 39%. If it's 20%, we're down to 35%.

Unless you really believe the error rate is something like 97%, all this is just useless noise. And since we're talking over reporting, the error rate would have to be in the several hundreds -- like the percent is really 10% and the error rate is 400% yielding over 40%.

And if that is the case, we should never believe anything from the American Diabetes Association or the Center for Disease Control because they're WILDLY incompetent.

Is that really your argument? Or just throwing it out as a possibility? Because at this point, I think we should talk about the possibility of an asteroid hitting earth, or how this is just a conspiracy by some shadow group to scare Americans in to eating differently...or any other infinitesimal risk.

You said you had never seen any information that indicated any of these tests give false-positive results. I provided information about the tests, their pros and cons, and factors that can impact the test results.

This information supports my previous statements about how one time testing is not enough to diagnose an individual as insulin resistant and how other factors that the ADA would not be aware of when reviewing the report could impact the results.

I'm not the one who made the claim about the percentage - the burden of proof of its accuracy falls on you, not me or anyone else. What I have done is provided sufficient evidence that this number may not be as accurate as you claim and that the MFP community should treat this information, as well as the claim that this is a huge problem, with a bit of skepticism.

If you have any data or actual facts beyond an info sheet from the ADA supporting the accuracy of that figure, I'm sure the rest of us would like to see them so we can properly evaluate it.

I'm not saying that tests don't give false positives sometimes, but whether that occurs in a meaningful way in diabetes/insulin resistance, I've never seen literature claiming that -- and that it leads to an overreporting on such statistics. This seems largely like a red herring or at least a huge "what if" scenario, which doesn't really add to the discussion much in my perspective.

I'm more with parkscs here, who eloquently put it: "Personally, I try not to get bogged down in the statistics on issues like this, in large part because I don't think it's relevant to the ultimate conclusions I tend to draw from this data. When I read those statistics, that says to me that "a lot" of obese people have some degree of insulin resistance. Is it 40%? 20%? 60%? I don't know, but either way it's a substantial number."

Unless you can show me with some reasonable assertions that the tests/methodologies are so fundamentally flawed to counter the general concept that the amount is not truly substantial, then it seems like a whole lot of useless noise.

lindsey1979

I'm not of one those people who believes insulin resistance doesn't exist. I absolutely believe it exists, and I agree with you that how you set up your macros can impact your success with losing weight. I've never said anything to the contrary on that matter. However I have seen people claim that insulin resistance was the cause of their weight gain - some with actual medical conditions that cause insulin resistance and therefore would play a role in their weight gain, and others who have gained weight and want to believe that they are insulin resistant and it's the carbs, and not that they were overeating high calorie foods. I felt the link accurately covered both the lifestyle choices that lead to insulin resistance as well as factors that are out of our hands that cause it as well.

Now, concerning the statistics, it has been repeated several times in this thread that the purpose is to raise awareness of insulin resistance based on the 40% statistic and how that is a significant portion of the population. But when the surveys that statistic was extrapolated from have methodological errors and oversampling of populations who are predisposed to insulin resistance anyway, one has to question the validity of the estimate and whether this is really a significant issue that people need to be concerned about first and foremost.

Fair enough. Personally, I try not to get bogged down in the statistics on issues like this, in large part because I don't think it's relevant to the ultimate conclusions I tend to draw from this data. When I read those statistics, that says to me that "a lot" of obese people have some degree of insulin resistance. Is it 40%? 20%? 60%? I don't know, but either way it's a substantial number. And given that it's a substantial number, that says to me that people (not you specifically, but just speaking generally) should be more careful when broadly proclaiming there's no point in following a LCHF diet, as a substantial number of obese individuals may actually see much better results from such a diet. That's my big takeaway here and it applies regardless of how accurate those statistics are.

The other takeaway would be that, if someone does suffer from this condition, then the positive aspect is that it may improve as they lose weight and become more active. And that sort of cuts against the whole "if you can't eat low carb for the next 10 years, it's not sustainable!" advice I see repeated on these boards all the time. If someone can use it as a tool to reach a healthy body weight and improve their insulin sensitivity, they may be in a much better place to reintroduce carbohydrates into their diet than they were when they first restricted them. But you're absolutely right that obesity-induced insulin resistance didn't cause the initial obesity (how could it?) and it's still not an excuse for not losing the weight.

Ultimately, I think we agree and we're just looking at it from different perspectives. I see it as a relevant counter to a lot of the derpy anti-LCHF posts I see on boards every day. But to the extent anyone thinks OI insulin resistance is an excuse for why they aren't losing weight, I'm with you on calling BS.

I think you and I have basically the same viewpoint as well, just differing on the value of the statistic.

FWIW, I don't have an issue with LCHF diets. I think they can be very beneficial to those with health issues or who find the diet fits well into their lifestyle and encourages adherence. My only issue with LCHF is that it is often promoted on the boards as being a magical solution to weight loss, and generally by people who don't seem to know much about it. We see a lot of recommendations right off the bat to cut carbs, eliminate this food or that, and it's only when people like LadyMiseryAli* and hookilau* find the post that we actually get some information about the proper way to do a LCHF diet as far as macro settings, starting LC, what to expect, how to know if it's a good fit for you, etc.

*No offense to the other LCHF people on the boards, those two just pop into my head immediately as posters who I frequently see giving solid information and realistic advice about LCHF (I know LMA is also keto) without necessarily pushing the OP towards that dietary change, especially if it doesn't sound like it would be a good fit for that person.

I agree with you for those that push LCHF as a magic bullet (or any other diet as a magic bullet). It's not, but it does have some benefit and considerable benefit for some (as do other approaches). And if in this thread, there were people claiming that, I can understand your counter to those specific attacks.

What drives me nuts are these sort of pre-emptive counters. No one on this thread said that (or at least not the OP), so pre-emptively attacking a non-existent argument seems totally silly.

And you see this a lot on here -- whether it's a Paleo thread, LCHF thread, etc. When people get self-righteous or are making outrageous claims, sure, counter them. But to start bashing things or tearing down other arguments as a pre-emptive strike against a later imagined, but as of yet non-existent argument just doesn't make much sense to me.

LumberJacck

Why is this such a big deal?

I've found a lot of mfp members easily get their panties in a wad. I haven't seen it on other weight loss message boards, I assume it's because this place is so large and it's easy to over react without any ramifications.