Foamroller wrote: »

@RalfLott. I understand your battle in getting the doc to take insulin test. Here the government pays it so the docs are very conservative in taking "unnecessary "tests. But there might be another proxy that could work, besides the symptom of no hunger.

Many of the people who comment on Dr Jason Fung's blog posts are T2D. Often they have good insights. I found this gem buried under there in this post:
https://intensivedietarymanagement.com/failure-blood-glucose-paradigm/

Ben Fury September 29, 2016 | Reply
All you need is fasting triglycerides and glucose to guesstimate insulin resistance fairly accurately.

“A novel criterion for identifying metabolically obese but normal weight individuals using the product of triglycerides and glucose”

SH Lee et al, 2015

“The TyG index is a simple marker that correlates well with the degree of insulin resistance measured by hyperinsulinemic-euglycemic clamp studies.”

TyG index Method:
Multiply fasting TG and BG.
Divide by 2
Run Natural Log (ln) [NOT (log)]

Men with values over 8.82 and women with values over 8.73 are most likely to be insulin resistant and have double the chance of developing type 2 diabetes in the future.

Handy PDF with the formula from Dr. Georgia Ede:
http://www.diagnosisdiet.com/wp-content/uploads/2015/08/insulin-resistance-tests.pdf

We're all frontiers in this kind of thing. It's not perfect, but we have to make ado with what we currently got.

Thanks, @Foamroller!

This method would seem to assume that fasting (as opposed to random) triglycerides and glucose are relatively constant in the short haul. ?? At this point, my fasting glucose is confined to a range that wouldn't make a lot of difference in ln(x), but I'm not sure about triglycerides - I'll have to look into it (but at least it's cheap and easily obtained....).

Thanks again.

@Foamroller - I came across an article that compares TyG favorably to the HOMA-IR model, but it cautions,

The TyG index may not be used in subjects with extremely high triglyceride levels or in those taking medications that lower mainly triglycerides.

https://www.researchgate.net/publication/51211706_TyG_index_performs_better_than_HOMA_in_a_Brazilian_population_A_hyperglycemic_clamp_validated_study

Hmm. I consume plenty of Omega-3 fatty acids (and take Glucophage to control blood glucose)....... ??

Foamroller wrote: »

@RalfLott. I understand your battle in getting the doc to take insulin test. Here the government pays it so the docs are very conservative in taking "unnecessary "tests. But there might be another proxy that could work, besides the symptom of no hunger.

Many of the people who comment on Dr Jason Fung's blog posts are T2D. Often they have good insights. I found this gem buried under there in this post:
https://intensivedietarymanagement.com/failure-blood-glucose-paradigm/

Ben Fury September 29, 2016 | Reply
All you need is fasting triglycerides and glucose to guesstimate insulin resistance fairly accurately.

“A novel criterion for identifying metabolically obese but normal weight individuals using the product of triglycerides and glucose”

SH Lee et al, 2015

“The TyG index is a simple marker that correlates well with the degree of insulin resistance measured by hyperinsulinemic-euglycemic clamp studies.”

TyG index Method:
Multiply fasting TG and BG.
Divide by 2
Run Natural Log (ln) [NOT (log)]

Men with values over 8.82 and women with values over 8.73 are most likely to be insulin resistant and have double the chance of developing type 2 diabetes in the future.

Handy PDF with the formula from Dr. Georgia Ede:
http://www.diagnosisdiet.com/wp-content/uploads/2015/08/insulin-resistance-tests.pdf

We're all frontiers in this kind of thing. It's not perfect, but we have to make ado with what we currently got.

So, because I'm MO, this calculation doesn't apply to me, @foamroller?

Because I am insulin resistant, but I am below the threshold stated above for women, though not by leaps and bounds or anything. My trigs used to be much higher, and my glucose has been steady for as far back as I have numbers.

EDITED TO ADD: I'm not taking any medications that affect my cholesterol or blood glucose numbers.

Prior to low carb or losing any real weight, I was around 8.74.

A few months on low carb was 8.7 (8.6982)...

My lowest trigs this past October made it 8.08...

retirehappy wrote: »

Foamroller wrote: »

@RalfLott. I understand your battle in getting the doc to take insulin test. Here the government pays it so the docs are very conservative in taking "unnecessary "tests. But there might be another proxy that could work, besides the symptom of no hunger.

Many of the people who comment on Dr Jason Fung's blog posts are T2D. Often they have good insights. I found this gem buried under there in this post:
https://intensivedietarymanagement.com/failure-blood-glucose-paradigm/

Ben Fury September 29, 2016 | Reply
All you need is fasting triglycerides and glucose to guesstimate insulin resistance fairly accurately.

“A novel criterion for identifying metabolically obese but normal weight individuals using the product of triglycerides and glucose”

SH Lee et al, 2015

“The TyG index is a simple marker that correlates well with the degree of insulin resistance measured by hyperinsulinemic-euglycemic clamp studies.”

TyG index Method:
Multiply fasting TG and BG.
Divide by 2
Run Natural Log (ln) [NOT (log)]

Men with values over 8.82 and women with values over 8.73 are most likely to be insulin resistant and have double the chance of developing type 2 diabetes in the future.

Handy PDF with the formula from Dr. Georgia Ede:
http://www.diagnosisdiet.com/wp-content/uploads/2015/08/insulin-resistance-tests.pdf

We're all frontiers in this kind of thing. It's not perfect, but we have to make ado with what we currently got.

I am wondering if I did this correctly, I used the scientific calculator on my PC, put in my fasting triglyceride and fasting glucose numbers, divided by 2, hit the log function key and came up with 0.30102999566398119521373889472449.

Since it is talking about 8.x numbers, I doubted my outcome. I used the Ede's reference . I used my last test results from my dr. in June.

I am not diabetic, my A1C tests are below 5.5 consistently but not much, that is why I wondered about this formula's number.

I am guessing you have a problem with your your math somewhere. First, your BG should be somewhere between 80-100 and triglycerides are hopefully under 150 and even on the very low end would likely be at least 30. Taking the smallest of each, you would have 80 x 30 = 2400. Divide that by 2 and you have 1200. The ln of that is 7.09.

KnitOrMiss wrote: »

Foamroller wrote: »

@RalfLott. I understand your battle in getting the doc to take insulin test. Here the government pays it so the docs are very conservative in taking "unnecessary "tests. But there might be another proxy that could work, besides the symptom of no hunger.

Many of the people who comment on Dr Jason Fung's blog posts are T2D. Often they have good insights. I found this gem buried under there in this post:
https://intensivedietarymanagement.com/failure-blood-glucose-paradigm/

Ben Fury September 29, 2016 | Reply
All you need is fasting triglycerides and glucose to guesstimate insulin resistance fairly accurately.

“A novel criterion for identifying metabolically obese but normal weight individuals using the product of triglycerides and glucose”

SH Lee et al, 2015

“The TyG index is a simple marker that correlates well with the degree of insulin resistance measured by hyperinsulinemic-euglycemic clamp studies.”

TyG index Method:
Multiply fasting TG and BG.
Divide by 2
Run Natural Log (ln) [NOT (log)]

Men with values over 8.82 and women with values over 8.73 are most likely to be insulin resistant and have double the chance of developing type 2 diabetes in the future.

Handy PDF with the formula from Dr. Georgia Ede:
http://www.diagnosisdiet.com/wp-content/uploads/2015/08/insulin-resistance-tests.pdf

We're all frontiers in this kind of thing. It's not perfect, but we have to make ado with what we currently got.

So, because I'm MO, this calculation doesn't apply to me, @foamroller?

Because I am insulin resistant, but I am below the threshold stated above for women, though not by leaps and bounds or anything. My trigs used to be much higher, and my glucose has been steady for as far back as I have numbers.

EDITED TO ADD: I'm not taking any medications that affect my cholesterol or blood glucose numbers.

Prior to low carb or losing any real weight, I was around 8.74.

A few months on low carb was 8.7 (8.6982)...

My lowest trigs this past October made it 8.08...

What's "MO"? There are lots of things that affect FBG, FI and triglycerides, so as a proxy it HAS a lot of caveats. I honestly don't know if the method is any worthwhile for outliers. But the trending is very important.

Again, I think that if making a detailed food diary with symptoms, f.ex. rating subjective feeling of hunger every day/meal is more useful for most of us. Why? Because according to D'Agostino, BHB is appetite supressing. By logic if the body is good at both creating and using ketones, you're good at using fat as energy and therefore insulin has to be lower. In opposite if you're hungry very often, I would guess insulin (and ghrelin) is higher at fasting baseline than desired. Maybe I'm completely wrong at this line of argument, so feel free to correct me.

I'm also not a medical doctor, so there's that.

Edit: I'm sorry I can't help you. I'm only a self taught amateur that has spent way too much time trying to piece together how keto, lowcarb and IF can help me and the beloved.

cstehansen wrote: »

retirehappy wrote: »

Foamroller wrote: »

@RalfLott. I understand your battle in getting the doc to take insulin test. Here the government pays it so the docs are very conservative in taking "unnecessary "tests. But there might be another proxy that could work, besides the symptom of no hunger.

Many of the people who comment on Dr Jason Fung's blog posts are T2D. Often they have good insights. I found this gem buried under there in this post:
https://intensivedietarymanagement.com/failure-blood-glucose-paradigm/

Ben Fury September 29, 2016 | Reply
All you need is fasting triglycerides and glucose to guesstimate insulin resistance fairly accurately.

“A novel criterion for identifying metabolically obese but normal weight individuals using the product of triglycerides and glucose”

SH Lee et al, 2015

“The TyG index is a simple marker that correlates well with the degree of insulin resistance measured by hyperinsulinemic-euglycemic clamp studies.”

TyG index Method:
Multiply fasting TG and BG.
Divide by 2
Run Natural Log (ln) [NOT (log)]

Men with values over 8.82 and women with values over 8.73 are most likely to be insulin resistant and have double the chance of developing type 2 diabetes in the future.

Handy PDF with the formula from Dr. Georgia Ede:
http://www.diagnosisdiet.com/wp-content/uploads/2015/08/insulin-resistance-tests.pdf

We're all frontiers in this kind of thing. It's not perfect, but we have to make ado with what we currently got.

I am wondering if I did this correctly, I used the scientific calculator on my PC, put in my fasting triglyceride and fasting glucose numbers, divided by 2, hit the log function key and came up with 0.30102999566398119521373889472449.

Since it is talking about 8.x numbers, I doubted my outcome. I used the Ede's reference . I used my last test results from my dr. in June.

I am not diabetic, my A1C tests are below 5.5 consistently but not much, that is why I wondered about this formula's number.

I am guessing you have a problem with your your math somewhere. First, your BG should be somewhere between 80-100 and triglycerides are hopefully under 150 and even on the very low end would likely be at least 30. Taking the smallest of each, you would have 80 x 30 = 2400. Divide that by 2 and you have 1200. The ln of that is 7.09.

I ran the numbers again this time
102 x 75/2=3825 log is 3.582....

Thanks I'm thinking I am not terribly insulin resistant now, correct?

KnitOrMiss wrote: »

@foamroller - MO is morbidly obese - yes, despite how much I've lost, I still qualify as morbidly obese. I read somewhere up in the main article that it mainly applies to not heavily obese people.

And my insulin levels are in the range of what they have been, even at my heaviest. Low carb has not made my glucose go down, but it was not problematic in the first place (I guess my obesity really has been in the process of protecting me from diabetes!). My triglycerides however, those have improved dramatically.

And with the built in insulin resistance and binge eating tendencies, "subjective feeling of hunger" is something still elusive to me. Like all morning yesterday, I felt "kinda" hungry, but I was able to fast through without much effort. Then "more hungry" at lunch, wanted all the food...made a reasonable portion and it was almost too much food. Then last night for dinner, made reasonable portions, and at double what I expected despite waiting in between because I was still really hungry.

BHB?

Oh, I dunno all abbreviations, Ty for clearing that up

BHB is Beta-Hydroxybutyrate one of the ketone bodies that are produced.

Re hunger. I do understand that feeling hungry is awful. I remember that feeling all too well. But if avoiding that feeling and discomfort at all cost is holding you back, it could be worthwhile to inspect and be mindful about what that hunger is for you. In which context, physical symptoms, emotional ties etc. I'm always "hungrier" when stressed or avoiding uncomfortable feelings. It can be hard to differentiate between true and fake hunger.

Another aspect is that it's possible you're still so insulin resistant that your insulin is high ALL THE TIME, instead of naturally tapering down 3-10 hrs after meals. Not just 2ketodudes, but also ButterBob says keto fixed a lot of things, but only fasting lowered their FBG and therefore insulin beyond what keto alone can do. I understand this is not what you wanna hear. But if you desp wanna fix your hunger issue, fasting works as a reset of hunger. If you can live with the current hunger and don't wanna fast, experiment with other methods to accept the hunger. I highly recommend watching ButterBob's video on WHY elevated insulin levels is a physiological problem that is actually solvable.

https://youtu.be/7sAqy1lnWXo
I truly believe that for some of us going lowcarb is not enough to repair deranged metabolism. At least it wasn't for me. Good luck, hun

Edit: When fasting, in the transition it may take 2-3 weeks of body rebelling. It wants to be fed when it's used to get meals. It will throw tantrums like a toddler. If you can accept this discomfort for a bit of time, it will eventually calm down, just like a child when it realizes you're not gonna be an enabler for unwanted behavior.

nvmomketo wrote: »

Foamroller wrote: »

I understand your battle in getting the doc to take insulin test. Here the government pays it so the docs are very conservative in taking "unnecessary "tests. But there might be another proxy that could work, besides the symptom of no hunger.

Many of the people who comment on Dr Jason Fung's blog posts are T2D. Often they have good insights. I found this gem buried under there in this post:
https://intensivedietarymanagement.com/failure-blood-glucose-paradigm/

Ben Fury September 29, 2016 | Reply
All you need is fasting triglycerides and glucose to guesstimate insulin resistance fairly accurately.

“A novel criterion for identifying metabolically obese but normal weight individuals using the product of triglycerides and glucose”

SH Lee et al, 2015

“The TyG index is a simple marker that correlates well with the degree of insulin resistance measured by hyperinsulinemic-euglycemic clamp studies.”

TyG index Method:
Multiply fasting TG and BG.
Divide by 2
Run Natural Log (ln) [NOT (log)]

Men with values over 8.82 and women with values over 8.73 are most likely to be insulin resistant and have double the chance of developing type 2 diabetes in the future.

Handy PDF with the formula from Dr. Georgia Ede:
http://www.diagnosisdiet.com/wp-content/uploads/2015/08/insulin-resistance-tests.pdf

We're all frontiers in this kind of thing. It's not perfect, but we have to make ado with what we currently got.

Interesting formula. My last triglycerides were below normal low, which I think is caused by my celiac disease (fat absorption issues from damaged intestinal villi possibly). Anyways, I got a 6.18. Odd because I get reactive hypoglycemia from too much insulin being released after a carby meal which usually means IR.

Using triglycerides strikes me as odd, given their propensity to bounce around. But apparently the TyG formula, where reliable, outperformed the HOMA model in estimating insulin resistance, suggesting that IR is a moving target.

If so, it seems to suggest constant vigilance by T2Ds and therapy aimed at lowering IR (which may in turn suggest long-term Glucophage therapy, even after blood glucose levels have fallen to tolerable levels).
https://intensivedietarymanagement.com/ukpds-futility-blood-sugar-lowering-t2d

I fear we are barely into the foothills. May those of us still around in 20 years report back as to whose advice we should have followed.......

RalfLott wrote: »

Using triglycerides strikes me as odd, given their propensity to bounce around. But apparently the TyG formula, where reliable, outperformed the HOMA model in estimating insulin resistance, suggesting that IR is a moving target.

If so, it seems to suggest constant vigilance by T2Ds and therapy aimed at lowering IR (which may in turn suggest long-term Glucophage therapy, even after blood glucose levels have fallen to tolerable levels).
https://intensivedietarymanagement.com/ukpds-futility-blood-sugar-lowering-t2d

I fear we are barely into the foothills. May those of us still around in 20 years report back as to whose advice we should have followed.......

@RalfLott, I was on Janumet, which really helped bring my BG down to low 100s, 90s, and 80s. but the Janu part of that med worked to raise insulin to lower BG. Last month my dr. switched me to metformin, which didn't do a good job lowering BG and was disastrous to my digestive system - could barely leave the house for fear of a major problem. So my dr. switched me to Invokana, which works by releasing BG through the kidneys. BG have come way down since Thursday evening when I started the new med. Now I'm wondering if this is a problem med, like Dr. Bernstein and Dr. Fung talk about. I know they both think metformin is a safer med.

Thanks, @RalfLott. This was interesting. I will discuss the Glucophage XR with my Dr.

RalfLott wrote: »

retirehappy wrote: »

I ran the numbers again this time
102 x 75/2=3825 log is 3.582....

Thanks I'm thinking I am not terribly insulin resistant now, correct?

Here's the deal. You have to use an animal related to "log" (nope, not branch, twig, or cabin) called the "natural log" which is abbreviated "ln" in math notation and on calculator buttons.

ln(3825)= 8.25 - which is still not shabby!
http://www.rapidtables.com/calc/math/Ln_Calc.htm

Thanks so much. I really don't use those kinds of calculations in my world. I thought that was still way too low, but hey I am a computer nerd not a math geek.