How do I know if I'm insulin resistant?

[tacos]

I have had pcos for over 10 years but was thin for most of those years. I has a fasting blood glucose test done to see if I was insulin resistant. The doctor told me the test said I was not, but I don't think his interpretations are very reliable. A lot of tests doctors administer will not catch symptoms of imbalance unless it is very severe. Pretty much everyone I've read online about pcos says that it's caused by insulin resistance. Couldn't I be sub-clinically insulin resistant? How do I tell?

[Katie_Lucey]

Labwork.. A1c is what my doctors have used. I get it done annually to make sure things are under control. Research what's the norm and what's not and get your labs so you can see what's going in. Fasting blood sugar doesn't tell much on its own for ir.

[defygravity]

Also, not all women with PCOS are insulin resistant, not in the least. Many women here are not. It is true that it goes hand-in-hand for lots of PCOS women, but it's not really a cause.

Glucose Tolerance Test can also be used for diagnosis, but it's not commonly performed unless there are other indicators for the syndrome.

[PetiteFlower]

Fasting glucose and HbA1C will NOT tell you if you are IR. They diagnose diabetes. The whole point of being IR is that your glucose stays normal, it just requires your body to produce more insulin than normal to keep it that way. A fasting INSULIN level can provide an indication of IR, though it's not definitive, it's usually enough information. A glucose tolerance test WITH insulin levels done also will definitively diagnose.

Even if you're not actually IR, your symptoms may be related to insulin, something about how it affects the ovaries causing them to produce excess testosterone. That's why metformin can help PCOS people even without IR.

[Katie_Lucey]

While I agree no one test is enough they use labs for diagnosing diabetes to test for insulin resistance. Mine came back higher than normal but not quite diabetic range and that's what they used a long with high testosterone to diagnose insulin resistance.

Even if you google it you get varying answers about which tests are best but all agree you need various tests all together to see a bigger picture.

[JulieofDenial]

You definitely don't have to be insulin resistant to have PCOS. In fact I recently read that PCOS is not uncommon among women with LADA and Type I Diabetes many of whom are insulin sensitive. People with LADA and T1D have low insulin and eventually stop producing it all together. It's not really possible to have a disease caused by having too much insulin if you don't have any insulin to begin with.

The only thing that's known about PCOS for certain is that it's associated with too much androgen which might be because you have a massive amount of androgen for some reason, or they are only slightly elevated, but still too high for you. Other things such as obesity and insulin resistance are -associated- which doesn't mean that they necessarily cause you to have PCOS. However because your endocrine system works through positive feedback loops something that is a 'symptom' might actually make your condition worse.

[soulcyster.indeed]

The whole point of being IR is that your glucose stays normal, it just requires your body to produce more insulin than normal to keep it that way. A fasting INSULIN level can provide an indication of IR, though it's not definitive, it's usually enough information. A glucose tolerance test WITH insulin levels done also will definitively diagnose.

I have consulted two endo's who went through my GTT without insulin and said I am not IR. I have normal fasting sugar and insulin and normal sugar PP as well. I have never had my insulin PP tested.

And I had been thinking I'm confirmed non-IR

[Katie_Lucey]

I have normal fasting glucose and normal gtt and I'm IR.

[soulcyster.indeed]

I have normal fasting glucose and normal gtt and I'm IR.

Is your fasting insulin normal?

I have been spending a lot on doing tests on my own since docs have some 'compact' set of tests and they wouldn't go beyond that :|

[JulieofDenial]

Insulin resistance is like 'pre-prediabetes'. You don't need to have high blood sugar or diabetes to be insulin resistance. It's a sign that you may be on your way to diabetes somewhere down the line. In its early stages it can be reversed in less than 2 months so it's not a death sentence by any means. Pre-diabetes can be reversed as well. I don't understand why some people will have pre-diabetes without IR.

[soulcyster.indeed]

Insulin resistance is like 'pre-prediabetes'. You don't need to have high blood sugar or diabetes to be insulin resistance. It's a sign that you may be on your way to diabetes somewhere down the line. In its early stages it can be reversed in less than 2 months so it's not a death sentence by any means. Pre-diabetes can be reversed as well. I don't understand why some people will have pre-diabetes without IR.

Now I know I'm not non-IR for sure. I'm doing a healthy diet and regular exercise, except for occasions I fail to curb my cravings (once in 20-30 days). Does it make sense not to know if I'm IR because I'm on healthy lifestyle 'most of the time'?

[JulieofDenial]

Now I know I'm not non-IR for sure. I'm doing a healthy diet and regular exercise, except for occasions I fail to curb my cravings (once in 20-30 days). Does it make sense not to know if I'm IR because I'm on healthy lifestyle 'most of the time'?

I'm confused. Do you know you are insulin resistant, or not?

[soulcyster.indeed]

My sentence structure was so bad. After reading it, even I got confused what my sentence meant

Docs said I'm not IR, but from this thread I learn that my insulin after glucose intake, which is crucial for determining IR, has never been tested. In other words, I'm unsure if I'm non-IR

[JulieofDenial]

Usually they only do the glucose test if your initial insulin test comes back as abnormal. I am guessing that they also tested your blood sugar/glucose when they tested your insulin.

Rule of thumb is this: If your fasting blood sugar is low and your insulin is low you are not insulin resistant. Your insulin did what it had to do the last time you ate, and dropped back to normal when your blood sugar went back to normal.

If your fasting blood sugar is high and your insulin is low you are not insulin resistant. You may be prediabetic though because your pancreas isn't producing enough insulin to do what it needs to do. Not all diabetes is caused by insulin resistance though. Sometime your insulin works just like it should, but your pancreas gets worn out from making too much, or your immune system is attacking it (as with LADA and Diabetes type 1).

If your fasting blood sugar is high and your insulin is high then you -might- be insulin resistant. Your insulin either isn't doing what it should, or you did not wait long enough after eating to take the test. To make absolutely sure they need to do the glucose tolerance test.

If your fasting blood sugar is low and your insulin is high you might be insulin resistant because your insulin definitely should not be hanging out an high levels when it's not required.