How do you know if you are insulin resistant though?
Is there a simple test we can do?
Unfortunately there is not a single definitive test that you can ask your doctor to run. Here are the available methods though that can help you figure out if you are insulin resistant.
1. Euglycemic hyperinsulinemic clamp: This is considered the “gold standard” when measuring insulin sensitivity. This test is a two hour procedure where insulin is infused through a peripheral vein, concurrent with the infusion of glucose. it measures how much glucose that has to be infused in order to maintain blood sugar within a specified range during the last 30 minutes of the test.
This procedure is often used in research settings but is not generally used in clinical settings.
2. Testing insulin levels: Fasting insulin levels go along with the degree of insulin resistance. If you have low basal insulin levels it can indicate that you are sensitive to insulin. If you have high basal insulin levels it suggests that your pancreas is oversecreting insuline to compensate for insulin resistance.
On paper this sounds like a straight forward definitive test doesn’t it?
The problem is we don’t have an established or acceptable standard for determining normal vs abnormal insulin levels.
3. Homeostatic model assessment (HOMA): HOMA uses data from physiological studies to create mathematical models that they input into computer software. The calculations are based on fasting glucose and fasting insulin levels. The software then estimates the degree of insulin sensitivity and beta-cell function.
4. Surrogate measures: One of the simplest ways to measure your insulin sensitivity is looking at your triglyceride levels. When we become more insulin resistant our triglycerides tend to go up and our “good” cholesterol (HDL cholesterol) tends to go down. Doctors can also look for metabolic abnormalities such as hypertension and high C-reactive protein.
Out of these 4 methods you will most likely use the 4th one as it is simple and generally reliable in giving us a good indication on whether you are at a higher risk for insulin resistant complications.