How to Diagnose Prediabetes: March 2019 Lab Review


Cardiovascular inflammation and plaque is
insulin resistance; and most docs in the past just looked at fasting blood
glucose. When hemoglobin A1C became available, docs started looking at that
as well but we’re still very – in our country as well as others, the standard
medical practice is still not nearly as good as it should be in terms of
diagnosing insulin resistance or pre-diabetes; and again it’s – it’s what
drives so many parts of the aging process; heart attack which is the number
1 killer, stroke which is the number 1 disabler, Alzheimer’s dementia which
is quickly becoming the number 1 looks to overtake maybe stroke even. Already
overtook stroke in the United Kingdom for death and disability. I’m going to go
through some basic labs in just a few minutes you can tell someone’s status
and actually you can avoid some pitfalls as well. So why don’t we look at my labs
from the second healthy life summit in Orlando, March 2019. Most docs when they
start looking at this problem, at heart attack and stroke prevention, start
thinking first about cholesterol, the bad cholesterol. And as you can see I have a
107 that’s a little bit hig. It’s not too bad. I’m already taking a little bit
of statin, 2.5-5 milligrams of Crestor 3 times a week so it would be a
little bit higher if I weren’t taking that Crestor but that’s not why I look. I
look first at insulin resistance in this area. I don’t look for the lipid so much,
for the cholesterol, I look at triglyceride and HDL. Why do I look at
that? Well usually if you have significant insulin resistance problems
going on where you’ve got instantly too much insulin out there,
insulin stops the burning of triglycerides which are just fats. It
also tends to chew up HDL when you – when you have too much insulin and you have
too much triglycerides. So one of the first things you can do is look for
triglyceride to HDL ratio. I’ve mentioned that in – in several videos, covered that
in several videos. It’s a powerful predictor and you saw on
my numbers they were great. The ratio for Caucasians, once it gets over 3, 3 1/2
you start worrying about insulin resistance. If it gets over 3
and people of color mexican-americans, you worry about insulin resistance. Even
2.5 and African Americans are getting strong indicators of insulin resistance.
You go back to my number and mine was actually less than one. So I was in great
shape there; but let’s move ahead. There’s more than that to this. Now, again pardon
my – my images. I’m gonna have to interpret these for you. My hemoglobin
A1c was 5.2. So that’s a pretty good number. Actually if you look
back on some of my older videos a year, year or two ago, my hemoglobin A1c had
crept up to 5.5-5.6. Almost 5.8 which is a
number where most people would say, yep you’ve got insulin resistance. So I still
never had completed insulin resistance by that hemoglobin A1c number, ever but I
have it and we’ll see in just a minute why. Those of you who’ve seen some of my
other videos may remember that I got a little bit too high on my vitamin D3. I
get up to 90 at one point because I was getting a little bit. I got confused
on when I was taking the pills. Took them twice a day for a couple of months.
Stopped taking them for a while. Went back to daily and now I’m back down to
67. Thank you for your patience on that little bunny hill.
Now insulin itself, insulin should not go over actually 10 for a fasting insulin
and this number is 2.1. So that insulin number is really good as well.
And actually this glucose fasting, glucose number was 84. So again some
really good-looking numbers there. Most docs are not going to look at all these.
If they did, they’d say, man you are in great shape. You don’t have to worry
about it. I’m in great shape but it’s because I’ve been really watching my
lifestyle. I really crank on the high intensity intervals, 2 and 3 times
a week, walking 5 days a week. I’ve got my BMI down to about 21. My waist size is
32 and I eat less than a hundred grams of carbs every day, almost every day. In
addition I’m doing some water fasting 2 days a week. So I am doing a lot of
stuff; but let’s go back and look. These labs were drawn at the same time, that
those – that triglyceride over HDL number of less than one – ratio of less than one
was drawn and at the same time those that insulin number was 2.5 and at the
same time that that fasting glucose was 84. Look at this. So the fasting specimen
on the OGTT was 86. Again, close to 84. Quite often it’ll vary a little bit more,
just helps you understand the variation of labs. And we talked about that a good
bit at the healthy life summit and just to clarify for you, what we’re talking
about is you go in, your order fasting blood sugar with the OGTT, you
also get it with other labs such as the metabolic panel. So you’re drawing the
blood at the very same time and getting two slightly different numbers. 84 versus
86 is not a big deal, but again I will classically see it, 84
on 1 and 92 on another or 92 on 1 and 98 on another. Same blood drawn at the same
time. That helps you understand the kind of
variation that we get with lab tests. Now, remember up until now, everything looks
pristine for me. Very very good blood sugar levels. Oh at one hour, after taking
the 75 grams of glucose, my blood sugar is up to 183. So what’s going on?
I have insulin resistance. There’s no question about that. I’ve had it for a
couple of years and as I mentioned, I’ve worked hard to improve it and frankly I
have improved it. Does that mean it went away? mm-hmm
Is there an effective cure? Well you can argue over what a cure means for type 2
diabetes or insulin resistance. That’s beyond the scope of this video. If you
look at my 2-hour specimen, the labs would usually say, well just so it’s
below 140. Well it’s below 140 but the reality is
it should be under a hundred. Again there’s no question that I have insulin
resistance. Now should I go ahead and do of a Kraft insulin survey? I got it here.
I could unbox it for you but there’s no need right now. We already know that I
have insulin resistance. We also know that my lifestyle changes have greatly
improved this. Now let’s go back and look at some some other numbers from some
other groups. The standard that you see for pre-diabetes, for A1c
is usually 5.7-6.4 and you see that on – that on these 3 areas;
but let’s look at some other things as well.
Fasting plasma glucose, they say as diabetes routinely is 126 or above,
pre-diabetes is 100-125 . Normal is 99 or below. Again I’ve got great numbers. A
doc would look at another doc that didn’t know so much about what – what’s
going on here, would look at my numbers and say, you couldn’t be doing better.
You’ve got no problem. So let me help remind you in – in videos
like the ones with old Alabama Gardner and John, I’ve gotten a lot of comments
saying that the doctors were very bad. They didn’t know what they were doing
because they were missing full-blown diabetes or prediabetes.
Here’s why they miss it. They look at these studies and then they figure it’s
okay because that’s the standard of medicine. As you see the CDC and the ABA
and some other groups are pushing to get us much more sensitive to our
carbohydrate metabolism. We’ve talked about it many times before and the
reasons. It drives heart attack and stroke which
drives the major causes for death and disability in this country. It also
drives blindness, kidney disease, the other big problems in this country in
terms of health. Now, many groups such as this one, little entity – Latino Diabetes
Association, they’re saying, look with a hemoglobin A1c up to 6 even, you’re
fine. Well no, you’re not. But again I want to show that to help you understand.
Again some of the reasons why we have so much confusion about these very common
but very very important health conditions. If you’ve made it this far, I
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