Diabetes and Insulin Resistance

Diabetes is a condition in which the body doesn’t produce enough or any insulin, and doesn’t properly use the produced insulin, or exhibits a combination of both. 

When any of these things happens, the body is unable to get sugar from the blood into the cells. That leads to high blood sugar levels.

Glucose, the form of sugar found in blood, is one of the main energy sources. A lack of insulin or resistance to insulin causes sugar to build up in blood which leads to many health problems.

General symptoms of diabetes include:

• Excessive thirst and hunger
• Frequent urination
• Drowsiness
• Dry, itchy skin
• Blurry vision
• Slow-healing wounds

What is pre-diabetes and diabetes? 

Prediabetes is the range between being healthy to turning diabetic where blood sugar levels are higher than normal, but not high enough yet to be diagnosed as type 2 diabetes. 

During the blood test the following parameters are an indication of pre-diabetic condition: The HBA1C (the average blood sugar in the past for the past 2-3 months) is typically in the range of 5.7 to 6.4. Also, the fasting blood sugars would be in the range of 100 to 125 mg/dl.

In addition to these readings it is important to understand other parameters which give further insight into the extent of insulin resistance the body has developed:

Homeostatic model assessment (HOMA) is a method for assessing β-cell function and insulin resistance (IR) from fasting glucose and insulin or C-peptide concentrations.

HOMA – IR (Normal Range 0.5 - 1.4, Borderline 1.4 - 2.9)   - This parameter is an indicator of whether you have developed insulin resistance – i.e. whether the cells have stopped responding properly to insulin hormone. Higher the values, the greater the insulin resistance and the glucose is not able to enter the cells for energy which in turn increases the amount of blood glucose. In my case the  HOMA IR value was 1.69

HOMA2 – B (Normal >75) – This parameter indicates whether the beta cells in the pancreas are producing insulin. 

In case of Type – 1 Diabetes, beta cell function is compromised and so none to very little insulin is produced which leads to Hyperglycemia (high blood sugar). Type 1 diabetes is an autoimmune condition. Immune system mistakenly attacks and destroys the beta cells in pancreas that produce insulin. The damage is permanent. The reason for attacks isn’t clear. There may be both genetic and environmental reasons.

In the case of Type 2 diabetes, the body develops insulin resistance and cannot use the insulin that is made and over time insulin production diminishes. Type 2 diabetes starts as insulin resistance - the body can’t use insulin efficiently. This stimulates pancreas to produce more insulin until it can no longer keep up with demand. Insulin production decreases, which leads to high blood sugar.

My HOMA2 – B value was 98.80. which is good news and means that insulin was still being produced in my body. 

The third parameter is HOMA2 – S which is the insulin sensitivity parameter and a value greater than 65 is considered normal. In my case it was 46.90. Which again is due to Insulin Resistance. 

There is another test called the OGTT (Oral Glucose Tolerance Test) which measures the body’s response to sugar which is considered to be more precise.

• OGTT is a screening test involving testing plasma glucose level following a glucose-rich drink (a beverage containing 75 grams of glucose).
• OGTT may be used in people that show symptoms of diabetes but have not recorded diabetic levels with the HbA1c or FPG tests.
• OGTT may be used for diagnosis, instead of the HbA1c in people with certain blood disorders such as shortened red blood cell life.
• Clients who have impaired glucose tolerance (IGT) or pre-diabetes will have a plasma glucose level of less than 200 mg/dl but equal to or greater than 140 mg/dl.

Clients who have a plasma glucose level over or equal to 200 mg/dl after two hours will be asked to have a fasting plasma glucose test to confirm diabetes diagnosis.

Last updated on: Jan10/2023