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It's not only overweight people who get pre-diabetes and diabetes; people who are slim, generally healthy, and active develop insulin resistance too, but tend to get the brush-off from doctors when raising their concerns, because they don't fit the typical profile. Medical education needs to improve in this country, and the insurance industry needs to stop interfering with how doctors practice.
What I was implying works the other way around. They get overweight from being insulin resistant.
Insulin is an anabolic hormone which means it "builds". In other words, it makes you put on weight. Higher than normal levels of course. It's also useful for building muscle but that's another discussion.
It's a cycle, high glycemic food->Blood sugar spikes->Insulin Spikes->Weight Gain. This cycle is repeated over and over several times a day, day after day. After a while, the insulin stops working as it should, your pancreas secretes more and more to make up for the high blood sugar. THIS is the insulin resistance I speak of. This is assuming you lead a sedentary lifestyle. You can break the cycle with exercise or by cutting or reducing the high glycemic food and by that I mean stuff like bread, pasta, candy, cookies, soda etc etc.
Breakfast is bad enough on it's own. Pancakes, syrup, hashbrowns, orange juice, you get the picture. LOL. "The most important meal of the day"? Yeah sure.
Without adequate levels of insulin you would find it difficult or impossible to gain weight. You would also have higher blood sugar and also be classified as a diabetic. The medical establishment also classifies these types of diabetics as Type 2. This is to simplify things. They figure, high blood sugar, some level of insulin, so type 2 but they are more like type 1.5 in my opinion. Type 1 diabetics make no insulin, they have to inject it and the cause different.
Too many conflicts of interest at play and behind all of them is $$$$.
The medical establishment, for-profit hospitals, health insurance, food companies etc etc.
The current standard for diagnosing diabetes is the A1C. It's not perfect but it's the best they got. Too many variables otherwise. Short term factors like medications, illnesses and other conditions can affect blood sugar temporarily. The A1C spreads it out a bit. It's 90 day average, weighted higher for the most recent 30.
If you are concerned, you can even get a home A1C test. They sell them at Walmart. If you have a walk in cash lab in you area, get blood work done there. It would be more accurate. You don't need a doctor's order for it either. It costs me $20 for a complete diabetes test which includes glucose, A1C and insulin among others.
Fact is, a large percentage of the population is insulin resistant. IR would also affect any kind of test like the glucose tolerance. IR goes hand in hand with obesity. Somewhat of an epidemic in this country it seems. You can blame the SAD in large part for this problem. Americans eat crappy food and too much of it.
Thanks for the information, I knew the A1C gave an estimation of approx. 2 month average glucose levels, so being high ( with 6.5% being the cutoff point for a diagnosis of diabetes?) might be a better indicator of diabetes than a high glucose ( u less it's over 200mg/dL or so) or two.
So I asked my daughter, who works as a nurse with an endocrinologist, about the 2 hr GTT. She told me they don't use them much any more ( though it's still done for pregnant women at risk to rule out gestational diabetes, ), she said, as you mention,
they use A1C results more.
I''ve had my A1C checked along with the glucose ( as part of a chem panel) twice a year for a number of years when I see my PCP, and the glucose has always been a little over 100 mg/dL- generally from 104 to 110 or so (fasting), with the A1C being somewhere in the range of 5.6 to 5.9%. The last two times the A1C was 5.4% ( the lab's upper range of normal) and the glucose was 104. The PCP told me we'd watch it but she wasn't worried as the levels have not changed. I do watch my diet, and exercise and that seems to help the glucose and the blood pressure.
^^^ 5.7 is the actual cutoff according to the ADA between normal and pre-diabetes. You are fine with the 5.4. Many non diabetics are probably close to that. If you've been as high as 5.9, still not full diabetic, that would be 6.5.
I'm 5.6 but a full diabetic, diagnosed in 2006, probably already had it 5 years before that, maybe longer. Needless to say I am on a strict diet.
I didn't even realize I had a problem till I started getting severe pain in my feet. By that time, the damage was done.
Some people have a problem with using the term "pre" diabetes. I describe it as one step away from full. If you don't take drastic steps to stop the progression, you will get it. As well all know, once you cross the line, there is no going back. You can be controlled as I am, but me being able to eat anything I want without consequences, will not happen.
Think of the "pre" as a warning.
^^^ 5.7 is the actual cutoff according to the ADA between normal and pre-diabetes. You are fine with the 5.4. Many non diabetics are probably close to that. If you've been as high as 5.9, still not full diabetic, that would be 6.5.
I'm 5.6 but a full diabetic, diagnosed in 2006, probably already had it 5 years before that, maybe longer. Needless to say I am on a strict diet.
I didn't even realize I had a problem till I started getting severe pain in my feet. By that time, the damage was done.
Some people have a problem with using the term "pre" diabetes. I describe it as one step away from full. If you don't take drastic steps to stop the progression, you will get it. As well all know, once you cross the line, there is no going back. You can be controlled as I am, but me being able to eat anything I want without consequences, will not happen.
Think of the "pre" as a warning.
I'd guess labs vary some with their A1C reference ranges, in fact, I thought the lab where my testing is done had an upper limit of 5.6 or so at one time for their A1C, but seems they lowered it to 5.4 a couple years ago. New methodology, new instruments, new patient normal range studies, all of the above, who knows?
At a A1C of 5.6 you're well controlled as a diabetic, I know that takes vigilance and effort, so good for you! I think I hear people ( diabetics) say they're happy if their A1Cs are 7.0 or below, I guess compared to A1Cs of 12.0 or higher ( as my daughter says they see in some poorly controlled diabetics) it's better, but still high.
I'm one of those people who get somewhat prickly about the term " prediabetes", even pricklier at the thought of being treated for those numbers. Though I'm well aware that stepping over that threshold into diabetes brings many other health complications, so as you say it is a warning and bears watching and taking measures to control it. That's the agreement I've come to with my PCP, and so far so good.
I realized that I was pre-diabetes in 2016. I listened to your posts (about diabetes since 2016). I am able to keep myself from getting into diabetes. Thank you.
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