Blood Glucose and Insulin

HOMA-IR Calculator for Insulin Resistance

Determines insulin resistance and insulin sensitivity (QUICKI) to help with evaluation of glucose tolerance and diabetes

Disclaimer: This tool should NOT be considered as a substitute for any professional medical service, NOR as a substitute for clinical judgement. Please read the full disclaimer.

Estimate your Level of Insulin Resistance

Make sure you select the correct measurements.

For the USA, for example, the fasted glucose is normally given in mg/dL

The HOMA-IR calculation requires U.S. standard units. To convert from international S.I. units:

Insulin: pmol/L to uIU/mL, divide by (÷) 6

Glucose: mmol/L to mg/dL, multiply by (x) 18

Why the HbA1c is a

flawed metric

If you're looking for a better way to monitor your blood sugar and diabetes, you're in luck! In this video, we'll explain how hba1c (a measure of blood sugar control) is flawed and how the best measure of blood sugar control is blood glucose and insulin levels.

We'll also explain how a CGM (continuous glucose monitoring device) is great for monitoring your blood sugar levels, and how a finger stick is the optimal way to measure blood sugar levels. Don't let hba1c or glucose tolerance tests hold you back from reaching your health goals!

What is the most accurate method to measure your blood sugar levels?

It certainly is not the HbA1C because it does not measure your blood glucose levels directly. It is an estimated number based on a few assumptions and it's not even looking at blood glucose! It's looking at glucose bound to hemoglobin.

A number of conditions and situations will make the measurement off. If you're haemolytic or have an infection. Kidney disease, liver disease, pregnancy, and numerous other factors can affect your A1C measurements.

If your daily blood glucose is good
Fasting insulin is good
C-peptide is good
Then do you need to care about a1c?

The glucose tolerance test is flawed, when in nature would you consume 15 teaspoons of sugar? If you "fail" the test, what does it show? That your body does not want so much sugar in one hit. You're never going to consume pure glucose in your diet.

8 hours fasted blood sugar readings USA / UK. This is the mainstream stratification

Normal range 70 / 3.9 to 90 / 5.0
Pre-diabetic 101 / 5.6 to 125 / 6.9
Diabetic is over 126 / 7.0

For information

160 = 8.9
190 = 10.6
200 = 11.1

Blood Glucose & Insulin

People might be thinking because their blood glucose readings look good that everything is hunky dory. Sadly behind the scenes insulin might be raising to keep the blood glucose down.

This video briefly explains why blood glucose readings are not to taken in isolation.

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What is the HbA1c Measurement?

Basics

To start with we need to understand the gas exchange system in the body. The illustration above shows the path of red blood cells and the oxygen transport cycle. Both oxygen and carbon dioxide are transported around the body in the blood: from the lungs to the organs and again to the lungs.

Hemoglobin

The carrier of oxygen is the hemoglobin molecule that is contained in the red blood cells and over time it becomes glycated (sugar becomes attached) It is the hemoglobin that is referred to when you have a blood test for HBa1C levels.

HbA1c is a measure of glycated (sugar-clogged) hemoglobin in your blood averaged over the last 3 months. This is used as it is theorised that new red blood cells are made to replace old 'worn out ones' after around three months. The body makes between 1 to 2 million new red blood cells every second!

Many of us are told by our doctor that our A1c is a "little high" but nothing to worry about. This is bad advice and can lead to blocked arteries down the road. New research shows that you should have only one goal when it comes to your HbA1c and this video explains it all. Know your A1c and know what your goal-A1c really should be. Your health depends on it.

JACC study:

Background

The metabolic injury caused by protein glycation, monitored as the level of glycated hemoglobin (HbA1c), is not represented in most risk scores (i.e., Systematic Coronary Risk Estimation or atherosclerotic cardiovascular disease risk scale).

Objectives

The purpose of this study was to assess the association between HbA1c and the extent of subclinical atherosclerosis (SA) and to better identify individuals at higher risk of extensive SA using HbA1c on top of key cardiovascular risk factors (CVRFs).

Methods

A cohort of 3,973 middle-aged individuals from the PESA (Progression of Early Subclinical Atherosclerosis) study, with no history of cardiovascular disease and with HbA1c in the non-diabetic range, were assessed for the presence and extent of SA by 2-dimensional vascular ultrasound and non-contrast cardiac computed tomography.

https://www.jacc.org/doi/full/10.1016/j.jacc.2021.03.335

HbA1c Profile in the Study Population and Association With Subclinical Atherosclerosis

(A) Distribution of HbA1c across the sample. The color code represents the selected HbA1c categories used in the study. (B) Presence of SA in each vascular territory stratified by HbA1c category. HbA1c = glycated hemoglobin; SA = subclinical atherosclerosis.

Other Research

Pre-diabetes damages: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5583955/

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