Hello! Nurse Practitioner, Functional Nutrition & Fitness Coach Nicole here to talk to you about labs to evaluate for insulin resistance. This is a slow and insidious disease process, meaning you won’t “feel” anything until severe damage has been done to internal organs. This is why it is so important to be aware of insulin resistance and screen early in those at risk. As always, these videos are for information purposes only and are not meant to diagnose or treat any one person.
The most common cause of insulin resistance is obesity with rates of upwards of 70%. Those who are skinny fat, with body fat percent greater than 15% in men and greater than 25% in women are also at risk. This is especially true if the fat is located primarily around the center of the body.
In addition to general lab workup with a complete blood count (CBC), and complete metabolic panel (CMP) that includes fasting glucose, we also want to look at a full lipid panel including triglycerides, cholesterol, high-density lipoprotein (HDL), and low-density lipoprotein (LDL), triglyceride to HLD ratio, fasting insulin, and sex-hormone binding globulin (SHBG).
Insulin-to-glucose ratio can be used to assess the degree of insulin resistance in the early stages of insulin resistance when pancreatic beta cells continue to secrete appropriate amounts of insulin. In this setting, higher insulin-to-glucose ratios indicate higher levels of insulin resistance. As the pancreatic beta cells begin to fail, however, insulin levels decline, and the ratio is less useful.
Sex-hormone binding globulin (SHBG) can also give us clues about the body’s insulin-resistant state. SHBG is primarily known as a transport protein for sex steroids, regulating circulating concentrations of free hormones and their transport to target tissues. A low serum SHBG is associated with insulin resistance and an increased incidence of type 2 diabetes in addition to low levels of sex hormones in both men and women with insulin resistance. This may be related to dietary effects on the gene expression of SHBG.
In the next video, I will cover diet and lifestyle treatment for insulin resistance. If you or someone you know may have or does have insulin resistance, work with a qualified health professional to treat and even reverse this process before it’s too late.
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