Optimal insulin sensitivity -
In the long-term, however, the mechanism predisposes to increased risk for cardiometabolic abnormalities, manifested first as inadequate glycemic control and later as type-2 diabetes and its complications Last, because sex has an impact on several determinants of insulin sensitivity it is important to consider sex differences in glucose metabolism and insulin action and, thus, sex-specific standards when measuring IR-related cardiometabolic risk are also needed.
This study has some limitations. Because our sample was comprised of post-pubertal adolescents from low- to middle SES between a narrow age-range: 16 to 17y, our findings cannot be generalized to the overall population of Chilean adolescents.
However, because the glucose clamp is an invasive procedure, it is not easy to use in healthy individuals. Third, the cross-sectional nature of the study constraints the ability to conclude on the temporality of these associations. Future studies should longitudinally explore this indicator's performance in predicting the risk of cardiometabolic disorders later in life.
On the other hand, our study has several strengths. According to population-based surveys and national studies, the prevalence of obesity and cardiometabolic risk is much higher in adolescents of low- to middle SES.
They are more exposed to risk factors that lead to obesity, IR, and MetS than high-SES adolescents 4 , 10 , 12 , 24 , 28 , Second, we provide evidence of a biomarker that allows good early discrimination of adolescents with IR-related cardiometabolic risk, using a low-cost, easy-to-estimate indicator based on biological risk.
Hence, it might be potentially useful in both clinical and population settings. Third, we found sex differences in this biomarker's effectiveness to identify adolescents at higher cardiometabolic risk. The sexual dimorphism has not been described in previous validity assessments of the SPISE.
Also, we estimated post-test probabilities. While post-test probabilities may be quite useful in everyday clinical work, they are often roughly estimated or even guessed. When they are calculated, clinical decision-making may rely on pure quantitative criteria, allowing appropriate and comprehensive use of results from screening tests.
If more sophisticated or expensive screening methods are needed, or resources for interventions are scarce, the post-test probabilities allow focusing on those at higher biological risk. Second, post-test probabilities help to determine which test is best for the patient, in terms of costs and safety, using the most economical and safest option by which an acceptable post-test probability can be achieved.
Third, it is possible to determine whether the probability of a positive diagnosis has risen i. Another strength of the study has to do with the ethnic background of participants.
Our sample consists of Hispanic adolescents, and according to the evidence, this is a group less insulin sensitive than Caucasian adolescents 38 , 39 , Marcovecchio, M. Obesity and insulin resistance in children. Article Google Scholar. Tagi, V. Insulin resistance in children.
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Pediatric Obes. Razzouk, L. Ethnic, gender, and age-related differences in patients with the metabolic syndrome. Hypertens Rep. People with Type 1 diabetes cannot create enough insulin naturally to get glucose into their cells. Without treatment, they may quickly enter a health crisis.
Type 2 diabetes, on the other hand, often features excess insulin that becomes less effective. This cascades into many other serious health issues. Diabetes is perhaps the most prominent insulin-related illness, affecting But it is by no means the only one.
Many other serious health conditions have been linked to chronically high insulin hyperinsulinemia and its close counterpart: insulin resistance. There are several mechanisms that can drive this condition , including genetics, overnutrition, excess fructose, and excess visceral fat accumulation.
Another important one is the chronically elevated insulin , which can result from frequent refined carb consumption.
In the latter case, high glycemic variability and chronically high blood glucose levels hyperglycemia cause repeated surges of insulin. As cells are exposed to more and more of the hormone, they become less and less sensitive to it.
And it can take hold surprisingly quickly. In one study, for instance, researchers forced insulin levels to stay high in a group of 15 healthy people who were previously insulin-sensitive.
They became more insulin resistant after just 48 hours of this treatment. Fortunately, you can reverse prediabetes with lifestyle and diet changes. The mechanisms driving insulin resistance have to do with the inner workings of living cells. And finally, when glucose is received by the cell, the chemical reactions that convert it to a more refined energy source such as phosphorylation and oxidation can also be impaired.
As your tissues become less sensitive to insulin, your body creates more of it to meet its physiological goals. This elevated insulin level then worsens your insulin resistance, and so on.
At that point, your glucose levels begin to run harmfully high. This process can take years to unfold. In one study, for instance, high insulin levels preceded high glucose by as much as 13 years.
Another study found that hyperinsulinemia can predict glycemic dysfunction 24 years in advance. Unfortunately, most healthcare providers will not test you for high insulin. But by the time those downstream symptoms appear, the damage may have already been done by years or decades of hyperinsulinemia.
Here is a short list of other serious health conditions linked to hyperinsulinemia and insulin resistance:. This sobering and incomplete list reveals why insulin levels should be of concern to everyone, whether or not we currently have diabetes: Insulin plays a decisive role in your overall health.
By maintaining a safe, controlled insulin level, it may be possible to lower your risk of disease. Medical experts take a wide variety of positions on the matter, and a standard reference range has not been established.
Generally speaking, we know that lower is better. First, consider the reference range published by the physician resource Medscape. Note, however, that many metabolic health experts consider this range too high.
Source: The ultimate guide to understanding your cholesterol panel and metabolic blood tests. Finally, consider what relevant research has to say on the issue.
Some of the studies below set out to establish an insulin reference range for a given population. Others simply defined a healthy insulin cutoff for the purpose of studying a related illness. Both can be useful data points:. This ambiguity is due to a confluence of issues.
The first problem is that high insulin was historically viewed as a downstream effect of serious illness, rather than a primary cause. The second issue is that fasting insulin is entangled with a huge number of other independent factors, like body mass index and body weight, insulin sensitivity, and insulin clearance , as well as diet , exercise , and ethnicity.
These factors interact in complex ways, and some like obesity are major health risks in their own right. This makes it very difficult to tease apart the variables and identify an ideal insulin level. Is high insulin in an overweight person as harmful as it is in a lean person?
How much harm is done by elevated insulin versus the obesity that accompanies it? Should people of different sex and ethnicities have the same insulin target? These are not simple questions for medical researchers.
Ethnicity has proven to be a particularly tricky factor in these analyses. Many studies have found that fasting insulin level varies by ethnicity. For example, this paper found that fasting insulin is higher in post-menopausal Black and Hispanic women than in non-Hispanic White and Asian women.
Research has also shown that fasting insulin is higher among Black people than their White and Mexican-American counterparts if the participants are lean—but it is higher among Mexican-American people if they are obese. These differences can have very real clinical impacts.
For instance, the authors of one study found that a race-agnostic threshold for high insulin levels is less reliably linked to metabolic syndrome in Black patients than in others.
In other words, Black patients tend to have higher insulin levels by the time they are diagnosed with metabolic syndrome than other populations.
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Type II diabetes Metabolic syndrome diet Optimwl profound global health problem associated with Metabolic syndrome diet disease and disability worldwide. The WHO estimates that in alone, diabetes Multivitamin for stress relief the Metabolic syndrome diet sensitiviy of 1. Optial Medicine practitioners understand the importance of focusing on the root cause of cellular imbalances that lead to devastating diseases such as diabetes. Abnormalities in cellular glucose metabolism can be detected in blood work more than a decade before one develops diabetes. Insulin resistance IR marks the beginning of these metabolic changes and can be detected via blood work, glucose tolerance tests, or continuous glucose monitors.
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