Blood Sugar Tests Are Inappropriate For Assessing Insulin Homeostasis

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Majid Ali, M.D.

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Reversing Diabetes,

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Diabetes Cannot Be Diagnosed In Time, Nor Reversed Without Blood Insulin Tests

To provide a broader context for due deliberation of the data in Table 1 concerning control subjects,  Tables 2 and 3 present the data concerning insulin homeostasis of 506 subjects without diabetes and 178 patients with diabetes in a general New York metropolitan population.14  Note that a 1.3-fold increase in mean peak blood glucose level is accompanied by a 16.1-fold increase in mean peak blood insulin concentration (Table 2) glucose rise: from 110.2 mg/dL to 150 mg/dL; insulin rise: from 14.3 uIU/mL to 231.0  uIU/mL). The author’s conclusion: blood A1c level, fasting blood glucose level, 2-hour post-prandial blood sugar levels, and glucose tolerance tests of all types cannot be relied upon for assessing insulin status of the patient. I add here that blood insulin concentration determined with randomly drawn sample is utterly unsuitable for assessing insulin homeostasis.

 

The Challenge in Reversing Diabetes

is not to know what any doctor thinks about diabetes and drugs used to treat diabetes but how to learn to think for yourself about insulin, health, and healing.

I suggest you spend time at http://www.alidiabetes.org 

 

The Most Important Question in the Prevention and Reversal of Diabetes (Type 2)

No question is more important for stemming the global tides of insulin toxicity and diabetes than the question in the title.

 

The Answer:

Insulin levels rise first, usually by five, ten, or more years before blood sugars level rise.

Why is this important?

Because insulin toxicity continues to cause cellular damage in the liver, kidneys, heart, brain, eyes and other organs unknown to the patient and the doctor if insulin tests are not done. For more info, go to http://www.Ali Diabetes.Org for the author’s free-access course at

http://www.Ali Diabetes.Org.

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Blood Insulin Level Rises 16-Fold While Blood Sugar Level Rises Only 1.3-Fold 
Table 2. Insulin Homeostasis Categories in 506 Study Subjects Without Type 2 Diabetes
Insulin Category*
Percentage of Subgroup
Mean Peak Glucose  mg/dL
(mmol/mL)
Mean Peak Insulin (uIU/mL)
Exceptional Insulin Homeostasis         N =  12**
1.7%
110.2   
14.3
Optimal Insulin Homeostasis                N =  126
24.9 %
121.2    
26.7
Hyperinsulinism, Mild                             N =  197
38.9 %
136.5 
58.5
Hyperinsulinism,  Moderate                  N =  134
26.5 %
147.0   
109.1
Hyperinsulinism,  Severe                        N =  49
9.7 %
150.0   
231.0
#   Correlation coefficient, r value, for means of peak glucose and insulin levels in the five insulin categories is 0.84.
*Criteria for classification: (1) Exceptional insulin homeostasis, a subgroup of optimal insulin homeostasis with fasting insulin concentration of <2 uIU/mL and mean peak insulin concentration of <20; (2) optimal insulin homeostasis, peak insulin <40 accompanied by unimpaired glucose tolerance; (3) mild insulin homeostasis, peak insulin  between <40 and 80 uU/mL;  accompanied by unimpaired glucose tolerance; ; (3) moderate insulin homeostasis, peak insulin  between <80 uU/mL and 160 uIU/mL accompanied by unimpaired glucose tolerance;  and (4) severe insulin homeostasis, peak insulin  > 160 uU/mL accompanied by unimpaired glucose tolerance;

Why Do Diabetics Need Insulin Shots?

Because Their Pancreas Has Exhausted Its Lifetime Capacity of Produce Sufficient Insulin

Note the extremely high blood insulin level (298 uIU/mL) still cannot keep the blood glucose level in the normal non-diabetic level. 

Table 3. Insulin Homeostasis Categories in 178 Study Subjects With Type 2 Diabetes.
Insulin Category
Percentage of Subgroup
Mean Peak Glucose, mg/dL
(mmol/mL) 
Mean Peak Insulin (uIU/mL)
Diabetic Hyperinsulinism, Mild              N =  53
29.0%
252.0   (14.00)
55.4
Diabetic Hyperinsulinism, Moderate    N =  42
24.0%
242.1   (13.45)
112.4
Diabetic Hyperinsulinism, Severe          N =  24
13.9%
224.6   (12.47)
298.0
Diabetic  Insulin Deficit                             N =  59
33.1%
294.0    (16.33)
22.9

 

 

What Is Optimal Insulin Homeostasis?

It is the lowest blood insulin levels that can keep the blood glucose levels in the normal range.
In other words, It is ideal state of insulin utilization, in which insulin toxicity does not exist, nor is insulin wasted because there is too much of it in the blood.
is not wasted .   
In 2017, in a large survey of insulin and glucose profiles in the general New York metropolitan population, my colleagues and I reported a hyperinsulinism prevalence of 75.1%. Below is the link to get free access to the full text of this report:

http://www.townsendletter.com/Jan2017/insulin0117.html  

Or, you may get the report on this website by entering , please use the the following words on the search box of the site:  “Shifting Focus from Glycemic Status.”

Examples of Insulin and Glucose Profiles of Individuals With Perfect Insulin Regulation

Table 1. Post-Glucose Load Insulin and Glucose Profiles of Seven Individuals With Optimal Insulin Homeostasis as Defined Above.
Fasting
½-Hr
1-Hr
2-Hr
3-hr
Insulin Profile 1. Insulin And Glucose Profiles of a 47-yr-old 5′ 5″ Male Runner Weighing 130 lbs. Who Presented With Inhalant Allergy and Hemorrhoids.
Insulin uIU/mL
1.5
9.7
9.0
4.6
<1.0
Glucose mg/dL
72
148
134
108
54
Insulin Profile 2. Insulin and Glucose Profiles of a  45-Yr-Old  5’9″Man Weighing 125 lbs. Presenting With Allergy and Dry Skin.
Insulin uIU/mL
1.0
2.7
9.8
2.7
<1.0
Glucose mg/dL
85
110
75
70
52
Insulin Profile 3. Insulin and Glucose Profiles of a 51-year-old 5’6″ Man Weighing 120 lbs. He Consulted Me for Cardiac Rhythm Disorder, Hypothyroidism and  Allergy.
Insulin uIU/mL
2.9
—
6.0
11.5
2.5
Glucose mg/dL
89
103
134
110
59
Insulin Profile 4. Insulin and Glucose Profiles of a 52-Yr-Old 5’1″ Woman Weighing 120 lbs. Presenting With Constipation and  Allergy.  
Insulin uIU/mL
<2
—
17
15
6
Glucose mg/dL
78
61
72
71
Insulin Profile 5. Insulin and Glucose Profiles of a  52-Yr-Old 5’ 7″ Man Weighing 155 lbs. Presenting With Anxiety, Depression, and Diarrhea. A1c. 5.3%
Insulin uIU/mL
2.0
8.1
19.6
17.7
4
Glucose mg/dL
94
140
158
91
73
Insulin Profile 6. Insulin and Glucose Profiles of a  62-Yr-Old  5’3″ Woman Weighing 114 lbs. Presenting With Allergy and Hand Arthralgia.  
Insulin uIU/mL
1.8
17.8
11.0
10.0
—
Glucose mg/dL
80
159
76
75
68
Insulin Profile 7. Insulin and Glucose Profiles of a 51-year-old 5’2″ Woman Weighing 120 lbs. She Consulted Me for Hypothyroidism and  Allergy
Insulin uIU/mL
3.2
—
11.8
2.4
1.9
Glucose mg/dL
86
110
75
70
52
 
Insulin Lab Reference Ranges Not  Fit for Use
In a previous report the author and his colleagues have highlighted the serious problem of inappropriate prevailing reference ranges for blood insulin concentrations.13 The data in Table 2 reproduced from that publication dramatically illustrates the dimension of this problem with findings of a survey of major laboratories in the New York City metropolitan area. The study data also calls into question the clinical value of single and random blood insulin test results. Photographs of illustrative lab reports are posted online.14

 

 

Absurd Laboratory Reference Ranges 

Table 2. Upper and Lower Limits of Laboratory Insulin Reference  Ranges Expressed In uIU/mL Following a Standard Glucose Load From Six Major Clinical Laboratories in the New York Metropolitan Area.2
Laboratory
Fasting
1 Hr
2 Hr
3 Hr
Laboratory 1
1.9 – 23
8  –  112
5 – 35
—
Laboratory  2
2.6 – 24.9
0.0  – 121.9
0.0 – 163.5
—
Laboratory  3
2.6 – 24.9
8  –  112
5  –  55
3  –  20
Laboratory  4
6  – 27
20  –  120
18  –  56
8  –  22
Laboratory  5
00  – 30
30  –  200
40  – 300
50  – 150
Laboratory  6
Does not include insulin ranges in the report. Instead it includes the following note: Insulin analogues may demonstrate non-linear cross-reactivity in this essay. Interpret results accordingly. Personal communications with clinicians revealed that they do not find this laboratory note to be helpful.
 
 

 

Spectrum of Insulin Dysfunction and Hyperinsulinism in Autism

 
Table 4 presents insulin and glucose profiles of 10 patients with dysautonomia. Note that all patients suffered from allergic disorders.
Table 4. Insulin and Glucose Profiles of Individuals With Autism.
The Blood Insulin and Glucose Levels Are Expressed in uIU/mL and mg/dL respectively.
Fasting
½ Hr
1 Hr
2 Hr
3 Hr
Autism Case 1. Insulin and Glucose Profiles of 14-Yr-Old 5’ 9” Boy Weighing 115 lbs.Who Presented Without Expressive Speech Since Birth.
Insulin uIU/mL
24
300
235
211
83
Glucose mg/dL
83
129
98
95
61
Autism Case 2. Insulin Profile and Glucose Profiles of 15-Yr-Old Boy With  Autism, Allergy, and Fatigue.
Insulin uIU/mL
10.4
43.7
37.6
33.7
7.8
Glucose mg/dL
79
104
86
82
53
Autism Case 3. Insulin and Glucose Profiles of 17-Yr-Old-Boy With Autism, Eczema, And Anxiety.
Insulin uIU/mL
24.4
N/A
73.8
71.6
28.0
Glucose mg/dL
95
N/A
79
79
69
Autism Case 4.  Insulin and Glucose Profiles of 8-Yr-Old Boy Presenting With Autism, Sudden Mood Shifts, and Inhalant Allergy.
Insulin uIU/mL
6.2
40.36
41.5
24.8
3.9
Glucose mg/dL
96
192
131
109
57
Autism Case 5. Insulin and Glucose Profiles of A Three-Year-Old  Boy With Asperger’s Syndrome, Temper Tantrums, Eczema, And Inhalant Allergy.
Insulin uIU/mL
1.28
14.3
0.33
Glucose mg/dL
71
126
88
Autism Case  6. Insulin and Glucose Profiles Of A Four-Year-Old Boy Weighing 35 lbs. Limited expressive speech, Often in non-communicative trance. Mother’s Words: “Very Intelligent In Things That Interest Him.”
Insulin uIU/mL
2.3
24.2
20.2
17.8
0.8
Glucose mg/dL
89
151
102
98
79
Autism Case 7 .  Insulin and Glucose Profiles of A 5-yr-old Boy With Autism Focus Disorder. No Expressive Speech Until Age 30 Months, Single Words 10-15 Words. No Voluntary Sentences. Eczema, Recurrent Ear Infections.
Insulin uIU/mL
1.31
47.16
43.99
Glucose mg/dL
64
127
150
Autism Case 8 . Insulin And Glucose Profiles  of  A 7-Yr-Old Boy Presenting With Diagnoses of Autism, Inhalant Eczema, Food Allergy, and History of Multiple Courses of Antibiotics for Sore Throats.  
Insulin uIU/mL
11.0
–
–
–
–
Glucose mg/dL
73
–
–
–
–
Autism Case 9. Insulin And Glucose Profiles  of A Six-Yr-Old Boy Presented With Autism, Hypothyroidism, Food and Inhalant Allergy.
Insulin uIU/mL
—
13.0
—
—
Glucose mg/dL
—
85
—
—
The staff of a university hospital mishandled the blood samples on two different occasions.
Autism Case 10. Insulin and Glucose Profile of A 28-yr-old Man Who Was Diagnosed With Autism with complete Absence of Expressive Speech Until Age 4 And Then Transitioned to Asperger’s Syndrome. At Age 21, He Was An Excellent Athlete But Could Speak Only To His Mother.
Insulin uIU/mL
7
174
365
71.9
7.9
Glucose mg/dL
81
178
160
85
56
Follow-Up Testing One Year Later
Insulin uIU/mL
8.2
139.9
152.0
40.82
2.82
Glucose mg/dL
88
128
125
100
47

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