we recently looked at ways to lower our insulin resistance. but how do you know if you're insulin
resistant in the first place? today we'll look at three methods to estimate our degree of insulin
resistance and to follow it over time, and we'll throw in a bonus one at the end. now, why would
anyone want to know if they're insulin resistant? well, people with insulin resistance are at higher
risk of developing type 2 diabetes and a host of other conditions including cardiovascular disease,
and we can be insulin resistant for many years before things finally go haywire and we actually
become pre-diabetic, and finally, diabetic, so if we can get a heads up years in advance,
we can make some healthy changes and fix things instead of waiting for damage to accumulate.
the best way to measure insulin resistance is a complicated lab technique called hyperinsulinemic
euglycemic clamp. just saying the name is a pain in the rear end, and performing the
technique is even worse. you have to infuse both insulin and glucose into your bloodstream
for a while, it's risky, it's a hassle, so it's only done in the setting of a research study.
fortunately, there are several methods that are much easier. they're not quite as precise but
they can give us a pretty good idea. the first method we're going to look at is called Homa-IR.
it stands for homeostasis model assessment of insulin resistance, and to calculate your Homa-IR
you need two values, your fasting insulin and your fasting glucose. once you have those two metrics,
it's just a simple formula and you don't even need to do the math yourself, there's a lot of online
calculators so you just plug in the two values and it spits out your result. I'll link one of these
calculators in the description, you can enter both milligrams per deciliter and millimole per liter,
depending where you're based, just make sure you choose the right option so the calculator
knows what you're actually entering otherwise the final value won't make any sense. now, there's no
universally accepted cut off for homa-IR above which you say someone is definitely insulin
resistant and below which someone is insulin sensitive, it's a little more gray than that.
it varies with age and a couple other factors, but in general, above 2.5 or 3 is pretty suggestive of
insulin resistance, and the higher you go the more insulin resistant you probably are. you
can be six, seven, eight etc. and under two in general is a good value of someone who's pretty
insulin sensitive, so not insulin resistant. just so you know, there is another formula that uses
the same readings, fasting glucose and fasting insulin. the formula is slightly different and
it's called the QUICKI index. I'll leave the puns up to you, you guys have fun in the comments. it's
roughly equivalent to homa-IR, and the same online calculator I'm going to link for homa-IR also
gives you the QUICKI index, so just if you hear about that you know what they're talking about.
another tidbit to bear in mind is that these formulas that use fasting values, they mainly
reflect insulin resistance in the liver, your hepatic insulin resistance. it is possible to have
normal fasting metrics and yet have some insulin resistance in other tissues that is only reflected
in measurements taken after eating after a meal. there is something called the matsuda index,
which uses measurements taken post-prandially, so after a meal.
it's a longer test, you've got to go in and drink a sugar solution and wait a while,
and you need multiple measurements at different times, so it's more of a hassle,
but just so you know these things exist, that way you can have a more qualified discussion with your
doctor. and the third method we're going to look at is also the easiest because it uses metrics
that are very common, that most people already have. interestingly, it's also the least known,
you might have never have heard of it, it's called the T-y-G index or the TyG index.
I think it's more fun to say the Tyga. and it uses fasting glucose and fasting triglycerides,
and just like the others there's a little formula, there are several calculators, so I'll link one
of those below in the description, it does all the work for you, spits out the result,
even interprets it for you. again, bear in mind the units, make sure the units of your
readings match the units on the site otherwise the results are not going to make any sense.
worst case scenario you might need to convert, and there are a number of online converters as well,
from millimole per liter to milligram per deciliter, back and forth, and I'll link one of
those as well in the description. a lot of people ask about triglycerides to HDL-cholesterol ratio,
and it does correlate with insulin resistance but there's some evidence that these methods
we covered might be a more reliable measurement, like for example this TyG or tyga index, probably
tracks better with insulin resistance, at least in some contexts. finally, if you just want a quick
and dirty rough estimate, measuring your waist circumference is one thing you can do. it's easy,
it's fast, free of charge, but obviously it's more of a rough indicator. you want to measure it
at belly button level and ideally you want to be under 100 centimeters, which is about 40 inches.
so those are some common methods, homa-IR probably the most common if you have access to a fasting
insulin reading, if not the TyG or Tyga index is a pretty convenient alternative that can give you
a good idea of where you are. if you are insulin resistant. what can you do about it? we covered
that very recently. and this video goes over the best diets for diabetes. I'll see you over there