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Are The Following Tests Indicative Of Insulin Resistance?

Posted on Fri, 20 Feb 2015

Question: Is this indicative of insulin resistance? My dr says I am not insulin resistant & that the elevation was due to high levels of stress/emotion before & during draw. However I do have light shadows under armpits & feel tired immediately after eating esp carbs. My dr is adament its all due to stress not blood sugar. My A1C is 4.2 & glucose draws always optimal.

Answered by Dr. Binu Parameswaran Pillai (1 hour later)

Brief Answer:
Insulin seems to be high

Detailed Answer:
Good day

Noted your concern.
Your HbA1c is really good and is in normal range. What is your Haemoglobin levels? If it is low, Hba1c also can be low.

Noted your reports. DHEA-S is just above normal ( why was it ordered?? Do you have irregular periods or excess body hair growth?). It is not clear when was the Insulin test done? ( fasting or after meals). Cortisol level is good too ( why was cortisol ordered?).

Insulin levels infact is elevated. Can not agree with your doctor. Stress increase counter regulatory hormones like cortisol glucagon and nor epinephrine which reduce insulin levels and increase glucose levels.

What is your height and weight ? Periods? Any family history of diabetes?
Pigmentation of armpits and nape of neck may indicate acanthosis nigricans. ( if it is true acanthosis, it may indicate insulin resistance?

If you feel tired after a heavy carbohydrate meal, it is worth checking your 2 hour post meal insulin test as well to undergo an extended carbohydarte tolerence test. I feel you should get in touch with an endocrinologist who can examine you and guide you further. This will help you to avoid anxiety and unnecsary tests as well

Regards
Binu

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Binu Parameswaran Pillai (5 minutes later)

5'6 185 irregular periods . All other hormones LH etc normal

Answered by Dr. Binu Parameswaran Pillai (6 minutes later)

Brief Answer:
Higher body mass index

Detailed Answer:
okay, your weight is higher for your height. If you have a waist circumference of more than 88 cm, you may have insulin resistance. If the hormones are normal and if you have withdrawal bleeding after taking progesterone tablets, then you may likely have Poly cystic ovary syndrome. PCOS is associated with insulin resistace.
Was there any mention about PCOS in you ?

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Binu Parameswaran Pillai (2 minutes later)

Yes they said possible slight case of pcos. When I asked about insulin resistance they said no. Also prior to these labs I was on Macrobid for 3 days for UTI? Am I at risk for blindness bc of this antibiotic effect on insulin resistant ppl

Answered by Dr. Binu Parameswaran Pillai (12 minutes later)

Brief Answer:
Not to worry. It is reversible

Detailed Answer:
oh God, please do not worry. Please do not read blogs written by non professionals. Internet can give you so many wrong information. Please relax. Insulin resistance is reversible by losing few kilos of weight. Regular exercise and weight loss certainly help. This will improve PCOS and your periods may become regular too. If you are worried, you must do a glucose tolerence test.

Nitrofurantoin ( macrobid) will no cause blindness. Again, insulin resistance do not cause blindness. It is the diabetes which can cause diabetes if the person doesnt control the diabetes. Please relax.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Binu Parameswaran Pillai (8 minutes later)

I had read Macrobid can cause blindness. I was on 3 day for uti stopped a week ago

Answered by Dr. Binu Parameswaran Pillai (5 minutes later)

Brief Answer:
Optic neuritis is very very rare condition

Detailed Answer:
Many drugs can cause optic neuritis. Nitrafurantoid can very rarely cause optic neuritis if you take for long term. I HAVE PRESRIBED NITROFURANTON for hundreds of patents and i have never seen this complication in any one so far. Beleive me, it is very rare. And it is unlikely to cause it since you had a very short course of this antibiotic

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Binu Parameswaran Pillai (12 minutes later)

If optic neuritus were to occur, when is onset?

Answered by Dr. Binu Parameswaran Pillai (3 minutes later)

Brief Answer:
Difficult to predict

Detailed Answer:
tough question and very difficult one to answer. Can not predict it. to be XXXXXXX with you, i may need to refer and find out.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Binu Parameswaran Pillai (1 minute later)

I would like to know when I am in the clear? Does it happen during course, shortyly thereafter or can it be very delayed onset? Thank u

Answered by Dr. Binu Parameswaran Pillai (7 minutes later)

Brief Answer:
Will get back to you by evening tomorrow

Detailed Answer:
Dear Angelcmb, you seems to be very anxious. Anxiety is not helpful and will only make you worry more. By logical thinking, optic neuritis wouldvery very rarely occur on prolonged use for many weeks. ( Which is true with many otther drugs like anti tubercular treatment drug like Ethambutol). With regards to optic neuritus related to nitrafuratoin, i need to refer and find out. I will aswer it tomorrow as it is half past midnight here. I need to discuss with an ophthalmologist.
Good night

Note: For more information on hormonal imbalance symptoms or unmanaged diabetes with other comorbid conditions, get back to us & Consult with an Endocrinologist. Click here to book an appointment.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar