New Prediabetes Reseach

Found a new study on Prediabetes today. It compared insulin sensitivity and insulin response in people with different types of Pre-diabetes. You can get diagnosed with Pre-diabetes if you have Impaired Fasting Glucose (IFG) - high blood sugar in the mornings before you eat, if you have Impared Glucose Tolerance (IGT) - high blood sugars after you eat, or both. I have impaired glucose tolerance but my fasting levels are still good.

The study looked at obese adolescents, comparing 40 who had normal glucose response with 41 with impaired glucose responses.

They found that insulin sensitivity and first phase insulin was reduced for all groups - it was more severe for those with impaired glucose tolerance than with impaired fasting levels. For those with both impaired glucose tolerance and impaired fasting, the second phase insulin response was also impaired.

This follows the model of how blood sugar control deteriorates that is laid out over at BloodSugar101.com.

You start out producing enough insulin to handle the food you eat. As your insulin resistance goes up, you start losing the ability to produce insulin - high blood sugar kills beta cells.

So you have less stored insulin to release when you eat (first phase response), and eventually, you stop being able to produce enough backup insulin (second phase response) to cover what the first phase didn't get rid of.

As this goes on, you start showing elevated levels all the time because your system can't ever catch up without diet changes or medication or both.

Once you start showing both impaired fasting glucose and impaired glucose tolerance, you can be pretty sure you've lost a fair amount of beta cells. Getting diagnosed with only one or the other is a good sign, because it's being caught in the earlier stages.