Inflammation and Cardiovascular Disease (Part 3) – Insulin Resistance Tests


Take the extra hour or two or three. It’s
worth it. Stay at the lab, get a full-blown OGTT (oral
glucose-tolerance test) or even an insulin survey. These things are so
important. An OGTT is where you get… you fast for eight hours, you get a blood
sugar, and an insulin value. Then you take the Glucola. An hour later, you get the
blood sugar again. And an hour later, you get the blood sugar again. It tells us
exactly what’s going on with your body. Even more importantly, add insulin to
that one- and two- and three-hour value. Once you do that, you get a huge increase
in information. I’ve finally been able to get Quest Labs
to agree to do that. It took me months to get that done. Here’s what I’m
finding out. Two or three patients per month have a normal OGTT, but they have
they have to use double the amount of insulin to keep their blood sugars
normal. Why is that important? Because insulin causes inflammation, just like
glucose. So think about it once you get your CIMT today. And this is old
information in an old study. I will tell you, it’s incredibly conservative.
According to this study, done way back in ’11, they found that 70% of people
that had any plaque at all had insulin resistance. But here’s the thing. That was
measured by A1c and fasting blood glucose alone. When you realize that 20%
of the cases are missing missed through those studies, it’s probably more like
90%. And I would say 90% is much more the types of numbers that I see in my
practice. What about the other 10%? It’s usually people with inflammatory disease,
like lupus or rheumatoid arthritis. Those inflammatory diseases cause much risk
for heart attack and stroke as diabetes. So again, I’ve described the glucose
tolerance test. For sake of your time and David’s, I’m going to not repeat that you
can go into my other videos and we’ll go into details on how to interpret an oral
glucose tolerance test, how to get one done, how to interpret a Kraft
prediabetes or insulin survey. These are great tests. You can do those at home.
You know, if you want to know how to do them, we can certainly help you get that
done. A lot of people get very interested and got a lot
comments when I showed this diagram. It’s hard to see but it basically shows the
patterns that Dr. Kraft saw when he did thousands of these insulin surveys.
The first one is normal, with your blood sugar peaking up around 120, coming in
the 80s, peaking at 120, getting back to about a hundred at hour one and a half,
two, and then back down into the to the 80s. With insulin levels, going
starting between 0 and 5, going up usually no higher than 50, sometimes 80,
and then coming back down within a couple of hours to less than 10. Here’s
what happens as you start getting more and more insulin resistant. Your blood
sugar continues to climb beyond the 120 then up into 140 and then takes a little
bit longer to get back down to 120. So at hour 1, you’re at 120; hour 2, your 140; and two hours, three hours, you’re finally starting to get back down. Insulin levels are peaking up higher.
They’re going beyond 50, beyond 60, going up to 80. With pattern 3, a further delay,
and that’s exactly what I’ve seen with several patients. We demonstrated that on
a couple of our videos, we’re up at hours 2. Even you still have continuing
increase going up to 160, 140, 160, even 180 in terms of glucose values. And again
these are showing some fairly low insulin levels. I’ve seen insulin levels
go up over a hundred at hour 1, even at hour 1 and 2, trying to keep their blood
sugar down. And again, having a high insulin level is just as bad just as
inflammatory as having a high glucose level. What gets very interesting is what
I’m just this pattern 4 is the hyperinsulinemia pattern.
I’ve described that a couple of times already and then pattern 5 is insulinopenic.
In other words, you’ve burned out all of your beta cells, you don’t have
any insulin left. Your blood sugar goes up to 200 or more before it finally
comes back down. That’s full-blown diabetes. Once your blood sugar at any
stage with any kind of challenge including this one goes over 200, that’s
one of the criteria. You meet the criteria for being full-blown diabetic.
Don’t panic if that happens, and I have that happen again a few times a month.
Don’t panic if that happens. This happened to me. We manage that to a large
extent. The very same way that we manage is just that we manage insulin
resistance. It’s a stronger form of insulin resistance. There are things to
do and it usually does not mean that you’re going to have to go on insulin or
any type of injectable drug. Now again, I mentioned triglyceride to HDL ratio. I
mentioned home glucose monitoring. You can do that with finger stick but I
would strongly suggest that you try the Freestyle Libre. You see it on many of
my videos. And again, as I mentioned before, that’s like 70 bucks to get
continuous glucose monitoring. For a couple of weeks, what you find is what
your blood sugar’s doing between midnight and 6:00 a.m. I don’t care how
good you are in terms of doing your finger sticks. You’re not gonna wake up
in the middle of the night routinely and do that. This helps you understand those
kind of patterns. It helps you understand how you’re different from day to day, how
do you change. Some people have problems with lentils, other people’s… other people
don’t. There’s a lot of variation in this in our body’s reaction to different
foods, to different days, depending on how we slept, in our cortisol levels. This is
how you can start beginning to understand this. And again we’ve been
flying blind in this up until now. Now, information is available.
We can start managing this. So there are a lot of things that we can do to
manage it. By far, the most important is diet.
The second most important is diet. The third most important is diet. Other
things that are important: good sleep, exercise is incredibly important. One of
the major components of diet is keeping a proper muscle to body fat mass ratio.
Again, we’ve got videos available to you for all of that. Now, let’s say you’ve
gotten all of this done. You get a CIMT. You’re interested in doing more. There’s
a lot of different ways that we can get help for you, ranging from… you can
basically for the most part follow the free advice in the free videos on
YouTube and get very far. As you see in many of the comments, I’ve had many
viewers do just that. If you’d like more help, we can do that, ranging from a full
concierge type of service, all the way back down to one of our newest services-
webinar series. A webinar series is a way to… it’s sort of a mix between
do-it-yourself and working with the doctor. Basically what you do is we will
help… we will provide you with lab requisitions, things that you need to get
the proper labs lists and orders for the labs. And then you attend webinars, that’s
a plan to be small groups and so far we do continue to have very small group
webinars where you we talk about inflammation, we talk about plaque, we
talk about insulin resistance, and we talk about specific individual results.
So we help you interpret it. What time are those things? Right now, we may change
it. But right now, we’re doing them Tuesdays at 11:00 Eastern Time. I don’t
remember the price. I think it’s about 250 to get the labs that you need and
attend the webinars for three months. You also get a three month subscription to
the web our content that’s been presented during
that past three month time period. I’m, as you know, I’m passionate about this. I
want to make this kind of information available. I greatly appreciate what
you’re doing in terms of interest and taking a look at what we’re doing. If
you’d like to get into this and find out a little bit more, you can go to the
membership page, you go to our website prevmedheartrisk.com. There’s a new
button here… membership login. You just click on that button. If you haven’t
signed in already, it’s a free membership. You give your email, you sign in, create a
free account, and then that gives you the basic overview of all of the information
and content that we have. A lot of free content. We’ve got a book coming out
within a couple of months on plaque recognition and some of the things that
I talked about here. You get the intro and the first chapter of that book
for free on this membership page. You get… we’ve got two courses out there already
and a third getting ready to come out. One on plaque, one on inflammation, and
one on insulin resistance. Again, free content out of each of those courses is
available just by going into the membership site. And if you want to just
get it all done, you want to make some investment of a couple of days of your
time and the money to get all of the labs and the CIMT, you can come to an
event with us. So we’ve got one coming up in Louisville on November 8th and 9th.
My name is Ford Brewer. I started off as an ER doc. Then I became very
frustrated with the fact that most things that bring people into the ER
were preventable, like heart attack and stroke. I went to Johns Hopkins to get
training and ended up running the program there in prevention. There, I
trained dozens of docs, and again that was three decades ago. Since then, I’ve
trained thousands of docs. And even more importantly, supervised those docs.
And even most importantly, helped thousands of patients prevent things
like heart attack and stroke. Waiting for it, for the disease and hoping for a cure
for this kind of devastation, doesn’t work. So come to Louisville on November
8th and 9th. We have a boot camp type of environment for two days where you learn
all the things that you didn’t learn from your doc in terms of heart attack
stroke prevention things, like cardiovascular inflammation, how to
detect it, how to measure things like insulin resistance (the number one cause
of inflammation), how to detect it, how to measure it, how to stop it, how to manage
it. You also get you can get the labs there for that event if you’d like and
get a complete evaluation. In addition you get an arterial scan called a CIMT.
To get the right one of those is fairly difficult. So I’m looking forward to
seeing you there. Thanks.

8 thoughts on “Inflammation and Cardiovascular Disease (Part 3) – Insulin Resistance Tests

  1. The FreeStyle Libre is a REAL game-changer! Thanks for your helpful videos, Dr. B – we keep learning all the time!

  2. If I already know I have diabetes. What do I say to my endocrinologist to convince him to Get OGTT? What is the value
    To him and me?

  3. Have been doing cardiac rehab after a stent 6 months ago. Since I was considered a "diet controlled" diabetic they monoitored my blood glucose pre and post workout. What is irritating is if my blood glucose is less than a 110 (which it is always) before and/or after, they make me drink a 4 oz. hit if sugared cranberry juice, and a block of cheese. Last Thursday's session, my level pre workout was 99 (less than two hours after breakfast) and it was 96 post workout. They insisted I eat and this crap twice a day. It is really irritating. I understand why they do it, but still.

  4. Dr. Brewer, this is a very informative video with extremely valuable information. I am very glad that I recently found your channel and have been watching about 10 videos per day for the last 2 weeks. I'm 52 years old, recently diagnosed as pre-diabetic, and have some things in common with John, as I am also in the 95th percentile for Lp(a). I've started turning things around the last 3 months with a low carb- plant based diet and feel that things are heading in the right direction on several fronts. I do eat fish 3 times per week, per the guidelines of Dr. Valter Longo. Still trying to get as much information as I can and evaluate the research. Getting my arms around the elephant, as you say. It can be a challenge determining whether the plant based folks got it correct, or if the low carbers got it right. I think that they both have a point, and both have their biases. Low carb plant based has been working for me and seems to make the most sense for immediate blood glucose control, as well as long term health. I think that you do an excellent job, in fact better than anyone that I have found, at following the research and putting out the facts without any bias. I am very familiar with the work of Fung and Longo and believe you did an excellent job of explaining their research and positions in another video.
    Keep up the great work! I've shared your channel with my family and will continue to try to get as many as possible to subscribe and watch your videos. Do not underestimate the impact that you are having! You are saving lives!

  5. I did the OGGT few weeks ago and found I have normal blood glucose and my insulin levels numbers over 400 . Clearly I have hyperinsulinemea. I have been a vegan for 3 years now. Now I do intermittent fasting and keeping track of glucose and ketones. Vegan ketogenic diet . I calculate the G.K.I. (glucose ketones Index ). I bought the combo glucose monitor to do myself at home.
    Thank Dr. Brewer for explaining insulin resistance very well. I really appreciate it.

  6. Hello Dr brewer, I have been on keto for 3 months now and I am surprised about the figures you show concerning glucose levels. I haven't eaten any bread or sugary beverage for 4 months now and even a little bit of grapes puts py glucose at 8.2 and sometimes I even hit 10 from doing one breakfast with oatmeal and some fruit and fat milk. My waist went from 90 to 80 cm and i now weigh 67 kg before 77 kg, my height is 175 cm and doing every day weight training (callanestics for 5 months now) I wonder what would happen if I did my old breakfast(orange juice(freshly pressed, chocolate croissant and skim chocolate milk) I often felt exhausted after eating in the afternoon for at least 20 yrs
    I am 52 and only had a little bit of belly fat for the last 10 years as i was exercising less(running) and more sitting behind computer.
    My blood pressure went from 140 to 120 or less since I changed my diet(befor did 4 months vegan and lost 7 kg but only 5 cm at waist. Now I look ribbed and thinner at waist I have ever been. Was I prediabetic and am I still insuline resistant as I see my numbers (glucose ) spike as soon as I do a little carb (from fruit like grapes or carbs like oatmeal)?

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