OGTT & Kraft Insulin Survey – The More Definitive Prediabetes Tests

As usual, I’ve got some fuzzy
not-so-great images here. But again, the image is just to make the point.
Prediabetes and diabetes cause arterial plaque. And arterial plaque causes heart
attack (the number one killer), stroke (the number one disabler), dementia (rapidly
becoming it the number one disabler as well), as some other thing blindness and
kidney disease and erectile dysfunction. So those are all really bad items. We
know what causes them plaque, and we know what causes plaque – elevated blood sugar,
prediabetes, diabetes. This graph shows that the higher the dot
the blood sugar levels, the faster we developed plaque. Now what’s interesting
and frustrating and tragic is that so few of us know what’s going on with our
blood sugar and our ability to metabolize carbs. That’s even more tragic
because it’s not that difficult or expensive to do. I’m going to talk just
briefly about two of the ways to find out. One is that oral glucose tolerance
test. The estimates are more than 70% of people with plaque have insulin
resistance. That’s actually a gross underestimate and it’s based on the fact
that we’re not diagnosing it very well. We’re diagnosing it based on A1c and
fasting blood glucose. Once you start looking at OGTT or a Kraft insulin
survey, there are other 30% of these people become obvious that yes they have
carb metabolism problems as well. A1c misses up to half of the patients with
insulin resistance. It shouldn’t be used alone. Unfortunately, that’s the standard
of medicine today. So anyone with known plaque needs at least an OGTT or
preferably even a Kraft insulin survey. Let’s talk for just a minute about some
of the numbers and results associated with with an OGTT. If you have a one-
hour OGTT (oral glucose tolerance test) of 150 or more, you’ve got 13 times the
risk of full-blown diabetes over the next seven to eight years. A 2-hour value
of 120 to 139, and you see this a lot especially among 50- and 60-year-olds, you’ve only got about a third of your beta cell function remaining. Now you may
have significant… your beta cells may be putting out significant insulin but the
function is not working. In other words, your liver and muscle cells are
resisting that insulin. Maybe that’s getting a little technica,l I’ll back off
on that for just a minute. I mentioned the Kraft insulin
survey or prediabetes profile. It was developed by a fellow named Robert Kraft.
It’s like the OGTT, except slightly different, slightly more detailed with
the OGTT. With both of them, you fast for eight hours prior to taking the test.
With the OGTT, you take a challenge with 75 grams with glucose. With the Kraft
prediabetes profile, you do 100 grams with the insulin. I mean with OGTT, you
do one hour, you take blood right before the glucose at one hour, and two hours.
With the Kraft insulin survey, you take blood sugar right before you take
the glucose, then at one, two, three, and four hours. The other difference with the
insulin survey is that you get an insulin value during each of those four
blood draws. That’s very very helpful in terms of telling us: Are you actually
producing insulin or have your insulin of your beta cells just giving
out? These are not expensive tests. Can get an OGTT for one to two hundred
bucks. And we can get a full-blown Kraft diabetes profile for two hundred bucks.
What you find out in terms of your carbohydrate metabolism is just critical
based on this. And unfortunately, that critical information, less than 5% of
people that have insulin resistance actually know this information about
their body. So if you’ve made it this far, thank you again for your interest. So I’m
very excited to announce we now have a membership page. Now what is that? That’s
the one place where you can go and access all of our digital products. It
starts off with a few free things, like a lot of infographics which help you
understand the basics of insulin resistance, cardiovascular inflammation, and other key concepts on how to prevent heart attack and stroke. The next free
item is the intro and first chapter of the book that we’re writing on plaque
and the standards of medicine just aren’t doing very well right now in
terms of the number one killer and disabler – plaque. We don’t do a good
job of measuring it, we don’t do a good job of monitoring it, and there are
better ways. So that’s what this book is all about. Again, go in, get a free look at
the intro and the first chapter. And if you’ve purchased the cardiovascular
inflammation and IR courses, thank you so much for doing that. You purchase those
at a time before we had them totally cleaned up. And we’ve cleaned them up now
and they’re available for you right there on the membership page. Hit the
link below, register and go in, and take a look. Look forward to seeing you there.
Thank you.

7 thoughts on “OGTT & Kraft Insulin Survey – The More Definitive Prediabetes Tests

  1. May have asked this. If I know I have diabetes, and under treatment Metformin and Ozempic , is there a value of the OGTT?
    My HbAic is 5.3% and morning blood sugar was 113 mg/dL. Thanks for you

  2. Thanks again for the VDO Dr. Brewer. I really appreciate and value the content you are providing and I learned a lot. I am following your channel now for approximately 2 years. Please consider my note as a positive criticism: I noticed that over this period of 2 years, your channel is more and more becoming a one topic channel, i.e. about Insulin Resistance. I understand as you also mentioned in this VDO, that CVD in the majority of cases (which maybe even close to 90%) is caused by Insulin Resistance. However in my case it is not. I have a CAC of 150, am 56 years old, length 6.3, weight 180, BMI of 22, fat% of 14% (BMI has been like this more or less my whole live). My HbA1c = 4.8, fasted glucose is 75, my OGGT has the normal pattern, i.e. after 2 hours 101. I do a lot of weight training and HIIT. When I eat 300 to 400 calories more than my maintenance level (which is around 3600 kcal per day) for a couple of months I barely gain any weight. Clearly I do not have Insulin Resistance, rather I would say the opposite I have Insulin Sensitivity. Nevertheless a CAC of 150 was measured. So in my case most probably CVD is caused by something else than IR. I would appreciate if you could spent also some VDO's on other causes for developing CVD, than just Insulin Resistance. Again I very much appreciate your channel and the expertise you are sharing. Thanks a lot.

  3. Does anyone have ideas of mechanisms that blood glucose causes blood vessel damage? Is it that bacterial infections thrive in high glucose environments? Or what?

  4. Thank you Dr. Brewer for another information packed video! The timing of this video is excellent for me, as I plan to see my doctor today and want to get some baseline blood work done. I will definitely have him order me a Kraft profile. Do you know if Quest Diagnostics offers this?

  5. so some of these people are actually transitioning to Type 1. There has been discussion that an at home Insulin monitor would be more useful than the BS monitors. But they don't have these.

  6. Thank you dr. Brewer for all these infos of preventive medicine that are , as usual, great , scientifically robust, and life -saving. But what about the HOMA-IR Test in comparison to the 2 tests of the video ?Could you elaborate on that ?

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