An Important Test

You must remember how vigorously I encouraged you in Chapter 10 to have a GTT with insulin levels. This test demonstrates how your body reacts to receiving a fixed dose of glucose, the substance most readily convertible to blood sugar. Obviously, if your metabolism has been dealing with any of the assaults I've just described, the signs of such metabolic malfunction will be clearly evident on a GTT with insulin levels. I advocate that everyone take this test. However, if you are overweight, have diabetes in your family tree, have high blood pressure or high triglycerides, or have symptoms that appear when you are hungry and clear up when you eat, I must insist that you get a GTT.

Be sure to get a five-hour GTT with insulin levels. Here is what will happen: Blood will be drawn so that both your glucose and insulin levels can be determined. After an overnight fast (with no food in your system for twelve hours) the first blood will be drawn so that your fasting levels, or baseline glucose and baseline insulin, can be determined. You will then swallow the glucose solution, and the practitioner will plot out the schedule for drawing your blood over the next few hours. Blood will be drawn thirty minutes after you drink the glucose, again at sixty minutes and so on during the remainder of the test. Your glucose level is checked each time blood is drawn. Your insulin level is checked at the one-hour and two-hour marks only, because insulin levels peak within two hours after you drink the glucose solution.

How to Understand the Readings of a Glucose-Tolerance Test

Depending on your glucose level at baseline, you fall into one of three categories:

Range Category

70-109 mg% Normal

110-125 mg% Impaired Glucose

126 mg% or higher Diabetes

Beyond your baseline level of glucose, note that your peak glucose level measured within the first two hours after drinking the glucose solution should not exceed 160 mg%, and your nadir glucose (after two to four hours) should be between 60-90 mg%. The delta (the difference between the lowest and highest reading) should be 30-80 mg%.

If the delta is higher than 80 points and you are overweight, you most probably have hyperinsulinism. If the delta exceeds 100 points, the probability is very strong. If it exceeds 125 points, you unquestionably have hyperinsulinism.

The first number, your fasting-or baseline-glucose level, is a standard criterion for determining if you have diabetes. The ADA now regards 126 mg% as the number at which diabetes should be diagnosed, and considers 110 to 125 as a measure of impaired glucose tolerance (Stage 3). One to two hours after you drink the glucose solution, the highest normal reading is 160 mg%. Between 160 mg% and 200 mg% shows a clear indication of the progression to diabetes, and anything higher than 200 mg% indicates certain diabetes.

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