Diabesity: Tell Tale Signs and Symptoms

Diabesity is found in both overweight and TOFI ( Thin Outside Fat Inside) individuals, https://valeriegoldstein.wordpress.com/2015/05/04/stop-diabesity-in-its-tracks/#comment-5261. This bears repeating because we understand a consequence of being overweight is having diabetes but we assume that someone who is thin and looks good on the outside is immune to health issues.
I cannot emphasize the importance of everyone paying attention to the tell tale signs of diabesity. Be aware of these symptoms no matter who you are, no matter how much you weigh, REGARDLESS of family history.  Why? because 8.1 million people or approx. 28% of the US is walking around with diabetes and they don’t know it, http://www.cdc.gov/diabetes/data/statistics/2014statisticsreport.html.  
So if family history is what you use as a guiding risk factor DON’T!
In other words there are many people walking around with blood sugar issues and don’t even know it. If these “clueless” individuals are family, you do not have a “known” family history. But not being diagnosed with diabetes, insulin resistance or glucose toxicity does not mean you do not have a health condition that needs attention.
Discuss Tell Tale Precautionary Symptoms of Diabesity and Insulin Resistance With Your Doctor

• Abdominal obesity (apple shape)
• Sugar/carbohydrate cravings
• Hunger after meals
• Fatigue after meals
• Frequent urination
• Increased thirst and appetite
• Difficulty losing weight
• Gut issues (bloating, symptomatic of Decreased stomach emptying
• Sexual dysfunction
• Vision problems
• Numbness and tingling in lower extremities
• Rapid heartbeat
• Sudden mood changes
• Sudden nervousness
• Unexplained fatigue
• Pale skin
• Headache
• Shaking
• Sweating
• Difficulty sleeping
• Skin tingling
• Skin tags
• Gum disease
• Trouble thinking clearly or concentrating

Ask About Tell Tale Clinical references:

• Abdominal obesity
• Dyslipidemia (low HDL, high LDL and high triglycerides)
• Hypertension
• Hyperinsulinemia
• Hyperglycemia (fasting above 100 mg/dL, Hb1Ac above 5.5)
• Systemic Inflammation (elevated insulin production, C-reactive protein)
• Hypercoagulable State (tendency to form blood clots)

Ask Your Doctor To Include Tell Tale Blood Tests as Part of Routine Check-ups:

• Fasting glucose: blood glucose level after fasting for at least 8 hours
  • Normal: 70 – 89 mg/dl
  • Borderline: 90 – 99 mg/dl
  • Impaired glucose tolerance/Pre-diabetes : 100 – 125 mg/dl
  • Diabetes: >126 mg/dl
• Oral glucose tolerance test: blood glucose level 2 hours after a 75 gram glucose drink (adjusted based on weight)
  • Reactive hypoglycemia: glucose level less than fasting level
  • Normal: less than 140 mg/dl
  • Impaired glucose tolerance/Pre-diabetes: 141 – 199 mg/dl
  • Diabetes: > 200 mg/dl
  • Diabesity : Work-up
• Fasting Insulin level: insulin level after fasting for at least 8 hours
  • According to Stephen Guyenet, University of Washington, the average insulin level in the U.S. for men is 8.8 mIU/ml and women is 8.4 mIU/ml
  • Reactive hypoglycemia: less than 3.0 mIU/ml
  • Normal : 3.0 to 8.3 mIU/ml
  • Elevated levels : >8.4 mIU/ml
• Fasting C-peptide level:  a  substance produced by the pancreatic beta cells when proinsulin splits apart to form one molecule of c-peptide and one molecule of insulin
  • Reactive hypoglycemia: less than 0.9 ng/ml
  • Normal : 1.0 – 3.0 ng/ml
• Leptin: a hormone that is essential for regulation of metabolism and hunger. Blood levels are directly correlated with the amount of triglycerides stored in adipose tissue.
  • Normal for men: 1.2 -9.5 ng/ml
  • Normal for women: 4.1 – 25.0 ng/ml
• HgbA1c: average blood sugar level for the past 2 to 3 months. This test measures what percentage of your hemoglobin is glycated (coated with sugar)
  • Reactive hypoglycemia: less than 5.0 percent
  • Normal : 5.0 to 5.6 percent
  • Impaired glucose tolerance/Pre-diabetes : 5.7 -6.4 percent
  • Diabetes: >6.5 percent

• Fructosamine: a glycated serum protein that measures average blood glucose level over the past 2 to 3 weeks
  • Normal : 200 – 257 umol
  • Impaired glucose tolerance/Pre-diabetes: 258– 287 umol
  • Diabetes: >288 umol

The first step to maintaining or attaining good health is to be self aware of the early signs and symptoms of diabesity, glucose toxicity and insulin resistance. Use these lists to communicate with your doctor.  What can you do if you have a blood sugar or insulin issue? The solution, may or may not be easy but you have a choice and it is a powerful one that you can manage. The simple solution is up next week.