Welcome to my manual on How to Help your Doctor Help you more with your Diabesity, which I hope you will find an invaluable guide to what’s available and new in medical testing and how to get your doctor to prescribe these tests. On many occasions you are likely to find that your doctor has not yet heard of these tests since dissemination of new information down the medical profession’s pipelines is not always as fluid as you would expect it to be.
"An ounce of prevention is worth a pound of cure"
Though there is a lot you can do on your own to treat yourself for diabesity (Diabesity can be defined as a metabolic dysfunction that ranges from mild blood sugar imbalance to full-fledged type 2 diabetes and is associated with obesity), for example making changes to your diet and increasing the level of your physical activity, working with a healthcare provider (such a Functional or Integrative Medicine Practitioner) who is experienced in a comprehensive approach to treating this condition is critical for a successful outcome.
I recommend that you have an annual physical examination so your healthcare provider will be able to monitor important changes related to your diabesity, including elevated blood pressure, cataracts, early nerve damage, kidney and liver dysfunction, joint damage and any early indications of heart disease or dementia. In addition you should have an annual ophthalmologic (eye) test to check for early signs of eye damage that may lead to blindness. Diabetic foot exams are also important because loss of sensation in the feet may lead to injury and ulcers, which in turn could lead to amputations. These are not typically complications of insulin resistance, but nonetheless should be monitored if you were diagnosed with diabetes. An intensive treatment of diabesity at its early stages is essential for stopping or reversing its progress. Therefore, getting your healthcare provider to assist you with this process by providing you with the correct tests and assessments is crucial.
However, as much as this is crucial, there is a common problem that the vast majority of healthcare providers are not yet familiar with all the medical advances made in this area as well as they are not always familiar with all the medical tests I will mention below. Some may not take a truly comprehensive approach to diagnosis and treatment of diabesity or be aware of or order the appropriate panels or tests. Others may not test you at all until such time that you have progressed enough down the path of disease. In addition, many doctors interpret tests using a “wait and see approach,” which can be dangerous.
This guide should also play a significant role in better understanding your own health whilst working with your doctor.
Getting the Correct Tests Done
There are specific tests that can identify imbalances in blood sugar and insulin, inflammation, nutrient levels such as homocysteine (folic acid), clotting factors, hormones, and other factors that affect your risk of CVD (cardiovascular disease). If what you have in mind is having your overall risk assessed than you should request your doctor to prescribe the tests discussed below. Rather than provide “on or off” types of diagnoses—you have this disease or you don’t—these tests provide a picture of where you are on the continuum of the disease, from optimal health to full-blown condition. They will also provide you with a basic baseline, which will help you better understand how severe your imbalances might be, what exactly is going on inside your body and provide a way of tracking your progress.
Some of these tests identify problem in function, not pathology. A simple example might be that you might not have anaemia caused by lack of vitamin B12 (Folate), but you might have several important pathways which are blocked because you have vitamin B12 deficiency (that in turn may lead to cancer, low white blood cells (WBCs) and platelets, dementia, depression, heart disease, or serious birth defects in the spinal cord and brain of a developing foetus). I would like to add that whilst extensive blood testing is not always required, basic testing can be very helpful in pinpointing specific imbalances in your biochemistry that are likely to be creating problems for you.
I have divided these tests into three groups:
Basic Diabesity Tests – To help assess the presence and level of severity of the condition.
Added Value Tests – To help ascertain the degree of problems or dysfunctionality that are a result of the condition or may be contributing to it, such as nutritional deficiencies, inflammation, sex hormone and thyroid function and liver and kidney function. Selecting these test should be done based on consultation with a Functional or integrative healthcare provider, and need to be monitored and evaluated less frequently based on patients individual requirements and condition.
Specific Tests for detecting the primary causes of Diabesity – Nutritional Testing
Before I move onwards to discuss the specific types of test recommended, I would briefly discuss the Effectiveness of Measuring Blood Sugar.
Traditionally, if you had more than 140mg/dl (7.78mmol/L) measured in your fasting blood sugar level you would be diagnosed as having diabetes. At present it is recognised that diabetes complications may happen at much lower blood sugar levels, and because of that the cut-off level was recently lowered to 126mg/dl (7mmol/L).
Previously, blood sugar level higher than 110mg/dl (6.1mmol/L) was considered as glucose intolerance, however, now days it was adjusted to 100mg/dl (5.55mmol/L).
The reason the benchmark was adjusted is because the medical profession became aware that what was previously considered normal is no longer the norm. You still get sick at what were previously considered normal blood sugar levels. The real question is: What is the optimal level of blood sugar? It turns out it is much lower than we thought.
In a ground-breaking study which was published in The Journal of the American Medical Association in 2008 it was found that anyone with blood sugar level higher than 87mg/dl (4.83mmol/L) is at an increased risk for type 2 diabetes. This study was done on young healthy soldiers. It was surprising, because it found that the lowest risk for diabetes is a blood sugar level below 81mg/dl (4.5mmol/L).
It is widely believed by Functional and integrative medicine professional that we should consider any blood sugar level between 80mg/dl (4.44mmol/L) and 100mg/dl (5.55mmol/L) as a precursor to a problem and an increased risk for diabetes and insulin resistance.
The ‘normals’ we typically have in medicine are statistical ‘normals’ and may not necessarily reflect an optimal state of health. They may be normal for a sick population. For example, if 70% of the UK population is overweight, then the “normal” weight for people living in the UK is fat! Obviously a statistical ‘normal’ does not mean optimal.
The increasing loads of dietary sugars and the spikes of insulin they manifest increase our risk of cardiovascular disease even in the absence of diabetes. That means that you may have a perfectly “normal” blood sugar level and yet be at risk of CVD.
For this reason, the insulin response test described below is crucial in diagnosing diabesity. The only caveat is that the majority of healthcare providers do not necessarily know how to carry out or interpret this test’s results. You should be aware that even with a normal fasting blood sugar level, if your insulin is high, you may still be susceptible to having many of the problems and complications associated with diabetes, including CVD, stroke, dementia and even cancer.
Although not all cases of diabetes are capable of being stopped or reversed due to decades in which the patient’s body was subjected to the abuse of a toxic diet and lack of exercise, the good news is that with a comprehensive approach, we can still treat everyone effectively and prevent any additional complications.
Therefore, we must look at the basic diabesity tests more closely and with a new perspective so we can identify how to interpret them more effectively.