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The Insulin Resistance Checklist: How to Accurately Assess Your Level of Insulin Resistance

October 18, 2019


Cyrus: Understanding insulin resistance can
be somewhat challenging, but the good news is, it doesn’t have to be. Here at Mastering Diabetes, we define insulin
resistance as “the storage of fat in tissues that are
not designed to store fat.” When you become insulin resistant, your risk
for the development of chronic disease increases tremendously. The reality is that most people learn about
insulin resistance when they are first diagnosed with either
prediabetes or type 2 diabetes. The truth is that as you become more insulin
resistant, you increase your risk for conditions like high cholesterol, hypertension,
coronary artery disease, stroke, heart attack, cancer, Alzheimer’s disease and other
chronic inflammatory conditions. When reversing insulin resistance using your
diet, the goal is to become as insulin sensitive as possible, to prevent against
the development of all of these chronic conditions I mentioned earlier. Kylie: As a coach with Mastering Diabetes,
I hear the following questions all the time: “My A1c is now in the non-diabetic range. Does that mean that I reversed insulin
resistance completely? If not, what am I supposed to do now?” Another question that we receive a lot is:
“How do I know if I’m insulin resistant?” I found these types of questions to be more
complex to answer, because I often needed more information to help provide feedback
to our members. Why? Because there are many factors that contribute
to your level of insulin resistance, and it’s important to understand MULTIPLE biomarkers
in order to get a full picture of your metabolic health. As a nurse for over 18 years, I’ve loved developing
and using checklists in my practice in both clinic and hospital settings, and
so I created the Insulin Resistance Checklist to
help you understand how and what to measure to track your level of insulin resistance. Kylie: Simply tracking your A1c is NOT enough
information to determine whether you are becoming more insulin sensitive. Why? Because your A1c value is an
INCOMPLETE marker of insulin resistance. Your A1c is used as a biometric marker of
your average blood glucose control, and is typically used to diagnose type 1 diabetes,
type 1.5 diabetes, prediabetes or type 2 diabetes. It’s very important to understand that your
A1c value is simply an indicator of your blood glucose control, and only provides
you with information about your level of insulin resistance when interpreted
in the context of other biomarkers. Understanding your level of insulin resistance
can be challenging because it requires examining multiple biomarkers, each of which
is on a continuum. A simple way to track
insulin resistance is by using the mnemonic in our checklist, called PILAF. The
mnemonic PILAF stands for: P: Pressure
I: Ideal body weight L: Lipids
A: A1c? F: Fasting blood glucose Cyrus: Please note, with each of these biomarkers,
being free of oral medication to achieve these results is a key piece in understanding
how insulin resistant you truly are. On the checklist, you’ll see “free of oral
medication” as a checklist item, and one goal is
to check that box for every biomarker. Kylie: Let’s dive in to each of these letters
individually: P Stands for Pressure (or Blood Pressure) Your blood pressure is a measurement of the
effort it takes for your heart to circulate blood throughout your cardiovascular system. The higher your blood pressure, the
harder your heart must work to push blood throughout your body. In most cases, hypertension (high blood pressure)
is caused by the hardening of blood vessels, which creates resistance against
your heart. Over time, hypertension can
become life-threatening, because it increases your risk for a heart attack or stroke. Most doctors prescribe medication to treat
hypertension, unaware that simple dietary changes are more powerful and free of dangerous
side effects. The evidence-based research shows that hypertension
is an INDEPENDENT risk factor for insulin resistance. Reducing your blood pressure to less than
120/80 (systolic/diastolic) without medication is
essential in helping you reverse insulin resistance. Our Recommended Blood Pressure Range is… Systolic pressure=100-120 mmHg
Diastolic pressure=60-80 mmHg Cyrus: Great. Next up on our list is your body weight. Achieving your ideal body weight
is an ESSENTIAL component of gaining insulin sensitivity. Therefore… I Stands for Ideal Body Weight Kylie: Being overweight elevates your risk
for most chronic diseases, and is caused by the accumulation of fat in your adipose tissue
as well as in tissues that are not designed to store fat, like your muscles and liver. By losing excess weight, you burn stored fat
in adipose tissue as well as fat stored inside your muscles and liver. Now you can simply monitor your bodyweight
on an inexpensive bathroom scale – it’s very easy to do. This is how you calculate your ideal body
weight:? If you are female… The first 5 feet of height is equal to 105
pounds, and every inch thereafter is equal to
approximately 4 pounds. If you are male… The first 5 feet of height is equal to 115
pounds, and every inch thereafter is equal to
approximately 5 pounds. Cyrus: These ideal body weight calculations
target a body mass index (or BMI) between 20-23%. If you feel that your ideal body weight is
out of reach for you, aim for slow and consistent weight loss until you
approach your ideal body weight, and simply, don’t get caught up in hitting a certain number. When it comes to weight loss, slow and steady
DEFINITELY wins the race. Remember,
weight loss is NOT a sprint, this is a marathon. Kylie: L Stands for Lipids When your lipid panel is elevated, this often
indicates an insulin resistant liver, or fatty liver. Fatty liver is usually diagnosed via imaging
or elevated liver enzymes, resulting in an enlarged liver that is engorged with excess
fat. As you gain insulin sensitivity, your
cholesterol panel is likely to normalize. In order to significantly reduce your risk
for a heart attack, we recommend achieving the
following fasting lipid panel: Total Cholesterol: Less than 150 mg/dL
LDL Cholesterol: Less than 100 mg/dL (ideally as close to 70 mg/dL as possible)
Triglycerides: Less than 150 mg/dL HDL Cholesterol=Greater than 50 mg/dL for
women* HDL Cholesterol=Greater than 40 mg/dL for
men* Cyrus: One technicality that’s important to
pay attention to is your HDL cholesterol. You’ve probably been told that your HDL cholesterol
is the MOST IMPORTANT biomarker in your lipid panel, and that if
your HDL is low, it’s important to drink fish oil or
consume an omega-3 supplement. We have observed the same thing that many
professionals have as well – when you adopt a low-fat, plant-based, whole-food diet,
your HDL cholesterol can often drop below the recommended level of 50 mg/dL for
women and 40 mg/dL for men. But more and more, scientific evidence is
now showing that raising your HDL cholesterol is less effective than lowering
your LDL cholesterol. What this means is
simple: if your total cholesterol, LDL cholesterol and triglycerides are at or below the
range we specified, then don’t worry if your HDL cholesterol is low, it’s simply not as
important. An easy way to think about this is that if
there’s less “bad” cholesterol, then you need less “good” cholesterol. It’s just that simple. Kylie: A Stands for A1c As we discussed earlier, your hemoglobin A1c
is often the first indicator that that you are living with any form of diabetes. The evidence-based research indicates that
the lower your A1c value, the better your blood
glucose control, and the lower your risk for long-term complications. When following a low-fat, plant-based, whole-food
lifestyle, a lower A1c is a strong indicator of reduced insulin resistance. In fact, a low-fat, plant-based, whole-food
diet is one of the most effective ways to reduce your
A1c value and improve your glycemic control. Cyrus: Now, here’s where it gets confusing. When following a low-carbohydrate or
ketogenic diet, a lower A1c DOES NOT indicate a lower level of insulin resistance. In
fact, those eating low-carbohydrate or ketogenic diets are the MOST insulin resistant,
as we have explained in previous videos. You’ll see people with diabetes all over the
internet reporting an A1c value in the 4’s or
low 5’s, claiming that their insulin sensitivity is increasing. This is NOT true – your A1c is
simply a measurement of your blood glucose AVERAGE, not of your insulin sensitivity. That’s exactly why it’s really helpful to
interpret your A1c in the context of other biomarkers. It is important to understand that your A1c
is simply an indicator of your level of insulin resistance IF AND ONLY IF you are eating a
low-fat diet, and NOT if you are eating a high-fat diet. Kylie: According to the American Diabetes
Association: The A1c value of someone living with type
2 diabetes 6.4% or above The A1c value of someone living with prediabetes
is between 5.7% and 6.4% The A1c value of someone living free of diabetes
is below 5.7% At Mastering Diabetes, we recommend keeping
your A1c below 5.7% for 1 year in order to have fully reversed diabetes. Cyrus: And last, but certainly not least is
F, which stands for “Finally, you guys are done with this list.” Right. Actually… F Stands for Fasting Blood Glucose Kylie: Your fasting blood glucose value is
a key indicator of your level of insulin resistance, and is important to monitor daily
when living with any form of diabetes. As
you become more insulin sensitive, your fasting blood glucose is likely to decrease. Monitoring your daily fasting blood glucose
is a simple way to measure how your diet is affecting your glycemic control. The goal is to achieve a consistent fasting
blood glucose between 80-100 mg/dL. As you transition to a low-fat, plant-based,
whole-food diet, you are likely to experience fluctuations in your fasting blood glucose,
but an overall downward trend is a great indicator of increased insulin sensitivity. Your Fasting Blood Glucose Target is between
80-100 mg/dL Cyrus: Here’s the good news: Eating a low-fat,
plant-based, whole-food diet containing between 10-15% of your calories from fat is
the most effective way to reverse insulin resistance ever discovered by the scientific
community. If one or more of your biomarkers explained
above are out of range, then this could indicate that you are living with some version
of insulin resistance, and that’s why this checklist is helpful to understand where you
are on the continuum. Adopting a low-fat, plant-based, whole-food
diet, performing regular exercise and intermittent fasts, and doing so in a constructive
community of other people will maximize your insulin sensitivity and minimize
your risk for chronic disease. And that’s a fact. Kylie: Download the Insulin Resistance Checklist
below and post it in a visible location to help you achieve your most insulin
sensitive self. Use the checklist as a way
to help guide your path toward insulin sensitivity. As you check off the boxes, continue to use
the tools that we provide in our program to work your way towards the best health you’ve
ever had, and enjoy the fruits of your labor all along the way!

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26 Comments

  • Reply Mastering Diabetes June 27, 2018 at 5:15 pm

    We want to know your results. Comment below and let us know if you are living with insulin resistance!

  • Reply Robin Rae June 27, 2018 at 5:30 pm

    Today: My pressure 110/75
    Weight 120 (I’m 5’5”). (Lost 8 lbs on hflc diet.
    Lipids: Total 150 LDL 68 HDL 80
    A1c 5.0
    FG 87

    Nothing I can improve on. Still can NOT eat pastas and grains and fruits without blood glucose spike. And yes I exercise and do weights (probably in better shape than most). My 23andme raw data showed over a dozen genetic markers (alleles) pointing to diabetes. So maybe you guys don’t know EVERYTHING???

  • Reply ashamer June 27, 2018 at 5:40 pm

    hi! where can we get the list?

  • Reply Vegetto Blue June 27, 2018 at 5:43 pm

    This is LIT !

  • Reply Bad Don June 27, 2018 at 7:11 pm

    Great Information! Keep these informative video's coming! This will be LIFE CHANGING for the good for those who follow it!

  • Reply S O N J A June 27, 2018 at 7:14 pm

    This is very detailed. Good stuff.

  • Reply Dalibor Jankovic June 27, 2018 at 8:46 pm

    Insulin resistance is just a part of the problem. Low Carb diet destroys your thyroid gland. Increased LDL is a direct consequence of hypothyroidism. Yet your thyroid gland likes carbs.

  • Reply Paula Shackles June 27, 2018 at 10:40 pm

    Filmed at Jurassic Park 😛

  • Reply Karen LaVine June 27, 2018 at 10:43 pm

    Thanks for sharing this very helpful specific information – love the PILAF acronym! When I had "perfect PILAF", I was biking to work 10 miles each way several days a week (45 minutes each way), and eating a LF WF PBD. Then I nailed every PILAF marker. Trying to get back there in a more time efficient manner with aerobic interval training and kettle bell workouts.

  • Reply Jenny Ashmore June 28, 2018 at 1:45 am

    You are awesome. Seriously the only channel/group out there putting out evidence-based info without the absolutism of other ways of eating. Purely scientific and awesome and I can tell you have people's best interest at heart.

  • Reply TATTOEDVEGAN June 28, 2018 at 3:36 am

    I have question , I was watching one of you videos earlier & one of you guys said you don't recomend grains…. Why is that, & what about Walter kempner & the rice diet?

  • Reply Joyti Blogs June 28, 2018 at 5:08 am

    This was amazing. Thank you ❤️❤️❤️

  • Reply The Elder June 28, 2018 at 8:35 am

    Great info!

  • Reply Bike Vids June 28, 2018 at 3:54 pm

    Do one on dyslipedemia.

  • Reply Vynland July 9, 2018 at 6:07 am

    That dude from primal edge health will go nuts over this video.

  • Reply Trinity Salon & Spa July 12, 2018 at 10:30 pm

    Omg I want to hear this but the backround noise is so bad

  • Reply SilentCricket September 19, 2018 at 2:04 pm

    One of my clients has started taking metformin as recommended by her doctor to help generate weight loss after being diagnosed with insulin resistance (she also was diagnosed with high estrogen levels and poor blood pressure). She has had some initial success, but is considering upping her dosage after around 3 months of being on metformin. Could you share your thoughts on metformin and how it relates to people attempting to treat insulin resistance? I realize you said "no meds" in this video, but I'm trying to gather more information regarding this drug and it's potential effects

  • Reply Ejaz Ali November 22, 2018 at 7:52 pm

    In Jan this year my blood glucose was 401 and I weighed 90kg. I was shocked. I went on crash program, I hardly ate anything, rigorous exercise and strong medications. In May my A1C was 6.4 and weight 78kg. I was satisfied. I relaxed a little bit. By Sep I reduced to 72kg and my fasting glucose remained less than 100 mgdl. I left medicines, relaxed exercise and eating. During last month I lost track, attended many parties and ate anything and everything. I kept checking my blood glucose surprisingly it never rose more than 140 after eating. Yesterday my A1C was 4.8. I can't understand this. Am I no more a diabetic? Please say something.
    I am 53 years old male and following Low Fat Plant Based Whole Food.
    Regards.

  • Reply Robert Yerex November 23, 2018 at 10:44 am

    I have type 2 pretty bad and i have lost a of weight over the years. How can i maintain what little weight i have if i start a diet like you suggest. Thanks

  • Reply Kevin Polito January 8, 2019 at 9:40 pm

    I have been fasting for about 93 hours. I feel good. But my blood glucose (in the 200 to 250 range without meds before fast) still has not fallen below 144 mg/dl. I would have thought that after 72 hours or so there would be no stored glycogen and that liver gluconeogenesis would have ended. Where is the blood glucose coming from?

  • Reply Antonio Domene January 30, 2019 at 8:03 pm

    I have Type 2 ( fatty liver also )and I have been on a Keto diet for many years and I noticed that if ate more than 30 grams of Carbs my BS would go sky rocket. I have understood that " fat " is the precursor of insulin resistance. I have noticed that " fat " coming from almonds ( raw almonds from the shell ) or avocados have the same impact on the insulin resistance. During 6 weeks, I have eating around 300 grams of soaked almonds daily ( from the shell ) , salads and vegetables soups( no meat, dairy, oils,fish or process foods) and my BS remained the same.
    I have just switched to a Low Fat high carbs, (salads, legumes, green veggies, NO nuts, NO oil, NO dairy, NO meat, NO fish, NO alcohol ) and I eat around 200 Grams of complex carbs daily and my blood sugar has dropped from 160 to 100 in two weeks.
    I am 62 and I remember here in Spain the above Diet was very common and no one of my mother's family or my father`s family has or had Diabetes, but the second generation ( we are around 15 cousins ) we all have DT2 . The conclusion : I just have had a telephone call with my mother, she is 86 years ,and I said " Mam… I have returned to the all days Diet….she said wellcome !! )))

  • Reply BlessedMe11 May 8, 2019 at 4:23 am

    Thank You and God Bless You All, for helping us analyze, understand and cope with this dangerous health challenge! This is extremely critical, useful information and it's going to save lots of lives. Where can I get the check list pdf?

  • Reply ed low June 24, 2019 at 2:12 pm

    You're advocating a low fat diet? Really?

  • Reply Mohammed Hamid August 24, 2019 at 7:16 pm

    Some of the points discussed at contrary to the points in the following INSULIN RESISTANCE test

    https://youtu.be/S8cJPtud2tY

    Please help us understand correctly

  • Reply ankur khurana September 6, 2019 at 1:40 am

    Dr, I've had my homa ir test done, under which my fasting insulin came 4 uu/ml…is it good or not? I had 16 hrs of fast. My fg came 75, beta cell functionality came 91%, insulin sensitivity came 201%, homa ir came 0.5, and a1c came 6.5…….im type 2 diabetic from 2-2.5 yrs…… Please answer.

  • Reply Amarjit Singh October 16, 2019 at 10:38 am

    Can the beta cells of Pancreas be rejuvenated

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