Categories
Blood Sugar Heart Health Metabolic

How To Use The HOMA-IR Formula

HOMA-IR stands for Homeostatic Model Assessment of Insulin Resistance. It’s a formula used to estimate insulin resistance in the body. Insulin resistance is a condition where the body’s cells don’t respond effectively to insulin, a hormone that regulates blood sugar (glucose) levels. This can lead to higher blood glucose levels – a characteristic feature of conditions like type 2 diabetes.

HOMA-IR Formula

The HOMA-IR formula typically involves measuring fasting blood glucose and fasting insulin levels and then plugging these values into the equation below.

HOMA-IR = (Fasting Insulin (μU/mL) × Fasting Glucose (mmol/L)) / 22.5

This calculation gives an estimate of how well the body responds to insulin – how efficient the body is at utilizing insulin and blood sugar values. A higher HOMA-IR value indicates greater insulin resistance.

Using the Formula With Clients

First, we’ll say that it’s rarely necessary to use this formula since many other signs and symptoms can be used to estimate someone’s insulin resistance.

However, when we use it, we obtain a fasting insulin level and fasting serum glucose (not a finger stick) and track someone’s progress over time.

It doesn’t matter much what the actual value is; more important is how well we can manipulate the value to improve someone’s longterm cardiovascular outcome.

High Insulin Resistance

Someone with a high HOMA-IR value will have more insulin resistance, which increases their risk of Type 2 Diabetes and cardiovascular disease – specifically, the atherosclerosis associated with heart attacks and stroke.

Fortunately, insulin resistance is something easily manipulated by lifestyle factors. Well, we say easy, but habits are among the most immovable objects in the world.

Alternatives to HOMA-IR Calculation

Many of our clients don’t have access to this test, so here are some alternative methods to estimate if someone is insulin resistant:

1. Fasting Blood Glucose

Whether by a fingerstick test or a blood test, elevated values are suspicious for insulin resistance and metabolic dysregulation.

2. Elevated A1C

The glycosylated hemoglobin value, the A1C, when elevated, often indicates someone is insulin resistant.

3. Glucose Tolerance Test

Often, this is done by having the person eat a sugary drink that has an exact measurement, and multiple blood tests are done to see how the person responds to this glucose challenge test.

4. CGM Measurements

A Continuous Glucose Monitor, often worn on the arm, estimates the serum blood glucose, and high spikes often indicate insulin resistance.

5. Increased Waist Circumference

There are various cutoffs used, such as 35″ for women and 40″ for men. These elevated numbers indicate visceral adiposity, which is associated with insulin resistance.

6. History of Gestational Diabetes

Those with prediabetes, gestational diabetes, or a strong family history of diabetes may be insulin resistant. But of course, this should be confirmed since it’s just a risk factor for this condition.

7. Acanthosis Nigricans

This rather common skin condition is often associated with insulin resistance. It can happen in many parts of the body, not just the neck.

Reverse Your Insulin Resistance!

Are you tired of feeling trapped by insulin resistance? Ready to take control of your health and regain your vitality? Our coaching service promises a brighter, healthier future.

Why Us?

Experts: Our Heart Health experts understand the complexities of insulin resistance. We provide personalized strategies tailored to your unique needs.

Proven: We’ve helped countless individuals reverse insulin resistance, leading to improved energy levels, weight management, and reduced risk of diabetes.

Holistic: We believe in addressing the root causes of insulin resistance, not just its symptoms. Our comprehensive approach includes addressing all lifestyle factors and the habits needed to see positive results.

Book Your Consultation Today:

Invest in your health and future happiness. Act now to reverse insulin resistance and unlock a brighter, more energetic you. Contact us today to schedule your consultation.

Categories
Blood Sugar Diet Heart Health

Stubborn Fasting Blood Sugars

You’ve lost weight, improved your activity level, changed your diet, and that stubborn fasting blood sugar won’t get below 110.

In this article, I’ll share how we approach such outcome discrepancies in our Heart Health Coaching practice. The most important caveat is that any improvement is a massive step in the right direction and that perfection is the enemy of progress.

In other words, a FBS of 110, if brought down even to 108 is a major step in the right direction.

Elevated Fasting Blood Sugar Troubleshooting

In this case presentation, we assume that you are actively involved in improving your blood sugars whether you are a non-diabetic, prediabetic, or type 1 or 2 diabetic.

For some reason, your actions have made a huge improvement in your A1C percentage and your postprandial sugars but the morning fasting sugars remain high.

1. Data Error

The CGM (continuous glucose monitor) our client is wearing might show elevated morning sugars, but is it accurate?

Confirming any values with a handheld glucometer and serum fasting blood sugars is best. As a bonus, we also recommend our clients check their fasting insulins.

2. Body Composition Issue

Some of our clients are underweight, and others are overweight. Is there excess visceral fat in the body?

Fat inside the muscle cells will decrease the cell’s ability to respond to insulin which would help clear excess serum glucose.

A DEXA scan will tell us if the client has too little muscle mass or too much visceral fat.

3. Stress & Sleep

If there is undiagnosed sleep apnea or elevated stress levels, the fasting blood sugar will be hard to control.

Managing sleep and stress is just as important, if not more, than diet or exercise levels.

4. Dietary Extremes

A few clients, especially those in their 70s, seem chronically undernourished. A low dietary protein content combined with androgen deficiency leads to rapid loss of muscle mass, which is necessary for proper fasting blood sugar regulation.

5. Exercise Balance

Are you doing too much cardio and not enough resistance training?

We see too much cardio and not enough resistance training. It’s only been in the last decade that science has pointed toward the importance of weight lifting.

6. Excess Fasting

What does time-restricted eating do to your blood sugar long-term, not just short-term?

Some will do great with fasting, but many will experience glucose desensitizing during the fasting state and experience massive spikes upon waking, resulting in stubborn fasting blood sugars.

Improvement May be Enough

We remind clients that improving blood sugar profiles may be more than enough. Rarely do we recommend long-term use of blood sugar measurement via handheld glucometers or CGMs.

Even with some elevated values, health improvement is exponential as long as the changes are happening in the right direction.

Instead of obsessing over the last 10 mg/dl we encourage our patients to figure out their Heart Health Risk Score and aim to minimize other health risk factors.