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by tracker1 2712 days ago
To me, it would seem that there's a couple things that aren't considered in most of these studies. A lot of them have a lot of controls in place for the starting size/weight range of the individuals. Given this, and the change in hormone (particularly insulin) response it's not always the same advice depending on how overweight you are, how much you are showing insulin resistance or elevated/deflated insulin response.

I think that resting insulin levels should be part of annual exams for everyone. It's much easier to explain, hey you're heading towards diabetes clinically when people still feel relatively well and healthy.

My own advice to younger people, and to those who aren't very overweight is to limit meals to 2-3 a day, don't snack between meals, and don't drink anything sweetened or containing calories during the day outside of meal time. Limit sugars to around 20-30g/day, and if having more, limit it to a single treat/dessert every other week.

If you're more overweight, or "pre-diabetic", then I suggest reducing total carbs to 100g/day, and limiting to 1-2 meals a day.

If you're obese/diabetic, omad (one meal a day) and ketogenic macros.

If you're on higher doses of insulin, add a 3-7 day fast once a month. And a 48hr fast at least once a week.

The worse off you are starting the harder it is... fortunately, you can work your way up the scale/advice above as you reach closer to an ideal weight.

After you get used to not snacking and reducing sugar/sweetened things between meals, it gets easier. The first week or two can be grueling and if you're a social eater, it can be very hard too.

1 comments

Every annual physical and every work-related health exam I have had here in the US has included some kind of fasting glucose test.
An A1C test will only show problems after you've gone through a cycle of your body resisting insulin and your pancreas being overworked (resting insulin 4-7x normal) and then your pancreas wears out (damaged beta cell production) and then your resting glucose rises. This process can take many years. A resting insulin test will show resting insulin rising years before an A1C test shows a problem.
A1C is not the fasting glucose test.
It's not, the same stands... you'll go through years of elevated insulin before you see fasting glucose or A1C rise. A glucose tolerance test could be useful too, but a bit of a pain compared to simply testing insulin levels and comparing to the prior year.