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The "physiological insulin resistance" meme only started because so many people going on low-carb (and especially high-fat keto) diets saw worse fasting BG and A1C numbers, which flied directly in the face of the common-sense (but completely wrong) assumption that excess carbohydrate consumption is the primary cause of insulin resistance: >Wait, I cut carbs out almost completely, why are my numbers getting worse? Because you're eating more fat, and probably more saturated fat in particular, which means more intramyocellular lipids, and hence, you're becoming more insulin resistant. Cutting the carbohydrate consumption only masks the IR, at best. The simplest explanation is that "phsiological IR" is just plain-old insulin resistance: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6602127/ > OGTT is useless It's probably the best cheap test for clinically diagnosing insulin resistance:
https://pubmed.ncbi.nlm.nih.gov/23327814/ Fasting BG, fasting insulin, and HbA1C only measure blood sugar control, which severe carbohydrate restriction can sometimes obtain, but without actually reversing the underlying pathology of IR. An OGTT, by contrast, measures your insulin response to a bolus of glucose in real time. |