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

Understanding insulin resistance can be somewhat challenging, but it doesn’t have to be.

At Mastering Diabetes, our mission is to provide you with a clear understanding of what causes insulin resistance, and provide you with the tools to reverse it using your food as medicine, so that you can maximize your metabolic health safely and effectively.

Our team hears the following statement 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?”

The “what now?” part of the question is important, because if you’ve fully adopted a low-fat, plant-based, whole-food lifestyle, then your habits will continue to improve your insulin sensitivity over time.

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.

Technically speaking, when your A1c drops below 5.7% your diabetes diagnosis can be removed from your medical record. At Mastering Diabetes, we recommend maintaining an A1c value less than 5.7% without the use of oral medications or insulin for 365 days to claim that you have reversed either 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 a continuum. Since the amount of stored fat (triglyceride) inside your muscle and liver cannot adequately be measured at any given time, other laboratory biomarkers are necessary to provide context.

PILAF: How to Measure Insulin Resistance

Insulin resistance is the root cause of many chronic diseases. Often, being diagnosed with diabetes precedes the diagnosis of other chronic conditions, including coronary artery disease, high cholesterol, hypertension, Alzheimer’s disease, cancer, stroke, and chronic inflammation.

When reversing insulin resistance using your diet, the goal is to become as insulin sensitive as possible, to prevent against the development of these chronic diseases.

In order to help you understand your level of insulin resistance, we’ve developed a convenient checklist (downloadable PDF available below) to help you understand how to become as insulin sensitive as possible.

Download the Insulin Resistance Checklist Today

Insulin Resistance Checklist

Click on the button below to download the Insulin Resistance Checklist and track your level of insulin resistance over time...

Just remember the mnemonic PILAF, as described below:

P:    Pressure
I:     Ideal bodyweight
L:     Lipids
A:    A1c

F:     Fasting blood glucose

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 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.

Let’s dive in to each of these letters individually:

P Stands for Pressure (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 (1–5).

Most doctors prescribe medication to treat hypertension, unaware that simple dietary changes are more powerful and free of dangerous side effects (6,7).

The evidence-based research shows that hypertension is an independent risk factor for insulin resistance (2). Reducing your blood pressure to less than 120/80 (systolic/diastolic) without medication is essential in helping you reverse insulin resistance.

Recommended Blood Pressure Range
Systolic pressure = 100-120 mmHg
Diastolic pressure = 60-80 mmHg

I Stands for Ideal Bodyweight

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.

You can monitor your bodyweight on an inexpensive bathroom scale to measure your progress at achieving your ideal bodyweight and reversing insulin resistance. Here is how you calculate your ideal weight:

How to Calculate Your Ideal Bodyweight for Women

Measure your height in inches. The first 5 feet of height is equal to 105 pounds, and every inch thereafter is equal to approximately 4 pounds.

Ideal Bodyweight for Women = 105 + 4x

(x = every inch over 5 feet of height)

How to Calculate Your Ideal Bodyweight for Men

Measure your height in inches. The first 5 feet of height is equal to 115 pounds, and every inch thereafter is equal to approximately 5 pounds.

Ideal Bodyweight for Men = 115 + 5x

(x = every inch over 5 feet of height)

L Stands for Lipids

When your lipid panel (total cholesterol, LDL, HDL, and triglycerides) 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: < 150 mg/dL

LDL Cholesterol: < 100 mg/dL

Triglycerides: < 150 mg/dL

HDL Cholesterol: > 50 mg/dL (for women)

HDL Cholesterol: > 40 mg/dL (for men)

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.

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 and ketogenic diets are the most insulin resistant, as we have explained in previous articles.

Your A1c is 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.

The A1c guidelines set forth by the American Diabetes Association are as follows:

Type 2 Diabetes: > 6.4%

Prediabetes: 5.7–6.4%

Non-Diabetic: < 5.7%

F Stands for Fasting Blood Glucose

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.

Fasting Blood Glucose Target: 80-100 mg/dL

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 single 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 form 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.

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! 

Download the Insulin Resistance Checklist Today

Insulin Resistance Checklist

Click on the button below to download the Insulin Resistance Checklist and track your level of insulin resistance over time...

References

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About the Author

Cyrus Khambatta earned a PhD in Nutritional Biochemistry from UC Berkeley after being diagnosed with type 1 diabetes in his senior year of college at Stanford University in 2002. He is an internationally recognized nutrition and fitness coach for people living with type 1, type 1.5, prediabetes and type 2 diabetes, and has helped hundreds of people around the world achieve exceptional insulin sensitivity by adopting low-fat, plant-based whole foods nutrition.