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Forum Name: Diabetes

Question: insulin resistance?pcos?diabetes?and GTT


 tammyinwv - Sat Mar 05, 2005 3:38 am

I am 44 yo,with fibromyalgia.I suspected IR,possible pcos because of following symptoms: incresing facial hair,scalp hairloss,acanthos nigricans at base of neck and underarms,high b/p tryglycerides and cholesterol,rapidly increasing weight gain with inability to lose,infrequent episodes of hypoglycemia.Prior to partial hysterectomy at least 10 yrs ago my periods had almost stopped(just spotted for a day or 2), episodes of poss ruptured ovarian cyst(didnt go for ultrasound till after pain subsided) I asked doc to check insulin level for IR. he ordered GTT. I was sick this past weekend with pneumonia, started antibiotic on sat-zithromax. On tues test was done.It was supposed to have checked insulin levles also, but for some reason these either werent done or not returned yet.
fasting blood sugar: 125 ( 2 weeks ago and previously it has been 91-94)
1/2 hr after drink: 212
1 hr after:224
2 hr after:226
3 hr after:146
I read that illness can increase blood sugar. doctors office reading this as diabetes,but i don't think they took into account my illness and previous bs 2 weeks ago of 94.
My question is does this this seem like Insulin Resistance? What about possibility of PCOS? Or are above tests actually indicative of diabetes? I have read treatment of IR would improve with metformin(which would also check hirtuism,and hairloss,acanthos nigricans, and decrease weight). Is this recommended therapy?
Tammy
 Theresa Jones, RN - Mon Mar 07, 2005 10:13 am

User avatar Hi tammyinwv,
Insulin resistance in PCOS is commonly treated with medications such as Metformin. If polycystic ovary syndrome is related to insulin resistance women are at a higher risk for developing other disorders that have been linked to insulin resistance such as diabetes, high blood pressure, abnormal cholesterol and triglycerides, and heart disease. The excess insulin that the pancreas produces to keep blood sugar levels near to normal also stimulates the ovary to produce more testosterone which would explain some of your other symptoms. Your glucose tolerance test does appear impaired. The use of medications that improve insulin sensitivity is a relatively common treatment in PCOS. As for illness elevating blood sugar levels, this is true, but seen at more significant levels and more often in the diabetic population than in nondiabetics, unless steroids are used in the treatment of an illness. I hope this was helpful.
Sincerely,
Rntdj
 tammyinwv - Mon Mar 07, 2005 3:03 pm

my tests were:fasting blood sugar: 125 ( 2 weeks ago and previously it has been 91-94)
1/2 hr after drink: 212
1 hr after:224
2 hr after:226
3 hr after:146
you mentioned illness would raise blood suagr to a greater degree and mentioned steroids. I was started on albuterol inhaler 2 puffs 4 x day 2 days before the test was done because doc said he heard wheezing even tho antibiotic finished. Could this explain a rise in fasting blood sugar from 94-125?

Also, what is the norm for insulin fasting and 2 hr? at what level does it indicate insulin resistance? i read up to 20 was normal, but also read that anything over 10 indicated some insulin resistance.

Is insulin resistance usually treated with metformin?
 Theresa Jones, RN - Mon Mar 07, 2005 7:11 pm

User avatar Hi tammyinwv,
Normal values may vary from lab to lab. Generally speaking with Glucose tolerance test results for nonpregnant women are as follows: Fasting less than 110 mg/dL, 1-hour: less than 180 mg/dL, 2-hour: less than 155 mg/dL. I should have been more specific when I mentioned steroids. By this I meant prednisone, dexamethasone, hydrocortisone, etc. Metformin is one of the medications used in insulin resistance and PCOS. I hope this was helpful.
Sincerely,
Rntdj

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