Dr. Green was fond of using HOMA-IR (which requires both glucose and insulin measurements). Sometimes a high HOMA-HR reading can be a predictor of future insulin resistance problems not yet showing up in the A1C.
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I find HOMA-IR to be very useful - but the interesting thing is that is doesn’t correlate well with elevated HbA1C - at least not in my fit population. It will do much better in patients with significant obesity.
I have a lot of patients in their 60s-80s that are insulin sensitive, yet hyperglycemic.
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LukeMV
#23
Good to know. I’m not obese, so I won’t waste my money on Homa-IR
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There are still people who aren’t obese that will see their insulin sensitivity go down and it is a warning sign long before developing T2DM. However, I see a lot of fit older individuals simply have a pancreas that doesn’t alert and decide to make much insulin until the blood sugar is higher.
The only added test need is a serum insulin level, which through labs I use is $12, that and a fasting glucose and run it through a free HOMA-IR calculator.
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Note sur if HbA1c is that much a great number to look at, for example if you give blood a lot it can drop a lot, same if you’re anemic, or if your RBC live not enough time (bone marrow problem)
