Low triglycerides as a marker for insulin sensitivity?

i take no meds yet as i am pre diabetic and control my bg thru diet and exercise. i do not have elevated triglycerides and am not overweight. i remember reading that a normal/better than normaltriglyceride level was a sign of insulin sensitivity, while high tris indicated insulin resistance. is this correct?

I think it is important to understand association and causality. A key reason high triglycerides occur is that when your body experiences elevated glucose and your liver shuttles that extra glucose into lipids to store as bodyfat. High triglycerides (as well as lipid abnormalities) are considered a marker for Syndrome X of which insulin resistance is an element. But to say someone has a marker suggests some level of selectivity. You can have high triglycerides without Syndrome X or insulin resistance and vice versa. If you have insulin resistance you can eat a low carb diet and get very low triglycerides because your blood sugar is well managed. Triglycerides are not a good marker for insulin sensitivity. A better indication of insulin sensitivity can be obtained by doing either an OGTT or a stimulated c-peptide test.

1 Like

Well I agree with Brian. My triglyceride panel is a something to behold. I am low in every category. Still I have been diabetic for 40 years and I have hardening of the arteries, enough to cause the installation of stents. In a typical situation doctors might dismiss the chest pain as some crazy abnormality based on the triglyceride panel. My doctor did not and likely saved my life. Yeah for a good cardiologist.

But back to the central point, triglyceridesdo are not an indicator of diabetes.

This is interesting since I am in the same situation. My sister has triglycerides that scare doctors (low for her is around 500 and high is in the 2500-5000 range). Mine are typically well under 50. However, she has not been shown to have any blood sugar problems and I have been dealing with one sort or another almost my entire life. I did wonder the same thing about insulin sensitivity since my fasting c-peptide is also low, yet my A1C is just pre-diabetic and my fasting BG is normal when on a low-carb diet. I've never had a stimulated c-peptide test, however. I have trouble believing I have insulin resistance since I have a low fasting c-peptide and low triglycerides and cholesterol and blood pressure, but my history (reactive hypoglycemia, gestational diabetes, and pre-diabetes) follows the history of excessive insulin production. Who knows?

brian said; "A better indication of insulin sensitivity can be obtained by doing either an OGTT..." can someone not produce normal amounts of insulin as shown by an OGTT, but the insulin they do produce they are very sensitive to?

http://www.nejm.org/doi/full/10.1056/NEJMoa062418#t=articleDiscussion

"In either case, our results strongly suggest that these variants do not cause insulin resistance in persons with impaired glucose tolerance and support the notion that variants in TCF7L2 lead to diabetes by means of defects in insulin secretion."

can you have low tri's and be insulin resistant? rick, i know you said you had low tri's. do you require a lot of insulin to bring down your bg numbers, ie are you insulin resistant?

My lipid panel is low...my numbers according to the Mayo Clinic are the same as a new born baby...and show no outward signs of heart problems but did have a cardiac cauterization before my transplant and there where some signs of narrowing in a couple of spots. I'm insulin resistant and use about 90-100U each day...during my first 20 years of insulin use my TDD was around 30U but my regiment is much more aggressive today...

Your TDD should equal what's necessary to achieve your goals...JMHO

johng, so you started out insulin sensitive? at what a1c did you start to show heart disease? if your lipid numbers do not correlate with your heart disease, what does? family members showing a similar presentation as yours?

this is about the best I've seen on lipids
https://www.youtube.com/watch?v=9BFRi-nH1v8
https://www.youtube.com/watch?v=y2zoDsVimyw

During an OGTT you should have your insulin levels and even your c-peptide levels measured. If you produce normal levels of insulin but still go way high during the OGTT that suggests insulin resistance. If your insulin levels remain low during the challenge then that suggests insulin deficiency.