OGTT with Insulin results -- who is familiar with interpreting results?

I’ve posted here before while trying to figure out what I’ve been experiencing this past 6 months. This community has been AMAZING in helping to give me clarity. Thank you so much. I’ve learned more from members & posts here than I have anywhere else on the topic of sugar intolerance. You guys have encouraged me to get another doctor and I found someone that really listens and takes me seriously so thanks a lot. It helps to see I’m not crazy and tons of people have had experiences like me too.

I took a test suggested by another member here, which is an OGTT but with insulin levels instead of glucose. Dr. Kraft was a big proponent of these as I’ve seen some people talk about. Unfortunately, I’m having a difficult time finding online discussions and information for this. I’m going to discuss it with my doctor on my appt next month, but wanted to ask about it here too.

Long story short – normal hba1c and no T1 antibodies. However, my blood sugar goes very high after I eat and then often times very low. Hitting over 200 sometimes and then down to 50.

Here’s the results from my 3 hour insulin test:
Fasting: 3.0 (ul/mL)
1 hour: 47.2
2 hour: 11.5
3 hour 2.5

I test my own blood sugar during that OGTT and got:
Fasting: 94
1 hour: 197
2 hour: 100
3 hour: 55

(I previously did a 2hr-OGTT of just blood sugar from a lab before, so the one I have that’s officially from a lab is this):
Fasting: 83
1 hour: 233
2 hour: 91
3 hour: 50 (I did this 3rd hour reading on my own as it was a 2 hour OGTT).

I feel a little surprised to get the insulin results I did, because I expected the numbers to be higher to match the lows I feel at the 3rd hour. Are the insulin results I got normal? Or perhaps they’re BELOW what they should be? I remember looking at a chart a while ago that showed high readings, but those might have been for insulin resistance / T2.
I also have a low c peptide of 0.66.

At this point, I’m accepting that what I’m likely experiencing is reactive hypoglycemia, not diabetes. But I’m going to keep testing my blood sugar, and periodically my c-peptide to see if it goes down more, as I know many people experienced reactive hypoglycemia for years before presenting LADA, so I’ll be conscious about that possibility. Just frustrating that I wish there was a way I could medicate for this RH because it is incredibly burdensome. But oh well. I’m disciplined and I can stick to a LCHF diet since that appears to be the only solution.

I don’t have any personal experience with checking insulin levels since I’ve been on injected insulin since I was a toddler but this study is pretty clear and it looks like your insulin levels are spot on for a healthy adult.

However, you definitely are going too low at the 3 hour mark and too high at the 1 hour mark so keep on searching and keep an eye on your BG’s for your own safety. IMO you are getting the correct amount of insulin but you aren’t metabolizing it properly.

I do have a somewhat odd idea but I think it could help you. Have you ever had a “bulletproof coffee”? They are super high in fat from butter and MCT oil. I would drink one of those puppies and let it start to digest for 15 or maybe 20 minutes and then eat a normal meal. The fat in the coffee should slow down your digestion enough to allow your food and insulin to work at the same time possibly preventing the spike and subsequent drop. Controlling BG is all about getting your insulin and food to “peak” at the same time no matter whether you are on injected insulin or still making your own.

It looks like your phase 1 insulin response to food is impaired. That would explain the high BG at 1 hour. It appears that your phase 2 insulin over-responds to that high BG and it drives your BG into a hypo at three hours, reactive hypoglycemia.

I don’t think this is a normal glucose metabolism and would encourage you to follow-up with a doctor. Unfortunately, many docs seem to avoid drawing any conclusions to early symptoms, and will dismiss these observations until a full blown diabetes diagnosis can be made.

I would encourage you to consider a carb-limited way of eating trial so that you might restore insulin sensitivity and possibly a more effective phase 1 insulin release.

You could then follow-up with your own glucose checks with a personally set-up OGTT. You could use 75 grams (19 tabs!) of glucose tablets to recreate the challenge. Perhaps you could grind the tablets and then dissolve them in water.