Excellent summary! This series really should be part of the physiology course taught in medical schools; I know I would have been a better physician overall had I learned this information in this fashion at the beginning of my career.
If you are already diagnosed as pre-diabetic, an OGTT will not provide any additional information. You should already be on an aggressive lifestyle modification program to address and revert the core issue -- insulin resistance. Pre-diabetic diagnosis is simply a laboratory number designed to establish a diagnosis and execute the appropriate treatment -- the underlying metabolic dysfunction has been present for much longer before that diagnosis.
If you are diagnosed with metabolic syndrome, you already have some of the additional features of insulin resistance showing up: arterial hypertension, elevated triglycerides, low HDL cholesterol or evolving central obesity. If that is the case, aggressive lifestyle (dietary improvement and regular physical exercise) is the cornerstone from which whatever medication you take expands -- medications are adjuvant to dietary and exercise therapy never a substitute.
As far as measuring estrogen and testosterone levels go, that is dependent on your individual medical condition and I not privy to that. Adding a sex hormone-binding globulin (SHBG) level is more revealing than the hormones themselves to pick a possible subclinical ovarian anomaly resulting from insulin resistance -- polycystic ovary syndrome (PCOS).
So I should ask my endocrinologist for an OGTT test? How about checking my testosterone and estrogen? I'm due for tests for her in a couple weeks. She says I'm prediabetic, probably won't ever get to diabetes because I've been like this for a long time. She says have metabolic syndrome. She answers me back on My Chart. :)
Excellent summary! This series really should be part of the physiology course taught in medical schools; I know I would have been a better physician overall had I learned this information in this fashion at the beginning of my career.
Thank you kindly for your comment. Part two, three more to go.
If you are already diagnosed as pre-diabetic, an OGTT will not provide any additional information. You should already be on an aggressive lifestyle modification program to address and revert the core issue -- insulin resistance. Pre-diabetic diagnosis is simply a laboratory number designed to establish a diagnosis and execute the appropriate treatment -- the underlying metabolic dysfunction has been present for much longer before that diagnosis.
If you are diagnosed with metabolic syndrome, you already have some of the additional features of insulin resistance showing up: arterial hypertension, elevated triglycerides, low HDL cholesterol or evolving central obesity. If that is the case, aggressive lifestyle (dietary improvement and regular physical exercise) is the cornerstone from which whatever medication you take expands -- medications are adjuvant to dietary and exercise therapy never a substitute.
As far as measuring estrogen and testosterone levels go, that is dependent on your individual medical condition and I not privy to that. Adding a sex hormone-binding globulin (SHBG) level is more revealing than the hormones themselves to pick a possible subclinical ovarian anomaly resulting from insulin resistance -- polycystic ovary syndrome (PCOS).
Hope this helps clarify your questions.
-- Carlos
So I should ask my endocrinologist for an OGTT test? How about checking my testosterone and estrogen? I'm due for tests for her in a couple weeks. She says I'm prediabetic, probably won't ever get to diabetes because I've been like this for a long time. She says have metabolic syndrome. She answers me back on My Chart. :)