Diagnosing frank or hidden diabetes currently centers around glucose measurements. Fasting and post-meal glucose readings are often used. HbA1C (glycated haemoglobin) is another commonly used test. A normal blood sugar and/or a normal HbAIC level does not exclude this disease. Let me explain.
Diabetes does not develop overnight. It is a slowly evolving disease that takes many years to manifest as high blood sugar. Early on, the rising blood sugars are kept in check by the available insulin (a hormone). As the disease progresses, the body must produce more and more insulin to keep the sugars in check. When these compensatory mechanisms fail, years later, the blood sugar rises in spite of high insulin levels. This is when you are diagnosed with diabetes.
HbA1C can and does remain normal in hidden diabetes. It tells us nothing about the rising baseline insulin levels. Baseline insulin levels do rise in pre-diabetes, and this is measurable and distinct from meal/stressor spikes of insulin.
All diseases of hyperinsulinaemia are modifiable, to a large extent.
It is, therefore, highly probable that hidden diabetes is grossly under-diagnosed. If we understand the mechanisms and the progression of this disease, why do we wait until the final stage to make a diagnosis and start treatment? A good doctor would not ignore a worsening fever and cough that precede a chest infection. So why do we ignore the rising baseline insulin levels that occur early on in occult (hidden) diabetes?
Considering that diabetes is the number one modifiable cause of heart disease – the biggest killer on earth, would it not make more sense to measure insulin, rather than glucose, to make the diagnosis as early as possible?
We know that type 2 diabetes is the leading cause of cardiovascular disease worldwide. If we understand that it is a dietary disease, with dietary solutions, and we reverse it successfully in most people, then we can reverse most cases of cardiovascular disease. I have been known to call diabetes a cardiovascular disease, because of how often diabetes rots the heart, blood vessels, and brain.
Metabolic diseases (diseases of hyperinsulinaemia) are a variety of pathological manifestations insulin resistance. Medicines can be helpful in initiating health, but should not be necessary to sustain health. Dietary diseases MUST have dietary solutions.