Insulin - Fasting

Introduction

As a Nurse Practitioner practicing autonomously in Florida, I often encounter patients who are curious about various biomarkers and their implications for health. One such critical biomarker that often comes under discussion is fasting insulin. Understanding fasting insulin and its role in the body can help in managing and preventing conditions such as diabetes mellitus and metabolic syndrome. This article aims to provide an educational overview of fasting insulin, its physiological roles, clinical implications, and the factors that can influence its levels.

What is Insulin?

Insulin is a hormone produced by the beta cells in the pancreas. It plays a vital role in regulating blood glucose levels by facilitating the transport of glucose from the bloodstream into the cells, where it is used for energy. Insulin is essential for maintaining normal blood sugar levels and supporting metabolic functions.

Physiological Roles of Insulin

Insulin has several key physiological roles in the body, including:

1. Lowering Blood Sugar: Insulin helps to lower elevated blood sugar levels by promoting the uptake of glucose into cells.
   
2. Metabolic Shift: It shifts metabolism into storage mode, converting glucose and protein into fat for future energy use.
   
3. Fat Storage: Dietary fat is converted to storage, and insulin removes fat from the blood to transport it into adipose tissue.
   
4. Cholesterol Production: Insulin increases the body’s production of cholesterol.
   
5. Energy Utilization: It stimulates the use of glucose for energy production.

    

Fasting Insulin Test: Ranges and Purpose

The fasting insulin test measures the amount of insulin in the blood after a period of fasting, typically 8–12 hours. The standard range for fasting insulin levels in U.S. units is 0.00–18.40 µIU/mL, and in international units, it is 0.00–127.78 pmol/L. The optimal range is narrower, between 2.00–5.00 µIU/mL (13.89–34.72 pmol/L).

When is the Fasting Insulin Test Recommended?

• Ruling Out Hyperinsulinemia and Insulin Resistance
  
• Type 1 Diabetes Screening
  
• Blood Sugar Regulation Assessment
  
• Monitoring Type 2 Diabetes

   

Clinical Implications of Fasting Insulin Levels

Low Fasting Insulin Levels

• Type 1 Diabetes: A decreased fasting insulin level may indicate Type 1 Diabetes, characterized by autoimmune destruction of pancreatic beta cells.

   

High Fasting Insulin Levels

• Cardiovascular Risk: Elevated fasting insulin levels are associated with increased risk of heart attack and stroke (Fasting insulin, insulin resistance, and risk of cardiovascular or all …).
  
• Insulin Resistance and Glucose Intolerance: Early stages of diabetes where the body becomes less responsive to insulin.
  
• Hyperglycemia/Diabetes: High fasting insulin alongside elevated glucose and Hemoglobin A1C levels suggest diabetes, necessitating further tests like the Glucose Insulin Tolerance Test (GITT).
  
• Metabolic Syndrome: A cluster of conditions including elevated triglycerides, cholesterol imbalances, obesity, and hypertension, often associated with insulin resistance.
  
• Insulinoma: A pancreatic islet tumor causing hyperinsulinemia; referral to an endocrinologist is warranted if fasting insulin is high with hypoglycemia.

   

Interfering Factors in Fasting Insulin Testing

• Falsely Decreased Levels: Use of exogenous insulin or oral hypoglycemic medications can lower measured levels.
  
• Falsely Increased Levels: Pregnancy (especially second and third trimesters) and oral contraceptives may elevate fasting insulin.

   

Related Tests and Considerations

• Serum Triglycerides and Total Cholesterol: Indicators of cardiovascular and metabolic risk—triglycerides, cholesterol – total
  
• Hemoglobin A1C and Fasting Glucose: Assess long-term and immediate blood glucose—glucose fasting
  
• Lipoprotein Panels: HDL Cholesterol, LDL Cholesterol, VLDL Cholesterol
  
• Glucose Insulin Tolerance Test (GITT): Diagnoses insulin resistance

   

Drug Associations Affecting Insulin Levels

• Decreased Levels: Exogenous insulin usage
  
• Increased Levels: Oral contraceptives and some hypoglycemic agents (e.g., sulfonylureas, metformin)

   

Conclusion

In conclusion, comprehensive evaluation through functional medicine in Florida facilitates identification of cellular-level and molecular imbalances driving metabolic and hormonal dysfunction. By integrating evidence-based therapies with medical weightloss medical care services—where metabolic optimization is often the focus—we offer patients a regenerative, preventive framework to rebuild resilience and optimize wellness. Call (904) 799-2531 or schedule online to request your personalized metabolic health assessment.

Further Reading

• Albosta, M., & Bhatti, S. (2021). Intermittent fasting: Is there a role in the treatment of type 2 diabetes? World Journal of Diabetes, 12(2), 144-157.
  https://pubmed.ncbi.nlm.nih.gov/33531076/

• Sheehan, J. P. (2004). Fasting hyperglycemia: Etiology, diagnosis, and treatment. Diabetes Technology & Therapeutics, 6(4), 525-533. https://doi.org/10.1089/1520915041705910
  https://pubmed.ncbi.nlm.nih.gov/15321011/

• Karl, D., & et al. (2012). Fasting plasma glucose 6-12 weeks after starting insulin glargine therapy predicts glycemic control in type 2 diabetes. Diabetic Medicine, 29(6), 756-761.
  https://pubmed.ncbi.nlm.nih.gov/22413808/

• Hoddy, K. K., & et al. (2022). INTERmittent FASTing in people with insulin-treated type 2 diabetes: Study protocol for a randomized controlled trial. Diabetes, Obesity and Metabolism, 24(5), 904-913.
  https://pmc.ncbi.nlm.nih.gov/articles/PMC9304224/