CLINICAL BRIEF 02 // METABOLIC MEDICINE
Detecting Fasting Hyperinsulinemia 10 Years Before HbA1c Crosses 5.7%
Arjun Mehta, MD, PhD
Pancreatic beta-cell hypersecretion masks rising peripheral insulin resistance for a decade while fasting glucose and HbA1c still print 'within normal reference range.'
Standard primary care waits until fasting glucose exceeds 100 mg/dL to intervene. By tracking fasting insulin, C-peptide, HOMA-IR, triglyceride-to-HDL ratios, and DEXA visceral adipose mass every 90 days, clinicians identify hepatic and skeletal-muscle insulin resistance while lifestyle intervention remains 100% effective.
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