Insulin Resistance

I am a 34 year old male. Very physically active. I run 50-60 miles per week. I have been a competitive runner for 18 years. I basically eat a low carb diet. The South Beach diet. Good carbs, no refined sugars,white bread,rice,sweets,ect. My father is Type 2 Diabetic so I'm careful. My weight is 190 and I'm 6'4. About 4% body fat. You get the jist. Physically good.  My concern is my cholesterol. My total is usually 150-160. That is good. My HDL is my worry. It ranges from 30-39. As a athlete I would expect it to be more like 50. My internist/best friend since childhood say's not to worry. He seem to feel that is just how my metabolism of lipids is programed. My Total/HDL ratio is usually 4.4 to 5.0. I do not smoke. I have an occasional glass of Red wine. I am a type A personality. I kind of worry about insulin resistance due to genetics. My fasting sugar is as low as 77 and as high as 99. My doctor friend said as long as I keep my weight,diet and exercise in check that I will never develop type 2 Diabeties. My blood pressure is 112/58.  That was last week. Although when I first get to the doctor it is 130/75. White Coat. I go into fight or flight at the doctor. My doctor even thinks my blood sugar elevates in his office. Makes since that adrenalime could do that. I get very stressed at the doctor!!! Do you think my HDL is just me--genetics. My mom is very healthy and hers is on 44. Lower for a female. THANKS--JEFF

[Kevin Pho, MD]

With a fasting sugar between 77 and 99, this is completely within normal range and is neither diabetes nor impaired glucose tolerance.  Blood pressure is again within normal limits.   Total cholesterol is low at 150-160.  

Regarding the HDL, it can simply be genetics.  There are medications that are used to raise the HDL (i.e. Lopid or Tricor), but it is unlikely that it is needed at this time.  I would continue monitoring the cholesterol panel on a periodic basis.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Thanks,
Kevin, M.D.