Metabolic Health
We catch metabolic trouble years before diabetes.
Metabolic disease is a spectrum, and a normal A1c does not tell you where you sit on it. To keep blood sugar looking normal, your body can pump out more and more insulin for a decade before a standard checkup flags anything. We measure insulin directly, both fasting and during a two hour glucose challenge where we check glucose and insulin every 30 minutes. We look at your liver for early fat buildup and elevated enzymes, measure the fat packed around your organs with a DEXA scan, and track blood pressure. That lets us read the earliest warning signs while there is still time to change them.
A normal HbA1c (a three month average of your blood sugar) can sit on top of years of rising insulin, so we test underneath it. Our preferred tool is an OGTT (oral glucose tolerance test) with insulin measured next to glucose: you drink a set glucose dose and we check both roughly every 30 minutes for up to two hours, then read the shape of the insulin response as a Kraft pattern, which flags high insulin years before blood sugar drifts.
Around that we add fasting insulin, HOMA-IR (a calculation that estimates how resistant your body has become to insulin), a continuous glucose monitor when useful, a full lipid panel, and uric acid.
Because fatty liver is a major driver and usually silent, we track the liver enzymes GGT and ALT (blood markers that rise when the liver is stressed), calculate a FIB-4 score to estimate scarring risk, and image the liver with ultrasound to look for fat. Excess fructose is one of the biggest culprits.
We measure visceral fat, the fat wrapped around your organs that carries the most risk, with a DEXA scan (a body composition scan), rather than guessing from weight or waist size.
The path from high insulin to insulin resistance to high blood sugar to type 2 diabetes runs on a timeline. We read your trajectory and act early, while it is still easy to change.
This is one part of a complete, personal risk assessment.
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