Precision Medicine

Diabetes? Who Me….? Ya Me. Couldn’t Be….

Sonya's Diabetes Risk Score

Canadian Diabetes Association Risk Score

Or could it?  I was shocked to discover I was on target to become a Type II Diabetic and didn’t even know it!   It’s World Diabetes Day – a perfect time to share a personal story about my recent diabetes scare and discovery.

Amazingly, 86 million American adults which is more than 1 out of 3 people are pre-diabetic and 90% of people with pre-diabetes don’t know they have it!  I was sure surprised to discover I am one of those people!  (CDC.gov)  Doesn’t this just speak to the massive failure of our healthcare system?!  How are we failing 90% of people walking around about to develop a disease and not doing anything about it?! This is exactly why and how traditional healthcare is failing people.

I live a relatively healthy lifestyle.  I eat pretty healthy overall, I am not a couch potato and I’m averagely active, I’ve gained a bit of weight over the past couple of years but I’m not obese.  Millions of people are pre-diabetic and don’t know it but I honestly never would have thought that meant me!  Yet pre-diabetes was lurking in the shadows and I didn’t know it. My doctor didn’t know it. Look at the image showing my risk of diabetes using an online questionnaire.  You can clearly see my risk score is LOW according to the Canadian Diabetes Risk Score Calculator.

So how did I find out I was on a fast-track to joining millions of people who have Type II Diabetes and, in fact, was already severely insulin-resistant?

myAva’s Precision Medicine PCOS Program uncovered my pre-diabetic state! 

As you know, I am developing myAva’s Precision Medicine Program for PCOS and as the CEO and Founder, I made the decision to join the 10 women on our Patient Advisory Board in the screening and discovery process. I made this decision so that I could really get a sense of what we are putting patients through, how it feels to get this much data and to be able to have a real conversation with them about all of the things they are going through as they wade into this new style of healthcare called Precision Medicine.  And wow, what a great decision that turned out to be!

You may already be aware, women with PCOS are at a high risk of developing diabetes and 50% of women with PCOS will become diabetic.  I have never been diagnosed with PCOS and don’t meet the current diagnostic criteria, yet I have myriad symptoms related to PCOS.  A component of myAva’s program is to screen for insulin-resistance/pre-diabetes/diabetes due to the high risk for women with PCOS.  When I underwent our initial testing this summer, I was surprised to discover that I had already developed severe insulin resistance.  My blood work showed I was well on my way to becoming a Type II Diabetic!

My family was as shocked as I was.  To put my shock into perspective, keep in mind I have never been told I am at risk for diabetes, have no known family history, and don’t have PCOS or belong to other populations that are at risk. You see I eat quite healthy – I don’t drink soda, I don’t eat a lot of sugary or packaged foods or fast food.  My diet is mostly made up of whole foods including tons and tons of fruit. Fruit is healthy right? What I didn’t realize that many foods that we think of as healthy actually create an increase in demand for insulin. And no wonder my “healthy eating” wasn’t helping me lose weight!  Insulin blocks the breakdown of fat and tells the body to make more fat!  That’s a story for another day. Let me show you how the discovery was made.

Traditional Lab Testing:

This part is really interesting, and very relevant to you, as a patient with ONE doctor.  I am in a fortunate position due to development of myAva to seek advice from a number of medical and naturopathic doctors, lab personnel, geneticists and molecular scientists. Did you know there is more than one way to screen for diabetes, prediabetes and insulin resistance?  I didn’t know there were so many different methods that doctors use to help them assess your risk of diabetes.   In fact, what is the difference?  That US National Institute for Diabetes and Digestive and Kidney Diseases gives a good overview. 

So here’s the interesting part, when I asked various members of the group I’m working with how best to screen women with PCOS for insulin resistance and/or pre-diabetes I received a different answer from each of them!   Is this surprising?  Actually, not at all – there are several different tests to screen for diabetes risk and they are all valid. Some methods are more costly than others, some are better at finding diabetes but not as good at finding insulin resistance (pre-diabetes) and some take a whole lot of your time sitting in a lab and drinking what tastes like sugary pop.  But here’s the important thing to know, the issue is complex and although I won’t go into in detail here, some methods are going to uncover your pre-diabetes or insulin resistance and some are not going to detect the risk in everyone.  

Using HOMA-IR (Homeostasis Model Assessment-Estimated Insulin Resistance), which is a calculation that takes both your fasting glucose and your fasting insulin into account and provides a risk profile, we discovered I had insulin resistance, a condition I was completely unaware I had.  

Genomic Testing:

I was amazed to discover during my genomic consultation that I have a genetic risk for Diabetes and Metabolic Syndrome.  I have genetic variances (mutations) associated with both Type II and Type I Diabetes but they are identified as LOW. Interestingly, as far as I knew, I had no family history of diabetes but clearly I carry genetic variances associated with the risk. This was eye-opening indeed.

Molecular Profile:

As we delve further into my proteomic and metabolomic profile by measuring about 160 proteins and a couple of hundred metabolites, we uncovered a severe risk of diabetes for me which you can see below.  The most exciting part is that these are actionable measures – I can reverse these trends because I caught them early enough to do something about it!  Sonya's Diabetes and Metabolic Risk

 

I am forever grateful that I discovered this trend toward disease as it was sneaking up on me!  I caught it before I became diabetic. Thank God.  Thanks to myAva this is how data empowers patients.  

I can’t help but think about the millions of people walking around like me, completely unaware that their lifestyle and hidden risk factors could be pointing them in the direction of diabetes.  Today I am super happy to report that I was able to reverse this trend in just three short months.  I’ll tell you how I did it next time – it’s a very compelling story.

 

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