Alanine aminotransferase independently predicted muscle
glucose uptake measured by hyperinsulinemic euglycemic clamp in females only, whereas in males,
fasting insulin and leptin were stronger predictors
of insulin resistance.
Conversely, within non-diabetic populations, periods
of IER (75 - 85 % ER on restricted days) do not typically affect
fasting glucose levels 37, 41, 45, 48 or HbA1c 41, 48; results
of which can often be replicated by short term CER studies.62 - 65These findings are unsurprising given that frank hyperglycaemia within the T2DM diagnostic range is effectively a late - stage manifestation
of IR, which along with compensatory increases insulin secretion, can precede the onset
of T2DM by many years.66, 67 Findings from one large scale prospective cohort study, Whitehall II, reveal a sharp increase in the trajectory towards
fasting hyperglycaemia which is only detectable three years prior to diagnosis with T2DM.67 Consequently, it can be argued that changes in circulating insulin concentrations,
fasting (hepatic) insulin sensitivity and
glucose uptake / clearance are more sensitive markers
of deteriorating
glucose control than
fasting glycaemia in non - diabetics.68 - 70
However, this doesn't explain the improvement in
fasting insulin and
glucose, and thus our second benefit is increased
uptake of glucose into energy stores (study).