Assessment of Insulin secretion and insulin resistance

This is a talk by Dr. Om J Lakhani on Assessment of Insulin secretion and insulin resistance

[ankurapushpanjali]

Simple and lucid explanation.
Thank you doctor

[drpraveengangadhara]

Excellent talk sir, good you mentioned measuring c-peptide post glycemic control, many times diagnosis is missed during the work up when it's done when glucose levels are high.

[bennguyen]

Based on different calculators, I seem to get conflicting results..

TyG : ln [Fasting triglyceride 74 mg/dl x Fasting glucose 103 mg/dl] / 2 = 4.5 >= 4.5 ** INSULIN RESISTANT **
HOMA-IR : Fasting Insulin 3.4 IU/mL x Fasting Glucose 103 mg/dl = 0.9 < 1 ** NORMAL **
TG/HDL : 74/111 = 0.7 < 1 ** NORMAL **
QUICKI : 1 / (log(Fasting Insulin 3.4 IU/mL ) + log(Fasting Glucose 103mg/dl )) = 0.39 < 0.45 ** INSULIN RESISTANT **

The other tests I don't have..
McAuley < 5.8 : 2.715??? ln [Fasting Insulin 3.4 IU/mL] - 0.31 ln [triglycerides .87 mmol/L] = 3.37 ???
Disse : 12×(2.5×{HDLC 111 mg/dl / TC 282 mg/dl) - ??? FFA mmol/L}) - (Fasting Insulin 3.4 IU/mL) = ????
Non-fasting-random c-peptide

Do you know of an online calculator for the McAuley or Disse index.. I didn't see it on the endocrinology_co_in site.
Also, on Peter Attia's AMA#13 (12m) he talks about the holy grail of early IR detection.. a Continuous *INSULIN* Monitor!

Finally, I've seen different opinions on which tissue is the first become insulin resistant (for example, Ben BIkman says fat tissue, Gerald Shulman says muscle tissue).. do you have any thoughts on the first domino to fall?