Identify Diabetes Subtype

Purpose

This guide helps you identify which of the four Type 2 diabetes subtypes best describes your glucose patterns. Understanding your subtype is crucial because each requires a different management approach:

Subtype	Primary Issue	Key Strategy
Muscle IR	Muscles don’t respond to insulin	Exercise + lean protein
Liver IR	Liver overproduces glucose	Omega-3s + fiber + timing
β-Cell Dysfunction	Pancreas can’t make enough insulin	Low-carb + low-glycemic foods
Incretin Impairment	Gut hormones don’t signal properly	Fermented foods + fiber + protein

Note

Two Ways to Identify Your Subtype

Self-Assessment Quiz — Answer questions about your typical glucose behavior (quick estimate)
CGM Analysis — Use Continuous Glucose Monitor data to observe patterns (most accurate)

Part 1: Find Your Subtype Using CGM

Using a Continuous Glucose Monitor (CGM), you can identify your subtype by watching three things: your fasting glucose (morning/night), your post-meal spikes (how high), and your recovery time (how long to come down).

At a Glance

Subtype	Key Metric
🔴 Liver IR	High morning glucose ≥110 mg/dL fasting
🟠 Muscle IR	Slow recovery >3 hours above 140
🟢 β-Cell	Fast high spikes ≥180 within 45 min
🟣 Incretin	Prolonged elevation, erratic patterns

Detection Rules

Subtype	What to Look For	The Pattern
Liver IR	High fasting glucose	Consistently ≥110 mg/dL in morning (3-6 AM)
Muscle IR	Slow recovery	Stays ≥140 mg/dL for >3 hours post-meal; late peak (~60-75 min)
β-Cell Dysf.	High fast spikes	Very high early spikes (≥180 mg/dL); peak within 45 min; large Δ (≥80 mg/dL)
Incretin Imp.	Prolonged elevation	Long time ≥180 mg/dL (>45 min); erratic/repeated spikes; high AUC

Quick Decision Tree

Step 1: Check your fasting glucose (early morning, before eating)

Consistently ≥110 mg/dL?
You likely have Liver Insulin Resistance

Step 2: Watch your post-meal spikes (1-2 hours after eating)

Very high early spike (≥180 mg/dL within 45 min)?
You likely have β-Cell Dysfunction
Prolonged or repeated spikes?
You may have Impaired Incretin Action

Step 3: Time how long it takes to come back down

Still ≥140 mg/dL after 3 hours?
You likely have Muscle Insulin Resistance

⚠️ Important

Most people have mixed subtypes.

Research shows ~34% have IR patterns and ~40% have β-cell/incretin patterns, with significant overlap. Use 14+ days of CGM data for reliable patterns.

Part 2: Subtype Quiz

This quiz estimates which glucose-response pattern is most consistent with your day-to-day experience. It is educational and not a diagnosis.

Note

If you are reading the book – Please use the following link to open the quiz

https://diabetes-type2.com/diabetes--identify.html