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Kraft Prediabetes Profile: Patterns Overview

| Meridian Valley Lab

Prediabetes | Meridian Valley Lab

Why Dr. Kraft’s Research Still Matters

Dr. Joseph R. Kraft, a clinical pathologist, conducted over 3,650 glucose–insulin tolerance tests to detect diabetes mellitus earlier and more accurately than glucose alone.

While many patients showed “normal” glucose tolerance by ADA criteria, a deeper look revealed something else:

  • Over 50% of glucose-normal results were abnormal when insulin curves were measured
  • Another 14% were borderline
  • About 2.5% displayed insulin responses indicating future trouble

This insight—that glucose-only testing can miss early insulin dysfunction—is the foundation of the Kraft Prediabetes Profile.

The Power of Pattern Recognition

Dr. Kraft’s work led to five characteristic insulin response patterns that help clinicians recognize insulin resistance and insulinopenia well before fasting glucose becomes abnormal.

The Five Kraft Patterns

I: Normal Response

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  • Fasting insulin: 0–10 units
  • Peak insulin at 30–60 minutes
  • 2nd and 3rd-hour totals: < 60
  • Return to fasting by 3rd hour

Example: 37-year-old female with normal glucose and insulin response.

Kraft Pattern I graph: early insulin peak with return to baseline by 3 hours
Pattern I — Normal insulin response.

II: Delayed Peak

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  • Fasting insulin: 0–10 units
  • Later insulin peak; borderline resistance if totals 60–100
  • Definite resistance if totals > 100

Example: 19-year-old female with normal fasting glucose/insulin and 2-hr glucose; delayed peak suggests borderline insulin resistance (IR).

Kraft Pattern II graph: delayed insulin peak after 60 minutes
Pattern II — Delayed insulin peak.

III A & III B: Insulin Resistance

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  • Peak insulin at 2nd hour (III A) or 3rd hour (III B)
  • Glucose may be borderline or diabetic
  • Indicates diminished sensitivity to insulin

Example: 70-year-old female with normal OGTT glucose; 2-hour insulin peak indicates established IR.

Kraft Pattern III graph: insulin peak at the 2nd to 3rd hour indicating insulin resistance
Pattern III — Insulin resistance curve (late peak).

IV: Overt Resistance

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  • Fasting insulin > 10 units
  • Diagnostic for insulin resistance
  • High likelihood of diabetic glucose levels

Example: 67-year-old female; massive insulin outpouring maintains normal glucose.

Kraft Pattern IV graph: very high insulin output across the test
Pattern IV — Overt insulin resistance (very high output).

V: Insulinopenic Response

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  • Low insulin across all time points (< 30)
  • Seen in type 1 diabetes or exhausted β-cells
  • May appear with normal glucose in low-carb individuals

Example: 63-year-old male with diabetes; flattened insulin response suggests islet exhaustion.

Kraft Pattern V graph: flattened insulin curve indicating low secretion
Pattern V — Insulinopenic response (flattened curve).

Beyond Blood Sugar: Hidden Hypoglycemia & Modern Use

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Hidden hypoglycemia: Dr. William Hudspeth paired glucose–insulin testing with EEG monitoring and found some patients experienced hypoglycemic symptoms without obvious glucose dips—often correlating with abnormal insulin peaks.

Modern use in practice: In functional and integrative settings, the Kraft Prediabetes Profile helps detect metabolic dysfunction earlier, identify IR in low-carb or keto-adapted individuals, and guide interventions for fatigue, weight gain, and hormonal imbalance—bringing clarity to puzzling metabolic presentations.

References

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  1. Kraft JR. Detection of Diabetes Mellitus, In Situ (Occult Diabetes). Laboratory Medicine. Vol VI, No. 2. February 1975.
  2. Hudspeth WJ et al. Neurobiology of the Hypoglycemia Syndrome. Journal of Holistic Medicine. Vol III, No. 1. Spring/Summer 1981.