Confused about diabetes and insulin resistance

[rowan]

I thought diabetes was insulin resistance but from reading various threads on here it seems you can have both or one without the other? Can someone explain in simple terms please?

 

[novorapidboi26]

with regards to type 2 diabetes I believe the main mechanisms of it are not enough insulin produced and/or the insulin being produced isn't being used effectively...........the latter being insulin resistance.....

for me as a type 1, i too experience different levels of resistance at different times of the day, and its this resistance which determines my insulin/carb ratios..........

I feel I am not making things simpler...............

maybe someone else can explain better......

 

[Bluetit1802]

Some people produce normal amounts of insulin but for various reasons the cells that need it to act on the glucose we have eaten are rejecting some or most of it, so the glucose floats about in our blood stream with nowhere to go. This is insulin resistance, put very simply.

Other people do not produce enough insulin (or none at all) so again, the cells that need it to convert the glucose in to energy are not getting enough, or none at all. Again, the glucose floats about in the bloodstream. They may or may not have insulin resistance.

 

[satindoll]

Some people produce normal amounts of insulin but for various reasons the cells that need it to act on the glucose we have eaten are rejecting some or most of it, so the glucose floats about in our blood stream with nowhere to go. This is insulin resistance, put very simply.

Other people do not produce enough insulin (or none at all) so again, the cells that need it to convert the glucose in to energy are not getting enough, or none at all. Again, the glucose floats about in the bloodstream. They may or may not have insulin resistance.

Brilliant explanation, maybe you should get a job writing the how to manuals for some of the big companies who give out pages of gobbledegook instead of plainly written instructions.

 

[Bluetit1802]

Brilliant explanation, maybe you should get a job writing the how to manuals for some of the big companies who give out pages of gobbledegook instead of plainly written instructions.

The problem with that is the gobbledygook may be the correct version.

 

[satindoll]

The problem with that is the gobbledygook may be the correct version.

Ah but I was suggesting that you could unravel the gobbledegook and make it understandable to those of us that are gook challenged.

 

[rowan]

Some people produce normal amounts of insulin but for various reasons the cells that need it to act on the glucose we have eaten are rejecting some or most of it, so the glucose floats about in our blood stream with nowhere to go. This is insulin resistance, put very simply.

Other people do not produce enough insulin (or none at all) so again, the cells that need it to convert the glucose in to energy are not getting enough, or none at all. Again, the glucose floats about in the bloodstream. They may or may not have insulin resistance.

So how do you know if you've got both, seeing as the end result is the same?

 

[Bluetit1802]

So how do you know if you've got both, seeing as the end result is the same?

Insulin resistance is, in part, brought on by being overweight, and particularly by having too much fat round the liver and pancreas both inside and outside the organs. If a type 2 is overweight, especially round the waist line, and struggles to keep fasting levels down when levels later in the day are going down well, it is likely due to insulin resistance. Insulin resistance can also cause weight gain in the first place because the insulin produced isn't getting used, so like the glucose, it floats around in the bloodstream but is then stored as fat. Vicious circle sometimes! IR can be improved by weight loss.

Lack of insulin will eventually manifest itself in high levels that can't be controlled and the GP will intervene and prescribe injectable insulin or one of the drugs like Gliclazide that help the pancreas increase its insulin production.

 

[sanguine]

There are tests for the amount of insulin sloshing around in your bloodstream but I don't think they are part of anyone's standard suite. T2 can be regarded as a symptom rather than a disease as such, because there are various conditions resulting in the same thing (elevated blood glucose). @Bluetit1802 has nicely described the main two, but others (rarer) include communication breakdown in the nervous system, such as the stomach not telling the brain that food has arrived, or the brain not instructing the pancreas, either way preventing the release of insulin.

 

[Daks]

So diet is still essential as far as treating both scenarios ?

 

[Bluetit1802]

So diet is still essential as far as treating both scenarios ?

Diet is the key to control in both scenarios, although people that produce little insulin themselves will need more help from meds. But meds won't be the full answer, they have to be combined with diet. The less glucose we consume (from sugar and carbs etc) the less insulin we need to process it, so having less natural insulin isn't as crucial.

 

[rowan]

Insulin resistance is, in part, brought on by being overweight, and particularly by having too much fat round the liver and pancreas both inside and outside the organs. If a type 2 is overweight, especially round the waist line, and struggles to keep fasting levels down when levels later in the day are going down well, it is likely due to insulin resistance. ........
........Insulin resistance can also cause weight gain in the first place because the insulin produced isn't getting used, so like the glucose, it floats around in the bloodstream but is then stored as fat. Vicious circle sometimes! IR can be improved by weight loss.

So high morning levels and liver dumps are probably because of insulin resistance?

If that is the case (and I think I might have been insulin resistant long before I have diabetes) it's strange that I've been losing weight without even trying over the last year or so. I have to have 3-monthly hospital check-ups and I've lost around half a stone each time. I still have around 2 stone to lose.

 

[Bluetit1802]

So high morning levels and liver dumps are probably because of insulin resistance?

.

It is certainly one of the reasons.

 

[Brunneria]

Insulin resistance came long before weight gain for me.

But before that, came the hypoglycaemia and the carb cravings...

I've often wondered if the root cause was my body failing to turn insulin 'off' when it had done its work. Or my body over producing insulin...

Of course, I will never know.

 

[Daibell]

So high morning levels and liver dumps are probably because of insulin resistance?

If that is the case (and I think I might have been insulin resistant long before I have diabetes) it's strange that I've been losing weight without even trying over the last year or so. I have to have 3-monthly hospital check-ups and I've lost around half a stone each time. I still have around 2 stone to lose.

Hi. If you have been losing weight without really trying then late onset T1 becomes a possibility. This is when the pancreas islet cells start to fail and there isn't enough insulin to use up blood glucose and the body turns to burning it's stored fat to get energy hence the weight loss. This can happen either thru antibody or viral damage to the pancreas or cell death due to excessive insulin production thru long-term insulin resistance. If you continue to lose weight to a level below a normal BMI then ask for tests for Late onset T1 (LADA). You will, of course lose weight thru a low-carb diet but LADA tends to occur as a surprise and despite increasing carbs to try to compensate for excessive weight loss. Complicated isn't it!

 

[rowan]

Hi. If you have been losing weight without really trying then late onset T1 becomes a possibility. This is when the pancreas islet cells start to fail and there isn't enough insulin to use up blood glucose and the body turns to burning it's stored fat to get energy hence the weight loss. This can happen either thru antibody or viral damage to the pancreas or cell death due to excessive insulin production thru long-term insulin resistance. If you continue to lose weight to a level below a normal BMI then ask for tests for Late onset T1 (LADA). You will, of course lose weight thru a low-carb diet but LADA tends to occur as a surprise and despite increasing carbs to try to compensate for excessive weight loss. Complicated isn't it!

Certainly is! The weight loss could be due to the Crohn's Disease though, it tends to have that effect. I think the slow weight loss first started after i had my colon removed nearly 3.5 years ago, I've lost around 3 stone since then.
But this LADA, can that happen even though you're a type 2, can it change?

And if my pancreas was packing up wouldn't it show up on liver or kidney function tests, I have to have them every 3 months.

 

[LucySW]

You need the GAD antibody test. That's the most indicative.

 

[Daibell]

Hi. Around 15 to 20% of T2s are not overweight and many are likely to be LADA as I was. The NHS guesses the diagnosis of T2 without any specifc tests other than blood sugar level and sometimes gets it wrong. As Lucy says the GAD test will check for the most likely cause of LADA but there are other causes. I would add the c-peptide test as well which measures the amount of insulin you are producing.

 

[rowan]

Thanks, I do have several automimmune illnesses so I guess that would increase the risk of LADA? Will ask for a test when I see them in a couple of weeks.