Insulin

[fergus]

The one thing that unites all of us, but for some strange reason it's a subject that rarely crops up in the forum.
Insulin. Possibly the single most important hormone in the human body. But what is it, how is it made (in us or in the lab.) and what does it do?
What is its effect on our health and are there optimum levels that enable us to lead long and healthy lives?
How can insulin be made most effective and how do we minimise the risks that it holds?

With a bit of luck, we might put together a thread that lots of people could find very useful.
What do you think?

fergus

 

[Rick]

Yes I think we probably could

 

[cugila]

Fergus.
I was always told, Never volunteer for anything. Stood me in good stead.
Did you ever hear that one ??? :twisted:

 

[fergus]

So you volunteered the statement 'never volunteer for anything' Ken?
Whoa, you're messin' with my mind, man!

fergus

 

[cugila]

Mind....Easy done Fergus, easy done. 8)

 

[fergus]

It's a term more associated with radioactive decay, but it's interesting that insulin also has a 'half-life'. Insulin produced in a non-diabetic will usually be 50% used up within 5-7 minutes.

This from the AAFP, January 15 1998:

Insulin is necessary for the normal metabolism of carbohydrates, protein and fat. Normal insulin secretion has both basal and meal-stimulated components. Basal insulin secretion, which is usually in the range of 0.5 to 1.0 unit per hour, retards hepatic glucose production in the postabsorptive state.5 The fasting blood glucose level is the base on which prandial glycemia is added during the next 24 hours.6 The meal-stimulated phase of insulin secretion (1 unit of insulin per 10 g of carbohydrate) promotes the dispersal of ingested nutrients, primarily glucose, into the periphery.6 Insulin is also released when blood glucose concentrations exceed 100 mg per dL (5.6 mmol per L).5

In persons who do not have diabetes, insulin is very sensitive to the rise in blood glucose concentration that occurs in response to meals. Endogenous insulin secretion generally peaks within one hour after a meal. Once the meal-stimulated glycemia has subsided, insulin and glucose levels return to premeal levels within two hours. This does not occur in patients with diabetes. Therefore, commonly prescribed regimens consisting of combined short-acting (regular) and intermediate-acting insulins are used to mimic endogenous insulin response. However, these regimens have been incapable of adequately simulating the basal or meal-stimulated components of normal insulin secretion. The physiologic profile of insulin requires rapid changes in concentration as a result of food ingestion or other factors, such as exercise. Furthermore, insulin is a hormone with a half-life of only five to seven minutes.7

fergus

 

[hanadr]

For those T1s who sometimes seem to forget it
Many of us T2s get our control by diet and oral medication( which may have a long half life ) We cannot make fine adjustments to medication. so we need to make them to our diet.
There's far more freedom in insulin use. Correction bolus and so on.
Having lived with a T1 for almost 40 years, I'm thinking that increasing insulin doses to "cover" over indulgence in carbs, is Ok in the short term, but may hold problems for the future.
I think Bernstein's doctrine of small numbers has the right of it.
Yes I know I'm Not T1, but I do get to pick up all the pieces, often at 4:00 am not to mention the 1 mile hike from Reading town centre to the Royal Berkshire hospital, to fetch and carry a couple of times a day, with each admission.
I choose to walk. the car parking is a nightmare.

 

[sugarless sue]

I think Fergus is also talking about the bodies own natural insulin production as well though and the effects that over production,ie fat etc can have on the body.

 

[nessa-lou]

the whole point of this tread is for T1's who dont quite understand what is going on in their bodies or for 'those T2's' as we seem to referr each other too, might not understand how a T1 deals with it. its not as simple as oh lets take this to cover that. its a difficult process that we go through just like T2 have a difficult process of changing their diet and med's to control their diabetes, we are all different and ithink this thread has been set off on the wrong foot. were not digging at each other sayin 'T1's who seem to forget' well no we dont seem to forget but this could apply to T2's forgetting us T1 has a difficult time at it just like you. we all have diabetes but deal with it in different ways and that should be respected!

 

[fergus]

OK, the point of this thread isn't to create divisions between types 1 and 2. We all have issues concerning insulin and its effects, so the idea is to broaden our understanding of the impact of insulin on our health.
I've seen a number of postings from people who are happy to try and use insulin to cover all kinds of foods. Does that carry risks? At the same time, there are insulin resistant type 2's for whom the overproduction of insulin can cause all manner of long term problems.
In my opinion, since healthy non-diabetics often have low serum insulin levels, that's something the rest of us should aspire to.
Do others think this is important? If so, how do we keep our insulin levels low?

fergus

 

[nessa-lou]

wel you refer to non diabetics, do non diabetics eat what they like, do they eat carbs and meat and veg etc yes so shouldnt we live our life like those like we were intended to do if we didnt have diabetes. thats my opinion x

 

[phoenix]

I've seen a number of postings from people who are happy to try and use insulin to cover all kinds of foods. Does that carry risks?

wel you refer to non diabetics, do non diabetics eat what they like, do they eat carbs and meat and veg etc yes so shouldnt we live our life like those like we were intended to do if we didnt have diabetes.

I agree with Nessa's reply to a degree. It is perfectly possible to insulin to eat a normal diet, (NB Ferguses quotation 'Insulin is necessary for the normal metabolism of carbohydrates, protein and fat.' ie not just carbs . However if that normal diet is actually an abnormal diet for the persons activity level (ie too much of every food group) then the normal person may become a) overweight, b) insulin resistant. (I realise that it is not always as simple as that) So too may a type 1, resulting in 'double diabetes'
I think that today it is sometimes very easy to eat far too much. I did myself when I ate out the other evening at a harvester (download their nutritional info to find out why), I sucessfully covered it with a square wave and had a max reading of 5.8mmol . Great, but I think that eating like that regularly could lead to using too much insulin so won't do it very often.

 

[fergus]

It was 8 years ago that I first began to read of the connection between insulin and weight. Until that point, I had persuaded myself that I would simply use whatever amount of insulin was necessary to eat whatever I liked and keep my blood sugars reasonable-ish. OK, I'm a slow learner, and my main motivation was just to shed a few of the pounds (60 in total) that had accumulated as a result. The evidence regarding insulin is striking though, and made me completely revise my opinion:

"Insulin causes the deposition of fat in fat cells." Kipnis, University of Washington

"Insulin is a most lipogenic agent, chronic hyperinsulinism favour(s) the accumulation of body fat." Yallow and Berson

"Obese diabetics have elevated basal insulin levels in proportion to their body weight." Woods and Porte, University of Cincinnati

I think if this information was made available to others who may have weight issues, it would give them another method of tackling them, as it did for me.

All the best,

fergus

 

[hanadr]

Thanks Fergus and Sue for making the point that insulin is an issue for T1 and T2, even if there are differences.

 

[sugarless sue]

If it was insulin resistance that put my weight on ,and not just pigging out on things ,then I have had this for 18 years!!Now that is a scary thought!!

 

[Trinkwasser]

From the Type 2 perspective this is IMO a pretty **** good summation, and also covers why whacking in extra insulin to cope with high carbs is not such a good plan for Type 1s.

Not the misunderstanding between Type 1/Type 2 where I suspect he is confused by the old distinction between IDDM and NIDDM

http://www.marksdailyapple.com/diabetes/

 

[fergus]

Thanks for the link, Trink. Good stuff once again.

fergus

 

[jopar]

I’m aware that the insulin hormone is part of the growth hormones system playing a part in our growth, and that injecting insulin constantly into the same area will cause fatty lumps under the skin ‘Lipohypertrophy’ because the insulin is encouraging fat growth at that point..

But I find it difficult to believe that injecting ‘insulin’ or quantity per dose is the lone cause behind why some diabetic put on weight…

I think two other factors also play major part in the diabetic plight of weight issues…

1, the incorrect use of insulin, leaving the diabetic having to feed the insulin they’ve injected to prevent hypo’s

2, like every other human diabetic or not, if your calorie intake is higher than what your body is able to burn then the body stores this as fat, so one would then like everyone else be highly like to susceptibility to becoming overweight..

I’ve never had a weight issues, before I was diabetic, but since becoming diabetic I’ve remained between 1 to 1 ½ stone lighter than I was before I was diabetic, so one could safely say that injecting insulin hasn’t caused me to gain weight…

It’s not that I’ve really changed my eating habits as such, I eat the same types of food before diabetes as I do as a diabetic I just have to work out what type of carb, the amount of these carbs and several other factors to work out my insulin dose to cover what I’ve ate…

I got up for work today, fasting bg was 5.2 so had my usual cereal breakfast, went to work, by break I was 4.4, so had my work treat a kitkat (no bolus as I know I will work this off) and a hotcross bun that I bolused for (as this isn’t norm) I arrived home at dinner time to a spot on 4.5 BG… To suggest that using my insulin to cover the evil carb, that I’ve consumed and it’s causing me to be over weight hmm at 81/2 stone and being described by a consultant a very slender build!

So it’s no surprise that I remain a doubting Thomas, when I’m told that I have to restrict my carbs by reducing to a very minimum amount of carbs per day and meal, and that I am to avoid all certain carbs completely and see them as evil !

I’m either an anomaly to the rule, but even then this is hard to believe as my husband has similar control to me and not overweight!

 

[fergus]

It's not the injecting of insulin per se which promotes weight gain, it's the presence of excess insulin.
For a type 1, with a chronic deficiency of insulin, weight gain is atypical. Only when insulin levels are raised above a certain level will weight gain begin.
There is ample evidence in scientific literature to confirm that not only is insulin the primary fat building hormone, it also inhibits all of the fat burning hormones. Without adequate insulin, weight gain is impossible, yet at the same time possibly all overweight people suffer from hyperinsulinemia.
At the same time, it's perfectly possible for us to eat excess calories and still lose weight if there is a lack of sufficient insulin to transport those calories to the adipose tissue. Just before I was diagnosed, I lost probably 2 stones in weight very quickly despite eating and drinking like there was no tomorrow. One could make a strong argument that insulin levels are a much more reliable predictor of whether we lose, retain or gain body fat than the intake of calories itself.
I know of a number of type 1's who remain slim, not by limiting calorie intake, but by running consistently high blood sugars due to their chronic deficiency of insulin. Sadly, but not unsurprisingly, they also often seem to suffer from a number of complications too.

fergus

 

[fergus]

OK, enough about the fat-building effects of insulin for now, although there are lots of interesting links I could add. Some discuss the idea that insulin’s primary role is actually to enable the body to store excess nutrients and its blood glucose lowering properties are essentially just a side-effect of that.

Anyway, another little discussed effect of insulin is its role in cellular ageing.

“The level of insulin sensitivity of the cell is one of the most important markers of lifespan.” Dr Michael Lam

“Insulin sensitivity is going to determine, for the most part, how long you are going to live and how healthy you are going to be. It determines the rate of ageing more so than anything else we know right now.” Dr. Ron Rosedale

“I was a fresh-faced slip of a lad until my mars bars and my insulin habit got the better of me! Exterminate!” Davros (only kidding)

The theme here is that the more insulin we get through, the more quickly we age. It seems to be true for fruit flies, hamsters and rats, so I doubt we humans will buck that trend.

fergus