Catching Insulin Resistance before it becomes Elevated Blood Glucose

[Cocosilk]

No, they could either choose to use more insulin or eat fewer carbs so that their insulin needs per meal are less. (For example an IR type 2 COULD use exogenous insulin for the same reason or eat fewer carbs or if they were very IR and chose to eat too many carbs for their bodies they would still live but may well become ill and start to suffer the consequences of high blood sugars). Apart from that there is the insulin required in between meals which is less to do with what you are eating but still crucial, it takes care of the glucose your liver produces to keep things ticking over in between meals. So, even if you didn't eat a single carb your glucose levels would still continue to rise without basal insulin....and then you would die. If you think back to the good old days, the ONLY choice for type 1s was to eat no carbs but even that only kept them alive for a matter of weeks.

Thanks for explaining that. I had no idea how treatment for T1 diabetes worked in the past. So your overnight fasting levels (which is also a problem for me with Gestational Diabetes) and between meal fasting levels, would just continue to rise if you didn't use insulin as a T1? Because your liver continues to create glucose but your pancreas doesn't make insulin? What triggers type 1 if you are not born with it but it's an autoimmune disease? That's something I don't understand anything about. And you said in the past, the only way to survive for a period of time was the cut out the carbs but people still died earlier because their fasting blood glucose would continue to rise. So there's nothing that can be done about that other than taking insulin? That's scary alright. I wonder if any discoveries will be made for how to change whatever causes the pancreas not to make insulin at all.

With Type 2 it seems clear that diet and lifestyle are triggers, or in pregnancy, the hormones contribute, but I suspect prior insulin resistance due to diet and lifestyle must also contribute otherwise every pregnant women would have Gestational Diabetes, so diet and lifestyle must also be precursors for it... even though they don't list diet and lifestyle specifically as risk factors other than alluding to it by saying women who "Are above the healthy weight range" are at risk. But then again, some people who have Gestational Diabetes don't go on to get T2, and they possibly don't change their diets either, but without actually documenting how women ate before and after their pregnancies with Gestational Diabetes, we can't be sure how much diet is a factor.

I'm having trouble accepting that I need to take insulin for my fasting levels. I was hoping that lowering my carbs in the day, which helps control the daytime levels, would somehow help with the fasting levels, but the hormones seem to be getting the better of me. I'm only on the smallest dose of insulin and it's only been 2 days since I started so it's not helping yet either. But I guess it seems like my only option at the moment if diet doesn't fix the morning fasting level.

 

[zand]

No, they could either choose to use more insulin or eat fewer carbs so that their insulin needs per meal are less. (For example an IR type 2 COULD use exogenous insulin for the same reason or eat fewer carbs or if they were very IR and chose to eat too many carbs for their bodies they would still live but may well become ill and start to suffer the consequences of high blood sugars).

Most IR T2's already have too much insulin floating around in the body. There are some of course who don't produce enough insulin anymore, but they are by far outnumbered by those who have insulin that the body just can't use effectively. It is well known now that hyperinsulinemia is even more damaging to the body than hyperglycaemia. Adding even more insulin would add to the problems. Hyperinsulinemia is the reason many T2s are obese, adding more insulin would be a disaster for them and their efforts to lose weight.

 

[zand]

With Type 2 it seems clear that diet and lifestyle are triggers,

That's the widely held view. It's easy to blame the patient. However there have been studies that show it's a genetic problem. I watched a video that was posted on here about this. I'll add the link if I remember it.

 

[KK123]

Thanks for explaining that. I had no idea how treatment for T1 diabetes worked in the past. So your overnight fasting levels (which is also a problem for me with Gestational Diabetes) and between meal fasting levels, would just continue to rise if you didn't use insulin as a T1? Because your liver continues to create glucose but your pancreas doesn't make insulin? What triggers type 1 if you are not born with it but it's an autoimmune disease? That's something I don't understand anything about. And you said in the past, the only way to survive for a period of time was the cut out the carbs but people still died earlier because their fasting blood glucose would continue to rise. So there's nothing that can be done about that other than taking insulin? That's scary alright. I wonder if any discoveries will be made for how to change whatever causes the pancreas not to make insulin at all.

With Type 2 it seems clear that diet and lifestyle are triggers, or in pregnancy, the hormones contribute, but I suspect prior insulin resistance due to diet and lifestyle must also contribute otherwise every pregnant women would have Gestational Diabetes, so diet and lifestyle must also be precursors for it... even though they don't list diet and lifestyle specifically as risk factors other than alluding to it by saying women who "Are above the healthy weight range" are at risk. But then again, some people who have Gestational Diabetes don't go on to get T2, and they possibly don't change their diets either, but without actually documenting how women ate before and after their pregnancies with Gestational Diabetes, we can't be sure how much diet is a factor.

I'm having trouble accepting that I need to take insulin for my fasting levels. I was hoping that lowering my carbs in the day, which helps control the daytime levels, would somehow help with the fasting levels, but the hormones seem to be getting the better of me. I'm only on the smallest dose of insulin and it's only been 2 days since I started so it's not helping yet either. But I guess it seems like my only option at the moment if diet doesn't fix the morning fasting level.

Hi there Cocosilk,

Yes, your first para is spot on, even if a type 1 ate no meals (extreme example I know because you would die from starvation) their glucose levels would still rise without basal because a person cannot live without their bodies producing insulin. So the insulin required for fasting is different from that which is required to deal with a meal. In the final weeks of my (type 1) Mum's life she did not eat anything at all for the last week or so and because of many complications, they stopped giving her her basal insulin too....they still checked her glucose levels and they soared to off the scale after about 3 days.

I think if you can get your head around how insulin works it might make it easier for you, there are lots of books out there and others who know far more about it than my fairly basic knowledge. x

 

[KK123]

Most IR T2's already have too much insulin floating around in the body. There are some of course who don't produce enough insulin anymore, but they are by far outnumbered by those who have insulin that the body just can't use effectively. It is well known now that hyperinsulinemia is even more damaging to the body than hyperglycaemia. Adding even more insulin would add to the problems. Hyperinsulinemia is the reason many T2s are obese, adding more insulin would be a disaster for them and their efforts to lose weight.

Hi Zand, yes I know but if a type 2 refused to lower their carbs and their IR was causing their levels to rise then they would need exogenous insulin at some point wouldn't they? Of course it would add to the problems, most of us on this site know that which is why we are always talking about the majority of type 2s (outside of this site) gradually getting worse and having to go onto insulin.

 

[Guzzler]

Hi Zand, yes I know but if a type 2 refused to lower their carbs and their IR was causing their levels to rise then they would need exogenous insulin at some point wouldn't they? Of course it would add to the problems, most of us on this site know that which is why we are always talking about the majority of type 2s (outside of this site) gradually getting worse and having to go onto insulin.

You are forgetting those with T2 who suffer a greater degree of beta dell dysfunction.

 

[zand]

Hi Zand, yes I know but if a type 2 refused to lower their carbs and their IR was causing their levels to rise then they would need exogenous insulin at some point wouldn't they? Of course it would add to the problems, most of us on this site know that which is why we are always talking about the majority of type 2s (outside of this site) gradually getting worse and having to go onto insulin.

Yes they would. Also it has been pointed out to me that a T2 who has been diagnosed after being rushed to hospital with very high BGs could benefit from going onto insulin right away to bring the BGs down, and then being weaned off it when they begin to change their diet when they were feeling well again.

 

[Member496333]

What triggers type 1 if you are not born with it but it's an autoimmune disease?

I’m not sure anyone has the answer to that, but there’s a lot of opinion that T1, along with a host of other autoimmune conditions, is environmental and/or diet related. Whilst not the epidemic of insulin resistance, autoimmune diabetes rates are apparently also increasing, along with peanut allergies and the like. I’ve read a lot of research which points to the etiology of these conditions lying in intestinal permeability caused by grains and perhaps also seed oils. Obviously I cannot say whether or not there’s any truth to it.

 

[Cocosilk]

I’m not sure anyone has the answer to that, but there’s a lot of opinion that T1, along with a host of other autoimmune conditions, is environmental and/or diet related. Whilst not the epidemic of insulin resistance, autoimmune diabetes rates are apparently also increasing, along with peanut allergies and the like. I’ve read a lot of research which points to the etiology of these conditions lying in intestinal permeability caused by grains and perhaps also seed oils. Obviously I cannot say whether or not there’s any truth to it.

It's interesting that people are starting to reject the idea of eating beef from cows fed on grains rather than grass, and chickens, and eggs from chickens fed on grains rather than free range chickens that forage for insects and grubs. I wonder how long it will take for us to see how grains have also become a convenient food to farm humans - a very convenient way to feed the masses. It does sound like grain based carbs are one of the big evils in our diet leading to insulin resistance, which is now seen as a possible precursor for cancer as well as diabetes and a whole range of other health problems.

 

[AloeSvea]

I'll have to see what the equivalent is in Australia. In the meantime, I'm just going to assume that postnatally I will be insulin resistant, even if my BG returns to normal, and just start eating more low carb anyway. It makes sense to do that. We all know what the naughtiest carbs do to us but we like to keep our heads in the sand and enjoy them. I know I do anyway. Well, when you get an opportunity like Gestational Diabetes - a warning that 50% of us or even more are probably heading for Type 2 - we'd have to be fools to ignore that and think we should wait for a proper diagnosis and not start eating differently now.

There are just some extra challenges with pregnancy and breastfeeding and changing diet that I have yet to work out. Most people will tell me that I need extra carbs to produce a good milk supply. And it's one of those things that if you get it wrong, within a day or two, the whole breastfeeding thing can fail with baby becoming hungry and people turning to formula. So for me it's going to be about finding a balance between managing my diet for my own health, and eating the right things to be able to feed my baby efficiently. With my other babies, I was eating as many carbs as I wanted and never had problems with establishing a good milk supply, but you can't always see how much milk the baby is getting and you only find out when the baby isn't putting on weight as expected.

Why would one need extra/carbs for a good milk supply? Fat and protein all good! (Remember that extra carbs in our diet is a very recent thing in the lifespan of our species.) And breastfeeding isn't that easy to de-rail! As far as I know it's a pretty straight forward stimulus->response thing, as many other animal/mammal things are (with knowledge and skill and social support to accompany it)... And babies who are hungry have that definite way of telling us! Long before weight or dehydration issues become apparent. Thank goodness for women who have breastfed and/or are lactation experts! Which you are too already by the sounds of it

Yes, no need to head for type two - lower the carbs instead. As you say. And do tell me if your baby then goes hungry as your milk/supply was affected. But I can't see that happening! (There's no biological reason for that to happen is my understanding.) If you are eating good quality food and drinking good clean water.

 

[Veryanxious]

Ben Bikman is one of the best. There is no easy, cheap, quick way to measure Insulin Resistance, if there were it would go a long way in warning people that they should address their diet in terms of risk. There are no symptoms of early IR, whereas raised bg levels are the first signs of problems (with or without symptoms) but can be the last to manifest.

It must be said here that IR is normal in certain circumstances and that there people who show low level IR but do not go on to develope Pre Diabetes or Type 2 Diabetes. Another test that I feel would be of benefit is one that could show early signs of hyperinsulinaemia. Hyperinsulinaemia and IR is sort of a 'which came first, the chicken or the egg?' question.

If you are interested, Catherine Croft has a few interesting presentations on IR on YouTube.

I would like to add my case here. I showed all the sign of insulin resistance before my BG level went up to pre diabetes. My body was completely swelled up, had fatty liver and I was overweight. I went to two kidney specialist , 3 GPs as to why my body is swelling and I am getting severe Edema in legs Amy be like a kidney patient would get. All would write test and when it comes normal ,they say you have nothing stop coming to us. I think today doctor's are complete robots and just rely on blood test and some limit they are given to adhere to.