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Insulin Resistance and Insulin Production

LittleGreyCat

Well-Known Member
Retired Moderator
Messages
4,386
Location
Suffolk, UK
Type of diabetes
Type 2
Treatment type
Tablets (oral)
Dislikes
Diet drinks - the artificial sweeteners taste vile.
Having to forswear foods I have loved all my life.
Trying to find low carb meals when eating out.
@bulkbiker @Jim Lahey

Insulin Resistance is generally held to be when you are producing insulin but your BG is above normal levels.

One typical example is an overweight/obese T2 with very high insulin levels but also very high BG levels.

However this is not the only scenario. As long as your pancreas isn't producing enough insulin to keep your BG within normal levels you can have a combination of IR and insulin production across a very wide range.



As you can see from these results my fasting BG is a bit high but I am still producing (lower) normal amounts of insulin.

The test was in December 2017 almost 10 years after first diagnosis so this is unlikely to be a honeymoon period for a T1.

I'm not sure what is causing the IR apart from a sad tendency to retain fat around my middle.
 
Sure thing. No argument from me. But...the insulin deficiency is preceded by insulin overproduction. The etiology of T2DM is excessive circulating insulin, not too little. However, when the liver runs out of places to store the fat, both in itself and in subcutaneous adipose tissue, it begins packing it into the pancreas, which is when the deficiency begins. The point at which this crossover occurs is obviously a variable.

Good idea for a topic by the way!
 
Interesting this as recently had tset to see which type I am and it came back as type2 with too much natural insulin so have had to lower injected amounts and wow it feels weird to deliberatly let bgs go high but that is what the endo wants ,will be interesting to see what next weeks hba1c comes back as
 
Did the endo discuss diet with you as well to check that you were having a low-carb diet to help get any insulin resistance down?
 
What always gets me is how curious a pathology this condition is at the end of the day. It is so multi-faceted and is precluded by so much metabolic derangement that there is a near infinite way to manage or mitigate the disease. There is always going to be oddness with how the body works, sometimes it can be that the pancreas has halted production in some way or that it is just the fact that the body itself has ran out of stores and cannot deal with the production. I doubt that there will ever be a definitive answer to any of this however, there are so many subtypes now that it boggles the mind but I always say it is best to find a way of managing that works for you and keep going with it. IR is always going to be the culprit behind a LOT of this but how we live afterwards is going to have the biggest impact.
 

I'm fascinated that you think you are underproducing insulin..Mine has been measured 3 times and I've had results of

3.41mIU/l August 2017
7.85 mIU/L October 2017
5.47 mIU/L October 2018

the range I get for "normal" is 2.6-24.9 so why do you think you are underproducing?
I'd say you'd have to be sub 2.5 mIU/l to be an "underproducer"?
 

Sure, but the glucose level in the same test is elevated, while the pancreas doesn’t seem able to release a suitable concentration of compensatory insulin in order to return the blood to homeostasis. I agree that in this instance the pancreas cannot keep up. But that almost certainly was not the case previously unless there is/was also an autoimmune element brewing up.
 
It is the insulin resistance causing high levels of both blood glucose and insulin - I have got down to normal levels of blood glucose, and I am back to being able to put on weight just by taking a deep breath walking past a baker's door.
I am pretty certain that my insulin resistance has gone down, so the insulin shoves the glucose into my cells for storage - just as has been my normal for decades.
 

Fatty liver - the various hormones (not just insulin) that trigger the liver to stop dumping can't access the liver, so it continues to dump?
 
Bluetit1802 said:
Fatty liver - the various hormones (not just insulin) that trigger the liver to stop dumping can't access the liver, so it continues to dump?
Click to expand...

Again, sure, but in this instance you would expect the insulin concentration to be much higher in an attempt to bring down the glucose level, irrespective of what the liver is doing to raise it. The key here is in the image posted in the OP. Fasting glucose is out of range but the pancreas appears to be doing very little in response.
 
I would add, by the way, that given that the pancreas in question is producing insulin, this condition as it’s seen in the OP can be remedied fairly easily by burning off the hepatic and pancreatic fat. My guess is that this pancreas can recover most of its original capacity to produce and secrete insulin. Additionally the reduction in hepatic fat should return the liver to normality and stop it pumping out glucose for a laugh.
 

You lost me at the "fairly easily".

I assume that I would need at least an ultrasound scan to confirm fatty liver and fatty pancreas.
Without that this is just an assumption which may not be correct.

What other indications would you expect for a fatty liver?

I have been in ketosis for much of the last couple of years so I don't think that I am packing fat from carbohydrates into the liver.
 

In my case, my fatty liver completely resolved in a couple of weeks of changing my diet to LCHF. Hopefully, the pancreas is following as well.
 
"...for a laugh." lol For whoops and giggles.
 

Well fairly easily is relative I guess. Depends how much fat we’re talking about. It can take a while but admittedly two years of genuine ketosis should put a dent in it. Intermittent fasting will help.

Main indication of fatty liver is it deflating when the pressure of insulin is lowered and it starts letting all the sugar back out, manifesting as dawn phenomenon.
 
Bluetit1802 said:
Have you had tests to show this? How do you know for sure?
Click to expand...
Most of us don't have the benefit of proper tests for fatty liver, so have to go on the liver function tests that we have and our doctor's opinion. My LFTs were markedly improved within 3 weeks of reducing carbs.
 
Interestingly my liver function was, and has remained, normal since I came off seroxat. The seroxat made my live function bad, and I piled on weight. It took me 18 horrifying months of side effects to gradually wean myself of the tablet. I have not put on weight since. This was before I was diagnosed as type 2, as I strongly suspect the seroxat was a major contributor in my pre-diabetes (which I didnt know about at the time). Then along came the Eatwell plate and the rest is history. 15 years (in total) of mismanagement, and 7 years from when I discovered this place and got things under control again.

Not sure if this helps the discussion......................but it shows me how important my liver function was and is. My liver function was fine with the Eatwell plate, but my kidney function..............nope. That is all resolved too now : )

I cant work out, however, why the nasal steroids I now take seem to elevate my blood sugar levels, when it is not supposed to, according to the leaflet.
 
zand said:
Most of us don't have the benefit of proper tests for fatty liver, so have to go on the liver function tests that we have and our doctor's opinion. My LFTs were markedly improved within 3 weeks of reducing carbs.
Click to expand...

I am fully aware of the fact we don't routinely have scans for fatty livers, which was why I was asking @Caprock94 how he knew his fatty liver has resolved in a couple of weeks. The liver function tests we have can be markers for a fatty liver, but this not the whole story. If it were, then I would never have had a fatty liver as far back as my records on-line go (2007, diagnosed T2 in 2014). I was interested to know which criteria he used to be able to say what he did.
 

Indeed, to my knowledge you can return normal liver function tests whilst having significant fat content in the liver. This misunderstanding is probably why many with insulin resistance claim that they do not have fatty liver.
 
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