Insulin Resistance v Insulin Deficiency

OR 'Double Diabetes' when you are BOTH resistant AND deficient(Type 1 and type 2 running concurrently)...must be difficult indeed and luckily I am insulin sensitive so I can correct on a low dose.

Hi. I can give my own understanding much of it derived from this forum over the years. Insulin resistance occurs when the body deposits excess fat around the body and in a way that interferes with the way muscles and other organs take up insulin i.e. the body may have plenty of insulin around but can't use it effectively. The excess fat deposits typically result from excess carb intake which the liver converts to fat. Insulin deficiency occurs when the islet cells in the pancreas don't produce enough insulin. There are many causes of this including anti-bodies as in Type 1 which destroy the cells, viral attack, pancreatitis, Gestation and other hormonal problems that switch the islet cells off. Insulin Resistance is best managed initially by reducing carb intake which will stop fat deposits and with weight reduction it will reduce the fat deposits. Taking Metformin will help with this. The end result should be better take up of insulin. Islet (beta) cell failure often can't be fixed. Drugs such as Gliclazide can sometimes force more from the cells for a while but eventually insulin injections are needed. Stitagliptin, a DPP-4 inhibitor, can sometimes extend islet cell action after meal thru suppression of an enzyme. I'm generalising in the above and there are other drugs and regimes. Any criticisms welcome!

I agree with Daibell.

I'm Insulin deficient at the moment. I am autoimmune and have GAD antibodies which have attacked and killed off a number of my beta cells meaning I can produce some insulin but not enough to manage a 'normal' or non-diabetic lifestyle.

At the moment I have enough cells to manage with a low GI diet and metformin because any insulin produced is given a helping hand by the metformin and low GI foods break down slowly giving my poor remaining cells more time to break down and use the glucose I eat.

Eventually, though no one knows when, the antibodies will kill too many cells for me to be able to rely on this alone and I will then have to inject insulin to break down and use the glucose instead.

Insulin deficiency is awful as you never know when the ticking time bomb of insulin dependency is going to hit you, it's almost like you are living in limbo land and the HCPs are reluctant to actually categorise you as anything due to the lack of insulin dependence (type 1) and the lack of excess weight/insulin resistance (type 2).

The only reprieve is not having to inject or carb count for a little while.... Though the impending doom of it kind of takes the shine off that!




Diagnosed with GD in 2010, Completely disappeared postpartum. Re-diagnosed December 2012 with type 1.5 diabetes, age 26, BMI 22 currently controlled by only Metformin, 500mg twice a day.

I'm not entirely sure I can be of any help with sharing information on these, but i can definitely share my experiences of them.

I've had T1 since I was 11 (now 31). I developed polycystic ovarian syndrome in my early teen years and that showed itself in a number of unpleasant ways. I do not fully understand the intricacies of the condition, but then I'm not sure the scientists do either. But I do know that it is related to insulin levels, insulin resistance and it makes it tricky to lose weight, especially around your middle. My case is also complicated by other health conditions including clinical depression, anxiety & an eating disorder which have meant I cannot work long-term and find it difficult to manage my diabetes anyway.

Gradually over the years because of my increasing insulin resistance my insulin requirements have gone up and up until I was taking 80u of long-acting insulin every day and 2u of fast-acting insulin for every 10g of carbs I ate. I thought that was 'normal' until I started getting more involved in my treatment and did some research online.

A year ago my consultant suggested I try going on Victoza to see if that could help. I have lost around 2 stone and am now down to a size 14. My insulin doses are now 58u a day for my Lantus and only 1u of fast-acting per 10g of carbs. It's not a vast improvement but it all helps. And the more weight I lose the more I should be able to reduce my insulin levels. Additionally, being a member of the board here means I've questioned the 'advice' of the NHS regarding diet and have reduced the amount of carbs I eat and this is really helping. Not feeling the NEED to have a substantial portion of carbs in every meal has been an eye-opener!

Insulin Resistance is a condition in which the insulin in the body become inactive when lowering the blood sugars. This may be occur due to the extra weight in the waist and the lack of actions such as movements etc

Insulin deficiency is the abnormal metabolism of carbohydrates due to the insufficient production of insulin

I have never been tested to find out which I am - resistant or deficient.

I was told that there was little point because the treatment in both cases is the same.

I wonder how many T2s have been tested for insulin levels?

Cheers

LGC

I think there is absolutely a point and it angers me that the HCPs think differently. Not only is it important for the individual to know whether they have an autoimmune disease or not but it is also important for research and development reasons!

How can statistics be spouted about diabetes type 2 being on the rise when they dont know whether the people diagnosed actually are type 2??

It should be standard practice in my opinion to run full bloods on ANY diagnosed diabetic to find out exactly what type they are...

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paul-1976 said:

OR 'Double Diabetes' when you are BOTH resistant AND deficient(Type 1 and type 2 running concurrently)...must be difficult indeed and luckily I am insulin sensitive so I can correct on a low dose.

Click to expand...

You've pretty much summed up how I see it too.

So glad I exercise/keep myself active enough to keep my sensitivity levels stable.

I agree with Elaine as the national stats must be invalid with the current approach of labelling 'everyone' as a T2 unless they end up in A&E with DKA. This affects research and many other things. Once labelled a T2 you tend to be treated automatically as insulin resistant with the focus on Metformin rather than adding other drugs and, as in my case, insulin was refused until my blood sugar rose very high.

Speaking to my consultant last week he is now thinking that instead of being extremely insulin resistant I might actually be allergic to it. I do have other severe allergies penicillin, nuts, strawberries, shellfish and certain anesthetics and he seems to think that my immune system is destroying a lot of what I'm injecting. Evidently this was reasonably common with the old bovine insulins but has anyone experienced it with modern ones? (I use Insulatard and HumulinS)

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Hi

This might be helpful to you http://www.faqs.org/faqs/diabetes/faq/p ... on-24.html

Thanks iHs, I will print that out and take it to my DNS tomorrow. Luckily she is very open to discussions and believes every diabetic is unique.

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