Insulin resistence

Interesting. My body does not produce enough insulin. Whether that is through genetics or autoimmune destruction of beta cells is the answer I am looking for, but that is another story. Here is my point/question. Does everyone with Type 2 diabetes start from a position of lack of insulin production in the first instance because of some genetic malfunction? Which seems to fly in the face of over production of insulin to counter the effects of insulin (in)sensitivity and insulin resistance. What comes first insulin resistance or lack of insulin production ? Lack of insulin production because of genetics will result in higher and unhealthy blood sugars floating around in the blood stream which results in greater insulin resistance. The body then has to produce even more insulin to counter the increasing insulin resistance which in turn will eventually lead to stressed out Beta cells and their eventual demise. The difference is, in my view, Type 2 can recover to a certain degree because beta cell production can resume once blood sugars are at a healthy level. If all this goes hand in hand with a big reduction in carb consumption and exercise to burn off the excess blood sugars and weight reduction (Body fat adds to insulin insensitivity) which allows the beta cells to recover. Then remission will occur . A huge over simplification but am I right or have I gone off the road? If I am right, would that be the reason for your blood sugar reduction even though you are not medicating with insulin raising drugs?

ajbod said:

Lack of Insulin production would be a different flavour of diabetes, unless diabetic drugs or the over working of the Pancreas due to increased demand.
By reducing carb intake, we are lowering the demand for Insulin production, aiding reduction in Insulin resistance, therefore again lowering the requirement for Insulin. This would allow recovery of the Beta cells if they are not too far gone. Our Pancreas can again keep up with demand, and the odd splurge is easily catered for thanks to some recovery.
The main aim as type 2, is to lower the Insulin level, lowering circulating blood sugars is the device we use.

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I know and I'm dancing on a pin head here, but bear with me, the lack of insulin production will go back decades long before anything has really began to go pear shaped. The effects of lack of insulin production have already begun: unhealthy levels of blood sugar are becoming more apparent ; body unable to burn the excess sugar off or use it; so it shoves it first around the organs, then around the body as fat. Insulin resistance begins and starts to take effect escalating the process. This causes even higher blood sugars creating a toxic environment for beta cells; those beta cells are having to create more insulin to cope with the excess sugar. Eventually the beta cells are worn out and start to perish due to the toxic egffects of too much sugar and the fact they simply wear out. By the time all this has taken place, T2DM is at full sail, meds are being taken, weight gain, lack of exercise, and over time beta cells are dying, artificial insulin is being taken. Going on a low carb diet and resulting in weight loss means a lowering of insulin needs which allows the beta cells to recover and a reduction in insulin resistance. The low card and weight reduction stops all this and the body will eventuall go into homestasis with ensuing diabetic remission as you are now balancing your own insulin production due to a significant lifestyle change more fitting for the level of insulin your own body is producing. That's my theory. It also may suggest why thin people can have 2DM too. I know i'm out there with this and I totally get your point, lack of insulin productiuon may be subgroup, but it could also suggest why the process can already start way back before weight gain due to high blood sugars (Pre-diabetes).

ajbod said:

The problem with that scenario, is that Insulin is required to shove the Glucose into fat storage. Therefore Insulin resistance must have been there prior to any drop off of production. For the Beta cells to die off, either they are immuno compromised, or simply flogged to death.
Insulin production had to be excessive, trying to cope with the raised blood sugars, to cause the wearing out of the Beta cells. There must be some improvement in Insulin production, as witnessed by many of us, who consuming something we ordinarily would avoid, are often surprised how well our systems coped with it. But we all know this is essentially a one off, and repeating will rapidly go down hill.

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I have been pondering which comes first, but I do acknowledge your point and when you google low insulin production it either leads to type 1 or type 2 which as you say always leads back to the primary problem - insulin resistance - so you are in good company. There are so many unanswered questions. And @annalou1971 is asking a valid question so just trying to get my head around that. My own C-peptides are lowish, I don't have insulin resistance and my own body is very sensitive to insulin. It got me wondering about others' low insulin production, if it's not related to a metabolic disorder. Just coming from it from a different angle. Thanks for your reply @ajbod.