Type 2 Misfiring pancreas or delayed insulin produced?

@ickihun people pre bolus because synthetic insulin isn't as good as actual insulin produced by the pancreas - in a non diabetic your pancreas produces the insulin as you are digesting the food and it works all in perfect timing, because it's working as the body is supposed to, like magic. Synthetic insulin just doesn't work as quickly, it's gotta make the journey from being injected under the skin for starters, when you think that natural insulin starts off in the system already, that seems like a big difference. Then it's gotta adjust to being at body temperature. Then we just have to deal with the fact it's not natural insulin so it's not as efficient - it doesn't know all the other hormones floating around in your body and isn't adjusted accordingly.

I don't know how the timing issues fit in with insulin resistance. But I hope the above helps a bit with why assuming pre blousing means pancreases know to make insulin 40 mins before we eat might be a bit of a red herring.

@catapillar is on the mark. The body produces insulin as it reacts to changes in blood glucose levels. Most of this is used by the liver to clear blood glucose out. Some is used by glut-4 transporters in the muscles.

Insulin resistance means the body doesn't react like it should, meaning blood glucose levels remain higher and more insulin has to be produced from the pancreas to get the same effect.

Timing for "artificial" insulin has nothing to do with how the pancreas releases insulin.


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ickihun said:

I've seen posts which state they have to take their insulin sometimes 30-40mins before food to get support.
How can our pancreas naturally know that in 40mins time to expect food ingested?

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That's an entirely different thing from natural insulin production and isn't relevant. 'Outside' insulin has to make its way from the subcutaneous injection site and needs time to start working.

Insulin resistance is when there's plenty of insulin, but the cells don't respond to it as they should.

ickihun said:

I'm assuming they checked my beta cells. They didn't say but I definitely heard him say severe insulin resistance and the option of bariatric surgery.
Drastic but if my insulin resistance gets any worse I'll be giving it serious consideration.
Lchf does guarantee anything.......unfortunately, for me.
I wish lchf had been found to help some insulin resistant people decades ago. So the hard work (mistakes and pit falls) had been ironed out by now.
I'm sick of being a guinea pig for diabetes!

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I'm no med or scientist, but the function of your beta cells is separate from insulin resistance. Sometimes people with IR actually have high levels of insulin - their cells (NOT beta cells - normal body cells) just don't respond to it.

ickihun said:

I'm assuming they checked my beta cells. They didn't say but I definitely heard him say severe insulin resistance and the option of bariatric surgery.
Drastic but if my insulin resistance gets any worse I'll be giving it serious consideration.
Lchf does guarantee anything.......unfortunately, for me.
I wish lchf had been found to help some insulin resistant people decades ago. So the hard work (mistakes and pit falls) had been ironed out by now.
I'm sick of being a guinea pig for diabetes!

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Hi. To check your beta cells the GP would need to do a c-peptide test which is only done by exception. Anyone who has noticeable excess weight will have some insulin resistance due to visceral fat. Well done in getting the weight down gradually. Hope full as that continues your insulin resistance will drop and you will need less medication to control blood sugar. As you have found, a LCHF diet is the key.

I don't think they can "check your beta cells" they can check whether you are producing your own insulin with a cpeptide test though. Cpeptide is an amino acid produced as a byproduct of insulin production in the pancreas, so if you have cpeptide, you have endogenous insulin and beta cell function.

@ickihun,
In normal people, there are two insulin responses to the glucose that is gained from food and drink. In T2s, if they are producing enough insulin, the same double response is made.
These are timed to rid the blood of glucose, when there is insulin resistance, the amount of insulin produced is more than what a non diabetic uses.
The excess insulin goes to cause visceral fat and usually obesity.

However, myself not being normal, and others with or without T2, have different response times and amounts of insulin produced. Also I only have one very high insulin response, this is why I spike very quickly when I have carbs. The insulin I produce keeps going until I respond by eating again to offset the hypo.
Insulinoma and hyperinsulinaemia are caused by having too much insulin in your blood.
As usual everyone's diagnosis is different, to how our hormones respond to what we do, either eating, drinking, exercise, sleeping, et al. Even doing nothing our hormones are responding differently.
This is why, having an endocrinologist, who has experience of how our metabolism actually works, when things are weird, is so important! So he knows what to look for and what tests to use!

Self funding a Libre would shed light on how your body is dealing (delayed spikes, 1st and second insulin responses, etc).
I know it is an expense, but now that the LibreLink app is around, you can use an Android phone instead of a reader, so you would just need one sensor to start you off.

And I agree that insulin resistance is a separate thing from insulin production.

Insulin resistance happens when the body's cells are exposed to too much insulin for too long. It is a natural mechanism. Remove the problem (being constantly bathed in insulin) and insulin resistance drops. IR is not a permanent thing, and it varies depending on insulin exposure.

With me, it takes about 24 hours for insulin resistance to improve through not eating (fasting).
Exercise reduces it too, and keeps mine lowered for several hours.
Other ways to reduce insulin resistance include low carbing (cos you need less insulin) and drugs like metformin.

People with PCOS, T2 and a number of other conditions (e.g. Obesity,Reactive hypoglycaemia, etc) and some medications have raised insulin resistance, but it can still be reduced/improved. Some of us have multiple factors. Injecting insulin is another factor.

But it is still possible to lower insulin resistance through the methods I mentioned.

@ickihun , I'm probably about to be very unpopular here. You're not asking for what I'm about to say, but I do think it needs to be said. If, after reading it, you want me to, I'll remove it, and even give my personal self a stern talking to from my Mod self.

OK. Here goes.

Ickihun, over the last few weeks you seem t have gone into a bit of a tailspin, questioning absolutely everything about your diabetes, everything about your diet, metabolic markers and metabolic processes. you seem to have become pretty bewildered. This is quite a change from what I was seeing a few weeks before that.

I don't know if it's borne of frustration or something else, but whilst questions are very healthy (I would say that as the most information hungry person in informationhungryland!), but I'm not sure it's helping with your day to day management - right now.

I recently posted that you were going from pillar to post, trying one thing, then another, then another, without necessarily giving whatever you are trying a decent chance to make an impact.

It is highly likely you suffer from insulin resistance. Most T2s have it to a greater or lesser degree, and Professor Taylor has a wonderful analogy he uses which, put simplistically, T2's use of insulin is a bit like riding a bicycle, with a very loose chain. You have to peddle really very hard indeed to achieve what would likely be much easier with a tighter, non-slipping chain. That's why many T2s produce too much insulin, then get carb cravings, then store body fat, which so often accumulates around the mid section.

Please, please decide on an approach and follow it for a decent period.

A while ago there was a great thread discussing bariatric surgery, which could make a decent read when the time comes. As I said on there, it's certainly not an easy option, and even more importantly not a sure fire success story. Around that time, I came across a .pdf of potential complications; in the immediate aftermath, medium and longer terms, which made sobering reading. Completely coincidentally, I found it again this morning when looking for something totally unrelated to diabetes (must do something about my laptop filing system). Think hard before seriously considering that route.

As I say, if you would prefer I delete this post I will gladly do so, but please to try to stop beating yourself up over whatever it is that's getting to you right now. You invest so heavily in your diabetes, you deserve outcomes more in line with your goals.

ickihun said:

I'm sick of being a guinea pig !

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What's wrong with being a guinea pig? The ginger one on Donald Trump's head is doing OK!
(sorry, thought a humourous reply might cheer you up!)

Ickihun,
These things do take time. I always say one bad meal equals three bad days. It doesn't even have to be bad food, just a high reading. For example, the 4 th of July the party I was at was serving delishous large BBQ chicken legs. I removed the skin and sauce and ate 5! 4 more than I normally would but they were so good. Bs went up of course and it still took 3 full days to get back to normal. FROM CHICKEN! Maddening. I tried everything. No carbs, no protein, just fat, fasting etc and nothing helped except TIME.
When I first started insulin it took weeks for bs to come down and then more weeks for it to stay down and then months for me to find the meals that worked.
If you are considering something as drastic as GB why don't you consider drastically changing your diet first? I can tell you that foods that make me insulin resistant. Anything with any grains and all dairy, I get so jealous of people eating these low carb toasts and breads but when I look at the ingredients I know I would require much larger doses of insulin. Dairy as well. It is considered very insulinogenic and proves so to me. Limiting protein to no more than 3 oz per meal. Protein is also insulinogenic. It won't raise bs as fast and maybe not as high but still requires insulin. Corn, too many nuts. I figured a lot of this out when I became type 1 as I now know how much insulin is required but when I was type 2 my body just did it and I didn't know how much it out out or when. Now I know more.
Start with smaller meals, ditch the insulinogenic foods, lower protein and eat healthy plant fats for now. Avocado, olive oil, olives, mayo nuts and seeds. Saturated fat is said to be the hardest to burn both as fuel and off the body. If you have fat on the body you will burn that if you don't have enough dietary fat so you don't need to gob it. LC, moderate protein and JUST ENOUGH FAT TO SATISFY? It may take a few days for your body to adjust but it has to be better than surgery.

@ickihun You might find making a meal plan would help - both for your own diet and planning family meals and shopping. There are some great free ones online. All you do is print them off and fill in your meals. You can then see what shopping you need, and not having to think about what to cook makes it easier, and means you're less likely to give in to poor choices.

If I was you, I'd also try to find people on the forum with similar issues to yourself and see what they eat. You may not find someone with exactly the same medical conditions as you, but hopefully you'll find someone close enough.

Whatever diet you choose, just do it steadily day after day, week after week. Most diets need time to work so you have to stick at them consistently and for some time.

& do your grocery shopping online - much easier to resist going "off list" if you can't see other temptations and it's easier to scrutinise the labels when shopping online (I find it's helpful for budgeting too)

catapillar said:

& do your grocery shopping online - much easier to resist going "off list" if you can't see other temptations and it's easier to scrutinise the labels when shopping online (I find it's helpful for budgeting too)

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I am not sure where ickihun lives but I know that there are a huge number of people who live where grocery shopping online is not possible, including me. It is a great idea, if it's possible.