Insulin Resistance Question - Page 2

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Insulin Resistance Question - Page 2


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Old 07-16-2014, 13:37   #11
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I fervently agree with John. There is no cure for diabetes - not type 1, not type 1.5, not type 2 or any other variation. And on this forum, promoting a cure is STRONGLY discouraged - 'strongly' as in people have been banned for it. Whatever 'cures' are described, they can hardly be true if all one need do to wreck said result is go back to eating carbs.

Regardless of type, diabetes is the inability to get enough insulin into the cells to nourish them, whether because the pancreas cannot produce insulin, or because the cells are prevented from accessing the insulin in the bloodstream, and both of these issues are present in many patients. Avoiding ingestion of carbohydrate helps all types, along with whatever other meds/methods are combined with the dietary adjustments.

Since weight gain can increase insulin resistance, it follows that weight loss may reduce it. But weight loss does not cure diabetes and neither does anything else. And using increasing doses of insulin does not overcome IR either. What helps IR is metformin, and it helps without forcing the pancreas to increase its output. Metformin helps in two ways: by unlocking the cells so they can access the available insulin, and it coaxes the liver to slow down the glucose delivery.
That's exactly what my doctor told me the day he told me I was a diabetic. No cure, but it's manageable. Of course, I was under the impression all I had to do was lose weight. This has been and still is an amazing educational journey these last 3 plus months since my DX.

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Old 07-16-2014, 13:42   #12
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I can't help you with a technical description of the concept of Insulin Resistance but on the use of the word 'cure' I entirely agree that for now, no cure exists.

Dropping weight using starvation diets or surgery will generally produce a reduction in symptoms but only because as a consequence of the procedure the carbohydrate intake has been reduced substantially.

As soon as the patient goes back to his old habits - back comes the high blood sugar. None of the reports I've seen of these techniques appear to be able to show evidence of sustained improvement, usually the follow up period is a few weeks only.
Thanks John !.
I agree with you that it may relapse if one goes back to old habits.

There is one more thing into play here and that is the supply of insulin through beta cells.

Supply of insulin decreases if high IR continues for long time. And that one is irreversible.

So even if you make your IR better, you cannot recover entirely because of the lowered insulin supply.

That's why probably pre diabetics have a better chance at it.

I think IR i pretty dynamic thing and I also read that its used by body for its own purpose. During period of starvation body increases IR so that only brain gets supply of glucose. For ex. In morning we have high IR and little carbs increase bg more than any other time of the day.

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Old 07-16-2014, 14:10   #13
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Also want to add that IR is a protection mechanism of cells.
It protects the cell from glucose toxicity. So for example if a cell already has glucose it doesn't want any more, it raise its IR.
Isn't our body cool. It ceases to be cool when we get T1 or T2.

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Old 07-16-2014, 14:25   #14
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And just so we're all on the same page - this being a support forum for people with diabetes, after all - we should be considered to usually be discussing these things from the viewpoint of diabetics - not that of the non-diabetic general populace, and we need to make very clear when we start referencing.

Most of what you find online & elsewhere is going to be talking either about the general non-diabetic public, or if they actually do reference diabetics, those will be out-of-control diabetics . . . not people like us who take our control very seriously. MSM has no clue about managing diabetes.




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Old 07-16-2014, 14:45   #15
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Also want to add that IR is a protection mechanism of cells.
It protects the cell from glucose toxicity. So for example if a cell already has glucose it doesn't want any more, it raise its IR.
Isn't our body cool. It ceases to be cool when we get T1 or T2.
Indeed - that is very cool. Now if they can just find out a simple way to get those recalcitrant insulin resistive cells to work at the right time that would be great. :-)

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Old 07-16-2014, 14:51   #16
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I skirt the whole issue. I'm in ketosis so my body is using ketones from fats for fuel. Don't really need any carbs for that.

So while I still have IR - it's irrelevant.

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Old 07-16-2014, 15:03   #17
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I agree with you that it may relapse if one goes back to old habits.
Now this may seem picky but 'relapse' comes from the same school as 'cure'. What we have when the individual reverts to his old habits is a loss of control not a relapse.

My concern is that new diabetics see posts on this forum and will grasp at any straw that appears to offer them a quick path to non diabetic status. I don't think it's fair to leave even an illusion of that possibility.

There is no quick path. We need to maintain a constant attention to our way of eating if we are to retain control. That done, diabetes becomes a minor inconvenience. Without that attention, diabetes is a disaster waiting to happen.

OK - now I'll get back off the hobby horse!

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Old 07-16-2014, 16:04   #18
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I agree. This is all so complex.
We know certain things work.
Taking good care by diet and excercising works.
Other things we are not so sure.

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Old 07-16-2014, 16:09   #19
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Skb,
So what exactly is IR? How does it develop ?
To understand IR better, letís first look at the action of Insulin, or at least actions that have been studied and understood till now. Insulin primarily (1) delivers glucose to the muscle tissue to be converted to ATP and used as energy (2) encourages the conversion and storage of glucose into glycogen by the liver and discourages its release back into the blood as glucose. (3) pushes glucose into adipose (fat) cells to be stored as fat (that is how weight is gained) AND blocks its release and use as energy.

Now, with IR the above three roles of Insulin get blocked and the resulting consequences would be something like this.
1. If insulin resistance is strictly of the muscle tissues, insulin and sugar will both rise. Since the liver is still responding normally to insulin, glycogen stores will be filled from the ample glucose in the blood based on the "signal" of the also elevated insulin in the blood. When the muscles - which are starving not because the glucose isn't circulating right in front of them but because they cannot utilize it - signal that they are starving and need glucose, the liver (still responsive) can respond with additional glucose from its ample glycogen stores. This further elevates blood sugar, especially after long periods of fasting and at dawn. Exercise would play a critical role in controlling blood sugar & circulating insulin levels as it would strike at the core problem.

2. Hepatic (liver) IR will lead to the over production of glucose by the liver. Recent studies indicate that this seems to be the larger problem with Type 2 diabetics, as the pancreas is still able to generate some Insulin. Because of IR, the liver doesn't get the signal from the pancreas to stop glucose production. For the type 2 diabetics, the liver dumps far too much glucose into the blood stream than for a non-diabetic both in the post-meal and in the fasted state. And in either 1 or 2 if the fat tissue is still responding normally to insulin, weight gain which is very "stubborn" and difficult to reverse - is the obvious result.

3. Scenario 3 is true for mostly leaner people with metabolic disorders. In diabetics mostly Types 1 or LADA suffer from this kind of IR. These types of people would suffer from elevated glucose but not lose or gain weight easily. In either of scenarios 2 & 3 exercise will not help much unless the timing & type of exercise has been carefully thought out.

It is highly unlikely that IR will strike in either of the scenarios in isolation. In all likelihood it manifests as a combination of two or all three of the above.

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Old 07-16-2014, 16:13   #20
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Also want to add that IR is a protection mechanism of cells.
It protects the cell from glucose toxicity. So for example if a cell already has glucose it doesn't want any more, it raise its IR.
Isn't our body cool. It ceases to be cool when we get T1 or T2.
That's true in the initial stages when IR develops. Later the cascading process of IR gets out of hand and becomes a problem on its own.

The posts here suggested a link between obesity & IR. Partly true, but leptin and/or insulin are both associated with weight gain & obesity, rather than just the insulin alone.

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