Re: Difference in Insulin Resistance and Type 2 ?

[Guest guest]

In a message dated 11/7/04 10:05:19 PM Central Standard Time,

dbi_mod@... writes:

> Most (not all) T2's have Insulin Resistance. The Insulin Resistance

> precedes their Diabetes, and continues after diagnosis. The Insulin

> Resistance is the what causes the pancreas to need to put out more insulin.

> Once it can no longer put out enough and blood sugar starts going high, T2

> Diabetes has developed. From that point on, the blood sugar needs to be

> " managed " in some fashion, diet & exercise, oral meds, insulin, etc. The

> Insulin Resistance that was there before hand still exists, but can get

> better or worse, depending on the person and depending on the success of

> their Diabetes management.

>

>

Rick, I'm sorry, I know you're explaining it -- I'm just not getting it. In

both insulin resistance and diabetes, the blood sugar is high? I understand

IR is pre-diabetic or pre-Type2, but what I'm not understanding is that the

other poster said she/he is not diabetic but is insulin resistant. I'm trying

to

understand how one can determine the difference. I hate to be a bore, but

I'd really like to understand.

[Guest guest]

In a message dated 11/8/04 1:24:28 AM Central Standard Time,

dbi_mod@... writes:

> The medical community is

> convinced that there are vast numbers of undiagnosed people walking around

> with T2 diabetes, completely unaware. The same goes for non-diabetic

> insulin resistance.

>

> Hope this helps. )

>

> Rick

>

By gosh, I finally get it ! LOL You really had to spell it out there (I

promise I'm not normally that dense), and I really appreciate you persisting -

with patience and good humor intact - till the light bulb finally came on in the

ole cranium !

[Guest guest]

At 11:12 PM 11/7/2004, you wrote:

>In a message dated 11/7/04 10:05:19 PM Central Standard Time,

>dbi_mod@... writes:

>

>

> > Most (not all) T2's have Insulin Resistance. The Insulin Resistance

> > precedes their Diabetes, and continues after diagnosis. The Insulin

> > Resistance is the what causes the pancreas to need to put out more

> insulin.

> > Once it can no longer put out enough and blood sugar starts going high, T2

> > Diabetes has developed. From that point on, the blood sugar needs to be

> > " managed " in some fashion, diet & exercise, oral meds, insulin, etc. The

> > Insulin Resistance that was there before hand still exists, but can get

> > better or worse, depending on the person and depending on the success of

> > their Diabetes management.

> >

> >

>Rick, I'm sorry, I know you're explaining it -- I'm just not getting it. In

>both insulin resistance and diabetes, the blood sugar is high? I understand

>IR is pre-diabetic or pre-Type2, but what I'm not understanding is that the

>other poster said she/he is not diabetic but is insulin resistant. I'm

>trying to

>understand how one can determine the difference. I hate to be a bore, but

>I'd really like to understand.

>

Hi ,

You're not a bore!

With pre-diabetic IR, the BGs may or may not be elevated. Here are two

scenarios:

1) A person with IR, but completely " normal " BG numbers. This person is

resistant to the effects of insulin. Since insulin is the " key " that

unlocks the door to let glucose into the cell, this person needs more

insulin than the non-diabetic person to maintain " normal " glucose levels.

For a while, this person's pancreas is quite able to meet the demand for

more insulin. If this person were to get the proper test at this stage,

there would be evidence of hyperinsulemia (excess insulin) in their blood

stream. The glucose tests at this stage would most likely show normal numbers.

2) A person with IR, but high glucose numbers. This is a person who's

pancreas valiantly met the demands for excess insulin for so long, that it

wore out and is no longer able to meet the demand for enough insulin. This

is where we get into the stage1/stage 2 area. Usually, the stage 1 insulin

release is the 1st to go. As I mentioned previously, the stage 1 release is

a larger dose to meet the immediate needs presented by a meal. Following a

leal, there is usually a large amount of glucose at first, with a smaller

but steady level later as the meal is fully digested. Phase 1 insulin

release meets the initial glucose challenge from the meal. As the glucose

levels diminish, the pancreas goes to phase 2 and secretes smaller amounts

of insulin, slowly over a period of time, till the glucose is normalized. A

person missing the phase 1 response will typically see high glucose numbers

following a meal, but eventually, the phase 2 release will be able to

normal the glucose level. Post-Prandial, or after meal glucose tests will

be high, but later tests, including fasting, may be normal. At this stage,

a person is usually said to have IGT or impaired glucose tolerance. The

high numbers following the meal (in IGT) don't reach the level of

" diabetic " at first. This period may continue for some time. Also, let me

say that the phase 1 doesn't just die in one day - it diminishes over time.

Eventually phase 1 is shot and phase 2 begins to falter. Usually by this

point, a person's glucose numbers have begun to rise to the " diabetic "

level. Post-Prandial levels are high, fasting levels are high, and an IR

person have made the transition from an IR non-diabetic person to an IR

diabetic person. This is the usual progression for T2 diabetes. The

underlying causes may differ from person to person, but the stages are

pretty consistent.

A word at this point - the person who is IR, but still has good fasting

numbers may show an elevated HbA1c test. This is due to the post-prandial

(after meal) excursions, or temporary elevations of the blood glucose

level. Some (many?) IR, non-diabetic individuals are diagnosed this way.

Their HbA1c test is elevated, but not yet to the point of being classed as

" diabetic " . The vast majority of people who develop T2 Diabetes pass

through these stages unaware of anything happening. Often, it isn't until

they start to have complications and go to the Doctor to find out what's

up, that they find out that they have T2 Diabetes. The medical community is

convinced that there are vast numbers of undiagnosed people walking around

with T2 diabetes, completely unaware. The same goes for non-diabetic

insulin resistance.

Hope this helps. )

Rick

[Guest guest]

In a message dated 11/8/04 12:13:14 AM Eastern Standard Time,

1185n@... writes:

>

>Rick, I'm sorry, I know you're explaining it -- I'm just not getting it. In

>both insulin resistance and diabetes, the blood sugar is high? I understand

>IR is pre-diabetic or pre-Type2, but what I'm not understanding is that the

>other poster said she/he is not diabetic but is insulin resistant. I'm

trying to

>understand how one can determine the difference. I hate to be a bore, but

>I'd really like to understand.

>>>>>>>>>>>>>>>

Questions are great - and if you have them, I bet someone else does too.

Some people are insulin resistant but have a pancreas that is able to keep up

with the increased demand for insulin so they never develop diabetes. It is

surmised that most overweight people have some insulin resistance, but most of

them do not go on to develop diabetes.

In order to trip over into diabetes, the pancreas has to stop being able to

keep up with the increased demand. There are mostly genetic factors at work

now - pancreas failure and insulin resistance are both genetic issues, though

it's more complicated than just being 2 genes that don't work right.

Stacey

[Guest guest]

In a message dated 11/8/04 8:20:52 AM Central Standard Time,

staceypmartin@... writes:

> Some people are insulin resistant but have a pancreas that is able to keep

> up

> with the increased demand for insulin so they never develop diabetes. It is

>

> surmised that most overweight people have some insulin resistance, but most

> of

> them do not go on to develop diabetes.

>

> In order to trip over into diabetes, the pancreas has to stop being able to

> keep up with the increased demand.

Thanks, Stacey. So now I'm wondering if this is where the C-Peptide test

that I heard about on this list would come in - would that be the medical test

that would determine if your insulin resistance has not yet tripped into

diabetes if it shows your pancreas is still producing plenty of insulin and yet

being overweight is not allowing the insulin to properly get into the cells?

[Guest guest]

In a message dated 11/8/04 1:58:46 PM Eastern Standard Time,

1185n@... writes:

>

> So now I'm wondering if this is where the C-Peptide test

>that I heard about on this list would come in - would that be the medical

test

>that would determine if your insulin resistance has not yet tripped into

>diabetes if it shows your pancreas is still producing plenty of insulin and

yet

>being overweight is not allowing the insulin to properly get into the cells?

>>>>>>>>>.

Mostly right. The c-peptide measures how much insulin you are producing.

Normally, for the couple of days prior to the test, one would eat as a normal

would eat, i.e. a higher carb diet than most of us eat. The lower the

c-peptide, the less insulin you are producing, the higher the c-peptide, the

more

insulin you are produding. It is, in a sense, a measure of insulin resistance

since if you are producing a lot of insulin, it's usual that you are not using

it

properly.

It isn't being overweight that doesn't allow the insulin to work, it's the

insulin resistance that doesn't allow the insulin to work. Being overweight is,

for most diabetics, a contributor to insulin resistance, and for some,

especially if the diabetes is caught early, weight loss might help lower insulin

resistance, but that isn't always the case. So, while many, most type 2s are

overweight at diagnosis, there are thinner type 2s, and there are type 2s who

lose weight but are still insulin resistant.

The combination of insulin resistance and pancreas insufficiency is very

complicated, and the cells, once insulin resistance, don't lose that easily, if

ever.

There is also insulin resistance caused by other factors - steroid use for

one.

Stacey

[Guest guest]

At 01:59 AM 11/8/2004, you wrote:

>In a message dated 11/8/04 1:24:28 AM Central Standard Time,

>dbi_mod@... writes:

>

>

> > The medical community is

> > convinced that there are vast numbers of undiagnosed people walking around

> > with T2 diabetes, completely unaware. The same goes for non-diabetic

> > insulin resistance.

> >

> > Hope this helps. )

> >

> > Rick

> >

>

>By gosh, I finally get it ! LOL You really had to spell it out there (I

>promise I'm not normally that dense), and I really appreciate you

>persisting -

>with patience and good humor intact - till the light bulb finally came on

>in the

>ole cranium !

>

No Problem ! Glad it helped!

Rick