Thanks @T2Tom. It’s interesting the different theories out there regarding how the test should be performed.
Thanks for starting this topic. It has been very interesting to read.
Thank you so very much for all your information.
Prior to my diabetes diagnosis, during annual exams, routine basic or complete metabolic panels were done. Then, suddenly one year, my glucose level came back in the 200’s. I was not told this but was called in to have another blood test. An A1C had been ordered by the doc and it came back 10.2. Upon this result, the doc called me in for a follow-up visit and informed me I had diabetes. Instant denial on my part hearing the news. At that time I didn’t have a clue as to what an A1C test was nor what normal numbers were for blood glucose levels. I was handed a prescription for Metformin and told to come back in a month to meet with a diabetes educator to discuss how to manage living with diabetes.
I found an endocrinologist and did some research and have always assumed I was type 2. No one has ever mentioned “type” or tested me for type. Having many of the signs of metabolic syndrome, I was told that I had insulin resistance.
When additional oral meds were not controlling my diabetes, I asked to go on insulin, but asked, . . . “If I am insulin resistant, then how will injecting insulin help?” Wouldn’t my body resist allowing injected insulin into the cells just like the insulin my body produces?
The response was flooding the body with insulin forces some into the cells. My insulin requirements have more than doubled over the past 2 years and my control continues to lessen.
My cholesterol and triglyceride levels were greatly improved several years ago and have remained within normal ranges for many years. My blood pressure has been controlled for years with medication.
How do I get my body to accept insulin within the cells? I still take the maximum dosage of Metformin ER daily in addition to both basal and bolus insulin. We tried to reduce the amount of Metformin and my numbers got worse so we went back to max dosage.
Again, I’m not a medical doctor, but it definitely does sound like insulin resistance is a serious issue for you. You might already be doing everything you can do, but here is what my research indicates:
- Supplements: D3 at a high dosage is a normal part of treating insulin resistance
- Losing body fat (especially “core” body fat): insulin resistance is associated with (not necessarily caused by) fat accumulation around the abdominal organs (liver and pancreas), and significantly reducing the fat deposits there tends to help anyone lower insulin resistance, whether T1, T2, MODY, or non-diabetic (yes, non-diabetics can have insulin resistance). Weight isn’t as important in this case, but losing body fat is.
- Diet: some people (here on TuD and elsewhere) have had good results from reducing fat consumption in their diets. I can’t really speak to this, since many people have the opposite effect and have had better luck on low-carb, high-fat diets (with emphasis on “healthy” fats). Regardless, it is worth exploring different ways of eating.
- Serious resistance exercise: Regular, high-intensity, strength-based exercise is, in my opinion, the most direct thing any of us can do to directly affect insulin resistance. In combination with body fat loss it seems to be particularly effective. It doesn’t cure (or “reverse”) T2 diabetes, but it can certainly help the body to be far more efficient, if effort is maintained. Not everyone has to do Olympic Weightlifting; any serious effort to engage in resistance training will have an effect.
- Reduce stress: More sleep, better eating habits, and some kind of regular meditation/relaxation practice shouldn’t be dismissed or scoffed at. Cortisol is the “stress” hormone, and it gets released by the body in a lot of different circumstances. Cortisol directly affects insulin resistance, and high-levels of cortisol in the body on a regular basis are bad news. This might be the most difficult step to do or measure the results of, but I suspect it is far more important than most people realize. I am not particularly insulin resistant in the general sense, but when I travel or have a work deadline, my control always gets worse/more difficult in direct relation to how stressed I am.
If I was in your place, I’d be looking to find a personal trainer (or a close friend who is very fit) to help getting started with a resistance-based workout. I’d also check my diet and work on reducing body fat %. If you are already very slim and strong, there may be something else going on! My suggestions are general, and there is a lot of variation from person to person. This might be a good question to ask on the /type2 section of the forum!
This is, in and of itself, a very interesting question! I think the answer is likely different for everyone, which adds to the maze of all things diabetes.
@David49’s answers are wonderful. I’d like to add that the more insulin you take, often times (although not always) the more you need. It’s a tightrope to find that margin where you can lower exogenous insulin (that which we inject. Endogenous insulin is what we naturally produced in the body.)
If you follow what David49 suggests with vitamins, food, and exercise, the amount of insulin you need may lessen.
My husband, who is a type 2, recently lowered his need for basal insulin by nearly 80%, all with a keto diet. He’s not yet reduced any of the metformin he takes. I’m a Type 1 and with a keto diet I also reduced my insulin needs; my basal has remained steady and constant, but I rarely need to bolus for food or to correct highs.
Another area I would look at too, is absorption. Are you injecting more than 6 or 7 units at one time in the same area? How is your rotation? Dr. Bernstein came up with “the law of small numbers” and says that you should not inject more than 7 units at one time in one area. If you need 21 units, say for your basal, then do three shots of 7 units, all from the same needle, just move it to different locations. Or, you could do [edited to fix] three [/] shots of 5 units and one shot of 6 units, which would even be better. Dr. B’s website is: http://www.diabetes-book.com/ You can find out more about his law of insulin absorption on this page, just scroll down until you see: THE LAW OF INSULIN DOSE ABSORPTION
And, finally, for now, I would check out our basal needs by doing a basal test. If your basal is not right, or you’re not absorbing it properly, what you bolus for food/corrections isn’t going to work as ell. You can find out more here, on Gary Schnier’s website, Integrated Diabetes:
I wish you the best of luck working through all of this; it’s not always easy, but it is generally doable.
Your comments are fantastic. I agree with everything you mentioned. I know exercise is very important and I am extremely sedentary due to other medical conditions. A few years ago, I enrolled in a fitness program provided by a local hospital and had a personal trainer. Spent an hour working out at his direction 3 x per week until I got kicked out of the program due to cardiac issues. Kicked out is not really accurate but I was not allowed to continue until cleared by a cardiologist. That is an entire other story which I will spare you from reading. Exercise is yet another benefit for my cardiac issues but then there are the spinal issues, and other health conditions that make me sedentary. I was a VERY physically active person before my health revoked that.
Your information and contribution is GREATLY appreciated. Thank you so very much for your time and comments. Loved them.
PS I do take Vitamin D3. Ten thousand units per week and my D levels have greatly improved.
Also forgot to mention that I have narcolepsy.
Edited to add post script.
Would it be possible for you to exercise using a reclining bike? I think they are pretty easy on the body and I’ve heard some inspiring stories from previously very overweight and severely disabled individuals who got good results from them.
You are very welcome