FDA approves Medtronic "artificial pancreas"

My IC ratio is lower than yours (meaning more insulin per carb) at least half of the day…

@Terry4, @Sam19, aren’t those ratios solidly in IR territory? IOW you guys (who are both T1 IIRC), have IR?

I know T1s can get IR, but I thought it was relatively rare.

I suspect you’re just not as insulin resistant as you’re come to believe. I follow Dr Ponder on Facebook. He’s a type 1, and appears to be not a big guy at all— he frequently posts annotated cgm pics— the one I specifically remember was him taking something like 20u over several hours for a serving of chicken fried steak…

You’re my diabetes twin.

I thought that the textbook definition of insulin resistance is calibrated in terms of how much insulin per kilogram of body weight.

People like to think about how individual all of us are, YDMV and all that. But I think there’s a lot of overlap in our experience, too.

Agreed. @Dave26 bear in mind that with TDd of 35-40u terry and I are talking about very low carb diets. If I was following the diet recommended by the ADA (which would certainly kill me quickly) I’d for sure be taking triple digit total daily doses. Interestingly, I only take 12u basal daily—

I was insulin resistant for several years, until 2012. I was taking about 80 units per day or more, I weighed more, had a higher BG average, a lot more BG variability, more hypos, and less time in range.

It might. What matters more is how much your bg would increase per gram of carbs if you did not take any insulin. You can get that number by dividing your IS (insulin sensitivity) by your IC ratio. As an example, for me, IS=50 mg/dL/U, IC=10 g/U (except morning, which is worse), so IS/IC = 5 mg/dL per gram. The lower this number is, the less difficult it is to bolus for meals - it’s that simple.

It makes me feel better that two other people have the same IC ratios as I do. I had a mild worry that I was becoming insulin resistant. Over the last couple of years I have been cutting carbs to stop the control problems I was starting to get.

Well I would say that 100g carbs/day is the explanation for that perfect flat line of Dragan. My lunch (only) is about 45-60g, add breakfast and dinner to that, plus some fruit inbetween, a piece of chocolate etc. Also, when doing sports I consume quite some carbs in order to keep the sugar floating above the low limit… I.e. with all due respect to Dragan and the line, for me, and I guess most of us, that line is not realistic - under the assumption that I want to eat normally.

Can you post a link for info on building a loop system? I have a 511 and a ping, not sure those are new enough.

in complete agreement. were all in this for the long hall with sub-par crap to deal with it.

Here are some details about the Loop.

I’m still learning!

Early on, about three years ago when I first started taking insulin, my endo characterized IR based on IC and ISF figures. The lower, the more resistant (i.e., takes more insulin to accomplish the same thing – what I understand IR to be).

I learned that a “normal” person has an insulin sensitivity in the range of 15-30 g/U or more, people with bonafide IR had ICs below 10 or so, most T2s being around where I am (5).

@Terry4, not sure how TDD can be a measure of IR, as it depends on how much carbs you eat. A person could be very sensitive (i.e., not “resistant”) to insulin, only need 1U to cover 30g of carbs, and still use a huge amount of insulin if eating a huge amount of carbs, yielding a big TDD. So I’m not clear on how you’re defining this.

Here’s what i’ve found about myself and BG volatility, however: There seems to be some storage-driven hysteresis in carb consumption, BG volatility, and response to insulin. If I eat a big carb load (say, 100g), especially at night, I can “cover” those carbs according to my IC and keep BG in line for the night. Then, all that glucose seems to “come out of hiding” the next morning, and I’ll battle high BG for half the day.

In the end, there’s just so much we’re blind to under the surface in terms of the machinations of glucose metabolism that its always a guessing game to a degree.

@Dave26 – I tried to find a definition of insulin resistance that I thought I had seen before that connected total daily dose with body weight. I saw reference to using body weight for an initial starting dose of insulin but that’s not what I remember.

What I did find was interesting. I guess the definitive test of insulin resistance is too costly to administer widely. It’s called a euglycemic clamp. My understanding is that they infuse a set amount of insulin based on body weight and then they infuse and measure the amount glucose that it takes to metabolize that insulin and keep blood glucose at a steady good level. The more glucose it takes, the less the insulin resistance.

I do know that doctors will cite many other variables found in blood tests to indirectly infer insulin resistance.

I think ISF is more relevant than IC in the realm of insulin resistance.

IC is measuring a function just as much, if not more, of how your digestive system is metabolizing carbs as it is of how your cells are responding to insulin.

My ISF is somewhere around 40, which I don’t consider anywhere near the realm of resistant…

But a 16g slice of toast in the morning would require 4u of insulin, the stars aligning properly and some good luck for me to not spike like crazy.

And yes that means that 1 slice of toast without insulin would probably skyrocket my bg somewhere in the neighborhood of 160 pts above wherever I started.

PS-- they charactized you as insulin resistant because you were in your 50s and overweight far more so than they characterized you as that because of how much insulin you were taking. I know 105lb girls in their 20s who take more insulin than you and nobody is talking about their resistance.

Sigh… I used to know 105lb girls in their 20s… those were the days :grin:

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I’m amazed at how small the amount of glucose is in an average size person when their blood glucose is at 100 mg/dL (5.6 mmol/L). If a person has 5 liters of blood with 100 mg/dL of glucose, then that means there are 100 x 50 d/L or 5 grams of glucose. That’s equals 1.25 four-gram glucose tablets.

Way back in high school, did you all ever do that sugar burning experiment in chemistry? Don’t remember exactly what the process was, but we did something to a few tbps of sugar that turned into carbon, water, and heat.

There’s a dang ton of energy in a little sugar! Stuff is like solidified gasoline.