Insulin Resistance/ Symptoms

I have had muscle weakness for many years. I assumed it was due to nerve damage. One of the most likely long term diabetes complications is nerve damage. After 65 years of type 1, I thought that nerve damage was the cause of my muscle weakness. The nerves and muscles do work together, so it seemed a logical conclusion.

I was diagnosed with IR in 1998, and now I see that my muscle weakness might be due to the IR. Then again, it could just be old age (71)???

Here are the possible symptoms of insulin resistance:

abdominal bloating


addictions, alcohol abuse or craving


anger, mood swings, irrational behaviour, aggression

anxiety, agitation, nervousness, constant worry, tension, panic attacks, panicky

caffeine needed to get going in the morning


constant hunger, appetite high, inability to tolerate long intervals without food

cramping in legs

cravings/binges for sweet things; sugar, breads, cakes etc



dry and itching skin

easily upset, quick to cry

excessive facial and body hair on women

excessive yawning

exhaustion, chronic fatigue, tired all the time, stamina decreased

frequent infections, poor skin healing

fuzzy brain, mental confusion, inability to concentrate


high blood pressure

high cholesterol, non-alcoholic fatty liver

hot flushes, night sweats

hypoglycaemia (low blood sugar)

inability to eat breakfast

increased abdominal fat

infertility, difficulty in falling pregnant


irritable, jittery, weak, tired or depressed if meals are skipped

muscle weakness

nausea, particularly in the morning

palpitations, shaking, trembling

PCO (poly cystic ovarian disease)

swollen feet and/or ankles

tendency to feel cold

tight chest

water retention

weight gain, inability to loose weight

all of the above, and don’t forget insulin allergies

have you tried going gluten-free? That may help some. Also take Co-Q-10 and see if you feel better. It won’t do harm.

I’m not sure exactly what led to the diagnosis of IR, or really what the diagnosis of IR is in a T1.

Traditionally, “insulin resistance” in a T1 has meant needing very large numbers of units every day, like hundreds of units a day.

Today that definition probably falls into “insulin allergy”.

Some T1’s here will readily attribute any upward change in insulin requirements to “insulin resistance” but I remember my first year as a teenager diagnosed as a T1 and all the crazy doses I was taking back then… today I take less than half of that. Still my needs go up and down but I always called that “dosage adjustment” and not “insulin resistance”.

So, in short, some doc might have said the words “insulin resistance” to you, but I’m not sure I believe it :-).

For a long-term T1 like you or me, 30 or 50 or more years in, especially overlapping the era when home bg testing was unavailable and we’d go for MONTHS without a single bg number available, I’m sure there’s lots of cumulative damage from the disease from half a century ago that might not be detected or explained until today. That doesn’t mean we are responsible for understanding the details ourselves does it? Isn’t it enough that we’re doing the best we can today?

As it has been explained to me by my endo, EVERYONE has insulin resistance… some just have more or less. There’s a very high correlation to weight (in other words, I use more insulin at 180lbs than I did at 135lbs), but she said she really doesn’t consider a T1 to have significant IR until they are using over 200 units a day.

At 135lbs I was using 35-40u a day. At 180 I use 55-60 most of the time… there’s a difference, obviously, but I don’t consider myself particularly insulin resistant. I am overweight, yes, so I do use more insulin than I would if I weighed less, but I am not using so much as to be a sign of a problem.

Last year I was on Metformin for 6 months to see if it could help with some of the variability I see every month due to my cycle, and I was interested to see if it would reduce my insulin needs overall, but the effect was very subtle, and really didn’t make a big change in my insulin needs. The only thing that the metformin really impacted with my dawn phenomenon, but interestingly enough that didn’t return even when I stopped taking it (because the side effects just weren’t worth what I was getting from it) so it’s hard to say if that was related to the met, or if maybe adjustments to my synthroid dose made over the past year had some impact on that… it’s all complicated.

Richard, you were on Avandia for many years, right? That is a drug known to cause muscle weakness… many statins actually have the same effect too.

I average 120-130 carbs per day, but my insulin:carb ratios are 1:4 at breakfast and 1:6 the rest of the day. My TDD is 40. Those statistics are not indicative of a T1D who does NOT have insulin resistance (IR). My TDD was much higher in 1998 when my doctor diagnosed my IR. With the aid of meds like Avandia and Actos I reduced my TDD to the current 40 units.

Yes Sarah, Avandia foe 12 years, with no side effects. Now Actos with awful side effects. I will start Metformin ER this weekend. I have T1D friends who have IR and Met works very well for them.

Others have suggested that statins may be the cause of mt muscle weakness. I do use Vytorin, and it is a statin. I also have a headache that has been present for almost 2 years, it never stops. If I stopped my statin and eliminated my muscle weakness and headache, I might see my cholesterol climb to 300. It was about that level before I started using statins. What could I use to keep my cholesterol low enough if I stop statins?

HI Richard, I went to my ENDO and i was doagnosed with insulin resistance but she REFUSED to put me on metformin. She said that it could lead to acidose of some sort. Did you do much research on Metformin and type 1 and if so, where did you find it? Thanks! :slight_smile:

I wasn’t necessarily suggesting that statins were bad or that you should stop - I take one myself, and the muscle weakness is a fairly common side-effect, one which I was warned of. Maybe switching to a different one could make a difference, but I don’t know.

I don’t personally think you have a lot of IR, but rather changing metabolic needs as you age… 40u a day is not excessive… insulin requirements of .5-1u/kg are normal. If you produce a lot of antibodies to insulin (everyone that injects insulin produces some) that can also effect your insulin requirements and isn’t related to IR at all.

T1 doses do vary a lot from person to person, and even in the same person over time. Your dose is certainly larger than some of the LADA’s here who get by on a couple units a day. But personally I would call your dose as being very close to “typical” (numerically it’s very similar to mine and I remember some docs that have hinted that mine is slightly on the low side!)

I hinted to you, that when I was a teenager my dose was much larger than it is today. Perhaps that is why I am more willing than others, to accept that doses vary from person to person due to many many factors that I do not fully understand.

Some take any variation in dose as being due to insulin resistance. I think that is greatly oversimplifying the issue. Personally I think that “insulin resistance” is commonly being used as a catch-all for a lot of individual contributing factors, and that rather than being an actual explanation, that those who are using the phrase are just copping out.

Had to share something - my father, dx’d T2, but all these years later, I’m sure he was 1.5 - had severe neuropathy. He went to the Mayo Clinic, and the first thing they told him was to try “Evening Primrose” oil. He was the last person on earth who would have agreed to take any herbal supplement of any kind, but it worked wonders for him.

Hi Lex, I have terrible insulin resistance (as of maybe 6 years back.) It was definitely a marked change as my insulin “just wasn’t doing the job” anymore, in larger, and larger, and larger doses. All it did for me was put on weight, yet my sugars were uncontrollable even with low to no carb diet! I have been on the name brand extended release Metformin for about a year and a half now and have seen tremendous results! I feel like “wow, my insulin is working again!” I’m very thankful that my Endo suggested I take it. She didn’t mention any acidose to me (I’ll have to research that) and the only side effects I had were in the very beginning with stomach discomfort, which subsided fairly quickly. If you really think you need it and would like to try it, is switching Endo’s an option for you? Just a thought…I’ve read that the more progressive Endo’s are trying it with IR in their Type I’s. Take care!

Jeannie, was it in pill form? And did it help with Insulin resistance, or pain? Thanks!

It was in pill form, and it helped tremendously with the pain. He didn’t have IR.

Okay. Thanks!!

Gina, and Lex. I have seen several type 1 diabetics with IR post on several websites. They sid that Metformin was the best med for their IR, and they were doing well and having much less resistance. I do’t know what dosage they were using. My endo is having me use Met ER , dosage = 500 at dinner. After adjusting, I am to use an additional pil at breakfast. The dosage will be increased later on, if necessary.

Lex, my friends are my research, both type 1 and type 2 with IR. They use Met and have good results. None of them have ever mentioned acidosis.

Lactic acidosis is a rare condition usually confined to people with kidney problems that cannot get rid of the excess lactic acid

Dr. B recommends Alpha Lipoic Acid (ALA) and Evening Primrose Oil (EPO) for neuropathy. Others suggest that certain forms of ALA (R-ALA) are best and it should be taken with Biotin. I took them both, but never really noticed a difference with my hands (I have Carpal Tunnel), but they may help. There are studies behind their use.