I am really not aware of IR actually “causing” muscle weakness. This huge list is actually more like a list of symptoms that may occur concurrently with IR. It is more likely that your weakness is from some other source. As others have mentioned, some medications are notorious for causing weakness (like statins).
I’d encourage you to also get more detail on your “weakness.” There is weakness associated with a loss of strength. That can easily be measured and tracked over time. There is also weakness is terms of fatigue where you just tire out after going up the stairs. Entirely different, and could be entirely different causes. On thing you might also consider is having your doctor do some tests. It is very common in men as they get older to have lower levels of testosterone (T) and this occrus at very high rates in those of us with D. Low levels can result in a loss of muscle mass (strength), increased insulin resistance and fatigue. Should you have low levels of T, there are various things you can do to help correct it.
How do we tell the insulin resisance blanket from normal “aging” or several overlapping proverbial blankets whether diabetic ones or not I wonder? Thats one heck of a loooooong list you got there
My doctor determined I had IR by looking at my charts, and seeing that I needed 1 unit of Humalog for every 4 carbs in the morning, and 1:6 the rest of the day. I was using much more insulin than a T1 without IR would. I am not aware that he performed any test to reach that conclusion. That was 1998, after I had gained 42 pounds while switching from animal insulins to Humalog. The modern day insulins can lead to the body storing fat. That did not happen with animal insulins.
Your ICRs are similar to our young teen (1 to 5 and 1 to 6.5) and I thought this was due to hormonal changes which do cause insulin resistance in teens. I wonder of insulin resistance shows up sporadically over the years having Type 1 (fluctuations) or if there are hormonal changes that may cause insulin resistance during/after menopause (for women) and men as they age? Perhaps it is age-related? Even non-D’s tend to gain weight with each decade and maybe that is related to insulin resistance in general? And Type 1s would be effected by this as well.
Ditto to what Jan said. My 13-year-old’s breakfast ratio is 1:5, and 1:7 for lunch, dinner and snacks. She uses 54 units of Levemir daily, and that Levemir dose for nighttime is dropping right now. She was on a TDD of Levemir of 36 units until age 11.
I wonder if it is hormonal, or the effecrt of another med you’re taking? Or as Jan said, a sporadic variation?
Jan, I gained weight in the 1990s and was dx with IR in 1998. I have several relatives with T2 and IR, so I must have the T2 gene that predisposes IR. After losing the extra weight, I still have !R, and will always take a T2 med.
The modern day insulins can lead to the body storing fat. That did not happen with animal insulins.
I have to respectfully disagree. Some weight gain in intensively treated T1’s was well known as a possibility (if not a “rule”… in fact some treated it as a rule) and existed long before the human/analog insulins.
e.g. from data in the 80’s in the first year of the DCCT:
Weight gain associated with intensive therapy in the diabetes control and complications trial. The DCCT Research Group. Abstract Identifiable risks such as increased frequency of hypoglycemia accompany the treatment of insulin-dependent diabetes mellitus (IDDM) with intensive insulin therapy. During yr 1 of the Diabetes Control and Complications Trial (DCCT), weight gain was identified as a sequela of intensive insulin therapy. [...] In addition, intensively treated subjects with one or more severe hypoglycemic episodes gained more weight than the intensively treated subjects with no severe episodes. There was no relationship between reported caloric intake or exercise level and the weight changes. These data suggest that improved utilization of calories through a decrease in glycosuria and perhaps other mechanisms led to the weight gain in the intensively treated subjects.
I too underwent the transition from animal to human to analog insulins so I think I have perspective. The change to humalog from regular is not just a change of brands but is using a tool that I like to compare to the neutron bomb in its surprising "kick" of insulin activity.
IMHO the fast acting analogs are in some cases too fast... and require some dietary adjustment to prevent hypos after meals. In many senses I feel that good old regular is a better match to lowish-carb-high-protein meals. Just because the fast acting analogs are available, doesn't mean they are always the best or most appropriate choice.
My doctor believes that the fat is stored because of the synthetic insulins. Many, many diabetics online have said that. I guess the overwhelming majority has convinced me???
IMHO, what they are all observing is that intensive control can lead to weight gain.
Again, this is true whether it’s synthetic or animal insulins. Note how the publications I cited, were before Humalog etc. were available at all.
Someone might begin intensive control at the same time they start Humalog, in which case they might blame it on the Humalog. But it’s the intensive control and increased utilization of calories, due to bg’s not being out of whack as much, that’s the common factor.
Tim, we were having a huge debate over insulin and weight gain in another forum, I was told in that my 22 pounds that I gained when I went on insulin was my fault. I say I will own 5 pounds of that from mistakes in battling lows, but I gained 14 pounds in one month, that is a huge amount of weight in a month even if I were eating candy every day.
So, here is what I am doing to try to lose the 22 pounds that I gained, instead of doing an extra bolus to battle higher than normal numbers 2-hours post meal, I am going to try to combat that with water and some form of exercise. Normally because insulin is so easy I would just take a few extra units to get my BG down, but for me if I have some rapid acting insulin in my system, a good amount of water can bring me down a lot, so this is what I am trying and if it works the way I think it might I should start dropping the pounds I gained to begin with.
Wish me luck and I will keep you guys posted on my progress. This is harder than just a needle poke but will be totally worth it if it works.
Note that the theory I tend towards, is that T1 diabetes without intensive control results in malnourishment as the body isn’t able to use all the calories. But that T1 with intensive control results in weight gain as other things in the body still aren’t quite in whack.
We know some of the “missing things” that insulin by itself doesn’t provide: C-peptide and Amylin. But there are probably others.
Big picture: T1 Diabetes is more than just not having enough insulin. Just as T2 Diabetes is more than just insulin resistance. I personally believe that T1 and T2 have a lot of things in common even if some aspects are different.
I totally agree with you. I am T2, I have low insulin production so I take insulin. I keep hoping I will get off one day but I don’t think so. Most T1 I know are very thin and is probably due to exactly what you said, malnutrition. When I was first diagnosed I was losing weight like crazy, when I started to control I stopped and doc said I was doing better because no more weight loss. Hmmmmm, makes a person want to stop controlling so they don’t gain weight, but, the alternatives to a few extra pounds is way worse than dealing with weight gain.
Richard, when I started my Met ER, almost immediately I noticed a difference. I had two full days of having to eat to keep my sugars up, which is unheard of for me! I have been taking 1000mg each am, and just this past week added another 1000mg at dinner. Adding in the second pill has brought about side effects (terrible nausea and lethargy) but I’m hopeful that within about a week or so those will wear off again. After day one of the double dose, I had to lower my basal rates on my pump, so it seems to be working again. How is it going for you so far??
Gina, I guess I am very lucky. I have not had any side effects. I took two pills this morning (1000mg) and did not have a problem with it. I also took two pills this evening, and now I am waiting to see if that gives me a problem. My blood sugar has run 80-110 since breakfast today, so I am pleased. I was taking Actos for my IR, and have stopped that completely, but I am aware that Actos takes about three weeks to stop having any effect. It is still too soon to tell how much good the Metformin is doing at this time.
