I am interested in what you say about a Type 2 not necessarily having insulin resistance. A type 2 with a pump, I just scrolled through my TDD, and it is usually 20-23. I have gasped at other Type 2s who take 40/meal. Having always been told that Type 2, are insulin resistant, wondered why I take so little. So, maybe I just don’t make a lot of insulin?
As mentioned, T2 covers a multitude of different profiles. Some of us don’t have much insulin left. I certainly don’t; my last c-pep came in at 0.1.
Suzan - insulin resistance as being the “root cause” of Type 2 diabetes is a misnomer. The root cause of diabetes is the pancreas not producing enough insulin for the needs of your body, whatever the insulin needs are. This goes back to my question which was why are we so caught up on knowing whether we are under an active auto-immune attack, have anti-bodies indicating there was at one time an attack or something else.
Here is a nice overview which has a good number of references Insulin Resistance Is Not Necessarily an Essential Component of Type 2 Diabetes1 | The Journal of Clinical Endocrinology & Metabolism | Oxford Academic
In a nut shell we know some things as fact. We know obese non-diabetics which are insulin resistant overcome the insulin resistance by growing more beta cells and secreting more insulin. If you look at an autopsied pancreas of one of these people its amazing how the body naturally adapts to secrete more insulin.
We also know diabetes “runs” in families but both identical twins do not always get diabetes. So there is often a genetic component but it is not solely genetic.
We also know some, about 10%+ of “so called” Type 2s show positive for anti-bodies which indicates something caused an attack on the pancreas’ beta cells. And, it could very well be that 10% is way understated.
What insulin resistance does is require the pancreas to make more insulin. In a non-diabetic, no problem they grow more beta cells. For one or more reasons a diabetic can not make enough insulin for the body’s needs because they are not able to grow more beta cells fast enough. Why they got into this state could be for a number of reasons but once in this state their only hope is to off load the insulin producing workload of the pancreas.
Reducing insulin resistance through exercise is a good first step as is reducing carbs but adding insulin in addition often shows a stoppage of the progression. Dr. Ralph DeFronzo is currently doing a study in Qatar and is claiming by using GLP-1 and TZD he has been able to offload the insulin production needs of the pancreas enough that he is actually seeing a regression in diabetes. Al Mann claimed the same with the use of his inhaled insulin afrezza. Additionally there are a zillion studies on early insulin intervention in “Type 2s” which have similar claims.
In your case you seem to be using the insulin you are making OK but you are just not making enough insulin for your body’s needs. Not knowing the range you are keeping but what these studies show is diabetics not under a current attack when kept in a 70-130 range for 3 to 6 months often show a stop of the progression and some, as Dr. DeFronzo is now saying are showing a regression.
There is a wide spectrum, and diabetes is not a single disease, or a single presentation. This is why simplistic definitions of diabetes, and 1 size fits all treatment approaches do people with diabetes no favours, and may actually promote poor management / labelling as brittle / non-compliant… when the problem is that the selected management approach may not be suitable…
Thank you, there is a lot of information, will definitely go through it again, But it makes sense. I think it is also possible for a Type 1 to be insulin resistant. I remember reading, on a now defunct pump blog, where one Type 1 commented on his disadvantage of being Type 1 with insulin resistance.
I agree, suzan. I too have got a lot of information from here and I would like to gather some more info definitely. 
Suzan - there is really no such thing as a Type 1. As JustLookin said its a spectrum. There are people who are not making enough insulin today and if not given extra insulin will die and there are people who are still making enough insulin not to go into a comma but over time bad things happen including microvascular damage leading to heart disease and other bad things.
The underlying reason which we don’t know how to treat “auto-immune” - doesn’t for the most part matter. Type 2 was a marketing label to sell Orinase which like most of the other current orals ended up being a huge mess.
Current T1s and T2s all share common issues on a “sliding scale”, It all depends on how much insulin their body needs and how well they are regulating their “time in range”.