Correction: The vast majority of people can eat anything, and as much, as they want. Insulin resistance is not caused by poor diet. It is caused by a genetic defect that leads to insulin resistance in the face of a variety of factors.
Current research is consistent with the theory that chronic high insulin levels in people with the genetic predisposition for Metabolic Syndrome develop insulin resistance in response to chronically high insulin levels. lifestyle that produces this situation is a high carb diet, not poor nutrition and/or food choices. Once can eat a very healthy diet loaded with carbs, and still wind up diabetic.
Once insulin resistance starts to kick in, it's a vicious circle... Insulin levels become chronically high, no matter what one eats. Eventually insulin resistance becomes bad enough that the pancreas can't keep up, and fasting BG levels start to rise, meeting the medical definition of diabetes.
While it is, of course, good advice to eat well, typing poor nutrition to diabetes as if it's the cause, and therefore the individual's fault, is not only wrong, it can lead to depression because people end up blaming themselves for something they really had little to no control over.
Post diagnosis, a T2 diabetic should get busy losing weight (if overweight), and agressively controlling their BG. Once diabetic, continuing a high carb diet and taking truckloads of insulin will only maintain, or exacerbate the problem.
All diabetics, if willing, should have insulin therapy (and all the technology available to support it) available from DX.
I'm T2, and finally getting over the "I failed, I'm just that much more enfeebled" nonsense about insulin therapy has changed my life as a T2 diabetic. Literally.
Getting and maintaining BG in a normal range (I target 85 and correct to stay there, manage food boluses so I don't go over 140 postprandial, good on that most of the time) will make you feel like a million bucks. Clear headed, energetic, happier, and in control.
Most T2's, even if their before-meal FBG is under 120 as prescribed by most doctors, are spending lots of time above 140, probably near or above 200, after eating. They don't know this because most don't check again for 4-5 hours at the next meal. They're swinging wide, which is another factor that makes one feel sick, sluggish, etc.
I went from intensive therapy for 7 weeks on shots (Lantus for basal, Humalog for bolus), to a pump and a CGM. That change was another one that, literally, changed my life.
I don't think your system will improve if you have T1 diabetes and are not balancing exogenous insulin with whatever carbs, even a really low number, you are consuming. You may last for a while, Elizabeth Hughes lasted 4 years between when she was dx'ed (1918) and "cured" (ha ha) with insulin in 1922, when it finally became available because 1) her parents loved her very much 2) her parents were very affluent and 3) they took all means possible to prolong her because they knew that science was on the cusp of creating usable insulin which was finally done in 1922. If you are very careful with your diet (I think that in the video they mention 450 calories/ day, whereas people in concentration camps were fed approximately 600-800 calories/ day of, obviously, lower quality food while being in conditions which killed them. Still, 450 calories is not a lot...).
The story, and that of other dawn of insulin heroes is told very eloquently in the interesting film, "The Story of Insulin". I also agree insulin can be very depressing, particularly if it's not balanced. I partied a lot and know my way around various things and insulin can be a very heavy downer. I wonder if perhaps it's something else but long term with T1 and no insulin is not a good solution. If there's an element of misdiagnosis, maybe the timeframe is longer but bread and raging BG is not a good sign. I'll post the link to the movie again, it's 3 parts and a bit long but I found it very well done and interesting:
T2's by definition are always insulin resistant. Insulin resistance is what causes diabetes in T2's. There are plenty of T2's that eat healthy, are not fat, and still develop(ed) insulin resistance.
People can have a double-whammy and have, basically, both T1 and T2, if they're unlucky to have the genetics that cause the autoimmune response, and insulin resistance. We have several here on TuD.
Actually, T2s by definition cannot be diagnosed as having any specific diagnosis (T1/LADA, MODY, etc.). Certainly, many of those diagnosed as T2 have insulin resistance, but many also have a range of other issues. Ralph DeFronzo talks about eight separate defects in his 2008 Banting Lecture which highlights these separate defects, only one of which is insulin resistance.
My diabetes is now milder and easier to mange than ever.
HOWEVER I am on a very potent immune system medication for Multiple Sclerosis.
I think maybe my MS medication is helping moderate my diabetes.
BTW auto-immune disorders like company or in other words, having one AI disease increases risk of having other AI issues.
Gomer on MDI
Actually, newer research and data looking at type 2 islets and work on extreme diets and bariatric surgery is most suggestive that as pancreas islets constantly sitting in excess glucose -oxidation products does not actually burn out but in fact gives up making insulin. Now some evidence is showing that get the glucose levels cut right back and the islets go back to work making insulin. They do not actually burn out as suggested in past!
A quick answer is that type 2 is progressive (most of the time) and insulin may be called for. It isn't due to failure on the part of the patient (altho lots of MD's will say it is). Several people have addressed the auto-immune - versus heredity causes of type 1 and type 2. Some people with type 1 could also developed type 2 if they have the type 2 genetics. Too bad having one doesn't immunize you against the other.
Some people - as noted above - have been rediagnosed as type 1 after an initial diagnosis of type 2. Not because they started insulin. It is most likely that they were misdiagnosed at first. That happened to me. I was 30 years old thus, the MD said it is type 2. I didn't know any better. No diabetes of any kind in my family. So I went off ready to follow the doctor's orders: lose weight (I weighed less than 100 lbs but what did I know), be more active (I was a recently retired ballet dancer, again what did I know) and make better food decisions (I lived on broccoli but what did I know) I didn't know enough about diabetes to ask any questions. It wasn't until I was admitted through the emergency dept in DKA that I was correctly dx'd. The endo on call thought I lasted as long as I did without insulin because of the ballet dancing and the broccoli lifestyle.
You would be insulin dependent but Type 2. I'm not sure if being an insulin-dependent Type 2 is easier than being a Type 1. Because most Type 1s are not insulin resistant and remain sensitive to insulin. Type 1s do have periods of insulin resistance (such as when growth hormones are active), and that is why I know how difficult it is to manage diabetes with insulin when you are insulin resistant. Managing our teen during puberty and early teen years when they are insulin resistant but only for a few hours a night... I will just say it was very difficult. So no, not the same, even with insulin dosage, which most probably is a lot more than a Type 1 would use, how you respond to insulin.... even though you are treating with insulin, it's a whole other ball game. You may only have to use Lantus and not too much fast-acting for meals or only take fast-acting if your sugar is high after meals. You will need a knowledgeable endocrinologist.
This months Diabetes Forecast has an article about some of the "sub-types" of D. One of them is type 1 with insulin resistance. Basically if the person has the genetic predisposition for type 2, and are already dx'd with type 1 they can be dx'sd with type 2 insulin resistance. Too bad having one doesn't cancel out the other.
This is very interesting. Even on a very low carb diet for the past 7 years, I started to experience higher blood sugar. My morning readings were scarcely ever below 100, and during the day they stayed between 110 and 140. In an effort to pinpoint what the problem might be, I decided to put myself on a severe diet for two weeks. Less than 500 calories and 15 carbs a day. By the second day, my blood sugar was never over 85, with lows of 68. I take no medication.This has continued for 12 days. Obviously I can't survive on a diet like this. Next week I'll start adding more food and see what happens. Now I'm wondering if my pancreas has been reactivated.
Labels.. Labels.. Labels.. usual practice is you KEEP the type-2 label.
Few docs will bother doing antibody tests at that point. Even then NOT ALL type-1s test positive for antibodies...go figure?
Even many type-1s have what is called (great misnomer) a HONEYMON in the beginning. There are also type-1s that get labeled (there is that word again) as type-2 in error.
Main feature of type-1 is insulin serious defiency & quick onset. Type-2 is mainly insulin RESISTANCE. Some type-1s develop insulin resistance over time.
I have insulin defiency and NO insulin resistance, never did. (hope I never do).
Now would you like me to muddy the waters some more?
Gomer
If doctors ignore symptoms and insist on prescribing insulin to a type 2 diabetic, that patient can refuse the substance until a proper diagnosis has been given in writing. That will force them to do tests, which are necessary for moral reasons.
(This happened to me and it was only the doctor's fear of the coroner's court that persuaded them to do a GAD antibodies test. They told me between 0 and 5 is 'equivocal', which means they cannot differentiate definitely between types 1 and 2. Between 5 and 25 is positive for type 1. Above 25 is strongly positive. My score was 2000. I was concerned they may have got the wrong test, but they had not, and 2000 is as high as their scale goes, so my count might have been a lot more.) Obviously it is a risk to refuse following a doctor's advice when they are talking about coroner's courts, so it really depends how much you want to know and how much you trust a doctor, who is RESISTANT to doing tests. Personally I will not allow professionals to run roughshod over my principles. Although I could follow anybody's advice, if I am going to stick needles into myself and insert substances, I require evidence that it has been thought through.
They diagnosed type 2 on account of a number (aged over 40). The only symptoms I had were excessive sweating and blurred vision. Four years later they finally got round to doing the GAD test. There are also ICA and insulin tests, both of which can help them differentiate.
Here is a poem I wrote about it:
FINALLY
Then finally
they gave me
the test results
and this wasn’t the type
with a resit
After years and years
of misdiagnosis
they finally came clean
After months and months
of palming me off
as a ‘lifestyle problem’
in spite of all the evidence
that I went to the gym
that I practiced my yoga
that I hadn’t got
an empty calorie
in the cupboard
they noticed my age
and told me that according
to empirical evidence
the figures indicated
I was type two diabetic
and after
days of
‘living with diabetes’
education
where they offered
the opportunity
to set my own goals
and told me I was
unrealistic
when I did,
they finally took my advice
and sent a syringe-full
of my blood
on holiday
to Sheffield
for four weeks
as a GAD test
and that’s not
generalized anxiety disorder
although gad knows
it could have caused
any number of them
but Glutamic Acid Decarboxylase Autoantibodies
and they advised me
that between 0 and 5
the results suggested Type 2 diabetes
between 5 and 25
or some such bracket
in the lower half of a hundred
the results might indicate
a degree of uncertainty
much like the weather forecast,
and if your figures are over 25
you are probably type 1
but with you, the results
are 2000 – at least
that is as high as our scale
scales so we wondered
what you would like
to do about it?
Answers on
a sharps bin.
8th August 2012
From a medical point of view exists clearly a Type 2 diabetes treated with insulin. :-)