Type 1.5's .. do you think you have insulin resistance at all?

Just curious. A new article this week says IR in LADAs is equivalent to that in Type 2’s. I do think I have quite a bit.

I don’t think I do…? But I don’t know anyone with Diabetes, and I’m fairly new on this forum. My insulin ratios are 1:15 for food and 1:50 for correction. What do other people use? (I’m LADA)

Those seem like modest doses to me but I am not using insulin myself, yet.

I have read “Everyone” over 40 has “some IR,” too. I would have expected more of a range of IR – from normal to high – in LADAs, though. Not simply “comparable to Type 2’s.”

Anyone else have thoughts?

No, I don’t seem to have insulin resistance. I take a fairly low dose of insulin (TDD 15-19), and thus my correction factor is 1 unit for 112 points (haven’t used it yet, as I would be afraid of going too low). When my doctor stupidly started me out at a basal rate of 25 I kept crashing so it was lowered to 20, 15 and then 10. My I:C ratios are 1:10, 1:12 and 1:17, though I seem to be having an insulin spurt currently and can cover a bit more carbs than that. My BMI is in the normal range. During the year + I thought I was Type II and was on oral meds I had good numbers with the meds and ate a lot of carbs (not saying that was a good thing)

Hi Linda: Where was this article published? Could you provide a link? I have adult onset Type 1 (age 35), but certainly no insulin resistance! I have always been very insulin sensitive. My ratio is 1:20, and my TDD is about 20 units. And at 5’9" tall, I can’t be described as a little thing, so 20 units isn’t much.

Melitta, it’s from 2006 and I found it in Pubmed … here is the abstract! Could it be those you who do not think you have IR still have enough residual secretion that it is not evident? Article is quite interesting as they refer to using an actual ASSAY for IR, though none is clinically available at this time (3 yrs later).

IR in LADA


Equivalent insulin resistance in latent autoimmune diabetes in adults (LADA) and type 2 diabetic patients
Harvey K. Chiu, a, , Elaine C. Tsaia, Rattan Junejaa, James Stoevera, Barbara Brooks-Worrella, Amit Goela and Jerry P. Palmera

aVeterans Affairs Puget Sound Health Care System, Department of Medicine, Division of Metabolism, Endocrinology and Nutrition, University of Washington Seattle, WA, United States

Received 15 August 2006; accepted 19 December 2006. Available online 17 January 2007.

Abstract
Insulin resistance is a primary component in the pathophysiology of type 2 diabetes. In latent autoimmune diabetes in adults (LADA), insulin resistance has been reported to be significantly lower than in autoantibody-negative type 2 diabetes (T2DM), but whether this might be related to differences in body mass index (BMI) has not been excluded. Furthermore, previous studies have used limiting inclusive criteria for LADA, requiring only the presence of GADA or IA-2A.

To apply more inclusive criteria for LADA, consistent with recent recommendations, we defined LADA by clinical manifestations characteristic of T2DM, but with the presence of any combination of GADA, IA-2A, ICA, or IAA. We recruited 43 LADA patients, 70 T2DM patients, and 150 non-diabetic controls. Insulin resistance was assessed by both the homeostasis model assessment and the quantitative insulin sensitivity check index, and BMI was calculated.

We found that insulin resistance in LADA is equivalent to that of T2DM. When insulin resistance is assessed as a function of BMI, both diabetic populations demonstrated an insulin resistance equally greater than normal controls. The interaction between insulin resistance and BMI in the two diabetic groups was significantly different from that demonstrated in non-diabetic controls. In summary, LADA demonstrates insulin resistance of similar magnitude to T2DM, but with the concurrent component of an immune attack against the pancreatic beta-cells. LADA patients may be at significant risk for metabolic consequences of insulin resistance other than glucose metabolism, such as those described in the metabolic syndrome. As complications and treatment regimens specific to LADA are realized, improved means of identification of LADA will become increasingly important.

Keywords: Latent autoimmune diabetes in adults (LADA); Body mass index (BMI); Homeostasis model assessment (HOMA); Insulin resistance; Pancreatic autoantibody

Could it be those you who do not think you have IR still have enough residual secretion that it is not evident

Nope, I’m making very little insulin.

I know I am very insulin resistant

Not TMI at all. I’m actually trying to figure out my monthly patterns as well. I’m much more sensitive between menstruation and ovulation. Much more resistant between ovulation and menstruation. This varies from woman to woman and depends on the hormone balance.

Check out these two discussions:
High blood sugar and your period
For the ladies

I am perimeno and I see NO difference so far over my month!

It may be diet-related. I heard an eminent endocrinologist researcher speak at a conference and he said that he observed the following in his practice. Type 1 Diabetics who followed the ADA high-carb diet became insulin-resistant. Even type 1 kids who followed this diet reached the insulin resistance of an adult type 2.
Maria

WOW, Maria. Just … WOW.