Type 1 With Insulin Resistance


#1

Type 1 With Insulin Resistance

I was diagnosed with diabetes in 1945, when I was 6. I used animal insulin. My doctor told my parents I could eat anything I wanted, and as much as I wanted, as long as it did not contain sugar. I lived on a small farm, and I ate large amounts of food, but I avoided all sugar (sucrose). I was very skinny, and I got a lot of exercise on the farm. In the mid 1990’s I started using a rapid acting insulin (Humalog). I began gaining weight, and I was overweight for the very first time. In 1998 a doctor diagnosed me with insulin resistance (IR). I had gradually reduced my daily carb intake from hundreds of grams to only 130 grams. I still had a lot of exercise, but I continued gaining weight. By the year 2000 I had gained 57 pounds! I had four relatives with type 2 diabetes. I think my IR was caused by genes passed down from those relatives. The weight gain triggered the IR. I was a double diabetic. That does not mean I had both types of diabetes. I had been tested, and found to be autoimmune. A C-peptide test showed I produced almost no insulin. I was a type 1 diabetic with a type 2 characteristic, but I was not also type 2. Many type 1 diabetics have been found to have IR.

My doctor was an internal medicine doctor, and he did not believe a type 1 diabetic should use Metformin. He prescribed Avandia, which slowed my weight gain, and I gradually lost about 27 pounds during the next few years. I continued using Avandia for many years. My weight stabilized, but I needed to lose another 30 pounds. I started seeing an endocrinologist, and she prescribed Metformin. In a little more than one year I lost 38 pounds. My weight before all the gain was 185 ( I am 6 ft, 2 in with a large frame). The doctor said my weight should be in the 170-200 range. I considered a weight of 185 pounds to be a good healthy weight. I continued using Metformin for seven years. After the weight loss I weighed 177 pounds. My IR seemed to have disappeared, and I stopped using Metformin in mid 2018. Recently, I have started gaining again. I currently weigh 186. My average daily carb intake is still 130 grams. I do not want to follow a Keto diet, I am happy with 130 carbs per day. I may start using Metformin again.

I have been type 1 for 73 years. My heart, kidneys and eyes are in great shape, but I have some neuropathy in my feet and legs. There is some numbness, but no pain. I feel that I have very good diabetes health.


#2

I too have type 1 but also appear to be becoming insulin resistant. Sometimes the insulin is like water and does nothing unless I take a whopping dose of it. Weight keeps creeping up even though I eat right and exercise every day. I tried Metformin for over a year, the maximum dose. It did nothing for me.

Wondering what other options might be out there for people who seem to have double diabetes. This is very aggravating!


#3

Question, I am a t2 with insulin resistance I find that low carb, Less then 30 a day, works for me. does that fit your definition of eating right?

I do diet and exercise only no meds.


#4

That sounds very good to me. The lower your carb intake, the more manageable your blood sugar will be. That’s the goal anyway.


#5

I’m also a T1D who has battled insulin resistance. I had slowly gained about 25 pounds over a 5-10 year period and I was unaware that insulin resistance (IR) was even a thing with T1D. My total daily dose of insulin increased from 40 to 80 units/day. No doctor ever raised the issue of insulin resistance with me.

When I reduced my daily carb intake to < 30 grams/day, I broke the back of the insulin resistance, lost 25 pounds and restored metabolic sanity to my life.

I don’t like the term, “double diabetes” because I think it confuses the actual situation. It’s a semantic objection I hold due to the confusion it creates. There is so much ignorance in the general public around diabetes and I don’t think this term helps.

I do recognize, however, that someone with T1D can become insulin resistant. Their insulin resistance is different from someone with T2D in that it’s the over-delivery of exogenous insulin that causes the IR, whereas, in T2Ds, it’s the excessive secretion of endogenous (native) insulin that drives IR. Reducing carbs, in both cases, can often fix this IR.

Richard, we share some characteristics in our T1D history and your story will help others who read it. Thanks for your testimony!


#6

@Terry4, I agree with you on the confusion that the term ‘Double Diabetes’ may cause. I do not know a doctor who uses the term, and that is a good thing.
Thanks for explaining the difference in IR for T1D and T2D.


#7

It seems then that in both T1 and T2 insulin resistance is caused by too much insulin being produced or introduced, Correct? So It does not sound to me like there is much difference. An in both cases reducing the insulin need by reducing the amount and type carbohydrate intake helps alleviate the insulin resistance.
And would also believe that exercise would reduce the insulin resistance in both T1 and T2.


#8

I agree that the driver of insulin resistance in both T1D and T2D is similar. Excessive insulin cause insulin resistance.

I do believe, however, that the actual delivery method of the excessive insulin is materially different. In T1Ds this excessive insulin delivery is deliberate but In T2Ds it is automatic.

The pyscho-social difference here is distinct. In T1D the person can aggressively treat hyperglycemia motivated by a fear of long-term hyperglycemia complications. In T2Ds, the automatic increase of insulin when consuming excessive carbs obscures the mechanism and makes recognition and realization of this process difficult.

In my mind, the similarity between the T1D vs. T2D experience is a paradox: it is similar but importantly different.


#9

The irony is that T2 have been told they are the ones doing it to themselves,

I have no problem with what term you want to go under for Insulin resistance.

It just confusing, I am controlling my T2 with diet and exercise only no medications and my A1c floats just above the non diabetic range. I have no issue calling my self a T2, but if I am that well controlled am I just a normal person with insulin resistance. I am not trying to be sarcastic, I have actually had two PC doctors tell me that I was no longer a diabetic. One actually wanted to change my original diagnosis. (I fired him!)

I also believe T1 and T2 have more incommon than we understand.

I don’t find that Being a T2 I have difficulty understanding the effects of uncontrolled diabetes. No, I don’t fear not waking in the morning, or going low and being unresponsive.

I do fear slowly being eaten away by High BG. At 73 I want stay healthy as long as I can.


#10

I don’t believe this, at all. Blaming the victim is intellectually lazy as well as wrong. I do believe that the larger society has fallen prey to this outrageous conclusion and this mistaken belief is part of the problem.

I believe that a quiet physiological switch of T2D is thrown first, followed by increased appetite and weight gain, and finally, often years later, a diagnosis of T2D. The root cause of this physiological defect is carbohydrate intolerance. Two people of equal weight and metabolism can eat the exact diet and one person gains weight while the other does not.

I agree. We need to remain cognizant, however, of the key differences: the autoimmune etiology of T1D, the absolute insulin deficiency of T1D, and the often characteristic marker of insulin resistance in most T2Ds.

Reading the many comments expressed by T2Ds online, I sense that I do not struggle with fighting inappropriate liver glucose secretions.

While you and I each employ diet and exercise as crucial tools to control blood glucose, I can never rely on diet and exercise alone - I need added insulin! You can use your native insulin combined with your diet and exercise. That distinction is important.

Many of our battles are the same, however. We all struggle with our sensitivity to carbs and using diet, exercise, and commonly medications to control blood glucose.


#11

I happen to be a T2 who stopped producing insulin. Apparently, I am now a T1 with insulin resistance. I have been on an insulin pump for 8 years. Until I went on the 670G last year, I was taking Metformin which reduced the amount of insulin I was taking. My endo took me off of Metformin when I started using the 670G. My A1c dropped from 7.8 to 7.2; However, I have gained 20 pounds. I now need to work more on my diet/carb intake.


#12

Hello Don1942, I have fread of only one other T2 who stopped producing insulin, but I am guessing that there are others with that same progression. That makes both of us “Double D’s”. I could not lose most of the weight I had gained until I used Metformin. I hope you will do well with the 670G pump, many people are complaining about it. Some have stopped using it, and they are going to use the Tandem pump that is integrated with the Dexcom CGM.


#13

Over delivery of insulin is not the only cause of IR. My daughter was dxd T1 at age 11. At 13 she was dxd with PCOS & has battled IR since. In her case, IR is caused by hormone imbalance, a hallmark of PCOS. She was lower carb prior to dx. It didn’t prevent PCOS or IR.


#14

Thanks for adding this point. I know little about PCOS but did listen to a fascinating presentation by Dr. Jason Fung about PCOS at the Low Carb Denver conference 10 days ago.


#15

Question, Years ago when I first started this. T1 was defined by an autoimmune disease.
Which meant no or little insulin was produced. But a positivie antibody test was required for diagnosis (although I have seen comments that, especially early test might not show a positive result).
If T2 stop producing insulin they were not considered T1, but insulin dependent T2. Has that changed?

Obviously treatment would be similar,


#16

There are many T2’s I know who have stopped producing insulin, with an over used or burned out pancreas, or side effects of drugs.


#17

As an insulin dependent T2, I find it difficult to explain to people, Medicare, my insurance carrier, and medical suppliers why I need an insulin pump and supplies. It’s easier to say I am a T1 without having to go through a long explanation.


#18

Hi, Richard157. My family genetics sound very similar to yours, but I reached a very different conclusion. I’m T1, LADA originally misdiagnosed as T2. One of my daughters is T1 starting in child hood. My grandmother and all siblings were adult onset (assumed T2) diagnosed in their 40s or 50s. My 2nd/3rd cousins from that lineage include at least a couple of diabetics diagnosed in 40s or 50s. So I came to the conclusion that my GM and siblings more likely T1, LADA than T2.


#19

@William7, interesting background. Your conclusion seems very reasonable. Sometimes we can see the correct path better than our doctors,