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Important Question about Diabetes

Hello BillyJoe, Rolfe,

I am pursuing this concept since about 20th sept, when I noted the effects of lowering the medications which were surprising.

Billyjoe, I think the abstract which I mentioned can awnser your questions. Millions means IR patients, if Insulin toxicity instead of Glacutoxicity will be the cause for IR as per my observations.

Rolfe, If insulin toxicity can not cause IR, then can you brief how it it caused & how BS sugar(without Somogyi overswing ) can be lowered, controlled on reducing the medications?
 
Kumar

If you continue to refuse to give the detailed observations that led you to make the conclusions that you did, we may as well just sign off.
You say it wasn't Somogyi, well I guess we just have to take your word for it hey?

BillyJoe.
 
Frankly, You can not give any conclusions unless this concept is tested by research authorities & doctors. I have sent my observations to several research authorites , doctors & mentioned on some forums. When I will get any reply, if they will take up this issue, I will let you know. Till today, I have not recieved any adverse remarks. All just says how it can be, but no one is able to satisfy me acordingly. Till then, you can check my remarks in this topic if you feel intrested. I am just intimating.

But till today,I feel very much encouraged. But this concept is just like finding a mistake of whole current medical science with a single observation & logic which can come out as a big failure. But we can think about it as least involvments in varifying this concept.

I am not finding any referance anywhere on any reputed medical research site confirming that this issue is already researched/varified. In the meantime you can discuss with your specialists casually & can post here accordingly.

Best wishes.
 
Some important information is found on one site:-

"insulin receptors are found on most mammalian cells in concentrations of up to 20,000 per cell.)." So insulin receptors are concentrated at about 20,000 per cell.
Insulin resistance is when insulin is not working efficiently. The insulin is present, but target tissues are less sensitive to insulin. From Harper's Biochemistry, "In conditions in which plasma insulin levels are high, e.g. obesity, the number of insulin receptors is decreased and target tissues become less sensitive to insulin. This down-regulation results from the loss of receptors by internalization, the process whereby insulin-receptor complexes enter the cell. Down-regulation explains part of the insulin resistance in obesity and type 2 diabetes mellitus (Page 619)." So part of insulin resistance is the result of high insulin levels leading to reduced numbers of insulin receptors.

The key point is higher levels of insulin create a vicious circle of less sensitive insulin due to down-regulation of insulin receptors, resulting in even higher insulin levels and increased insulin insensitivity. Diabetics mainly focus on blood sugar levels, but reducing insulin levels is vital. Losing weight, exercise, eating low glycemic foods, eating small meals, supplements, and other methods can reduce insulin levels."
 
Some more informations:-

Although researchers do not know the exact cause of type 2 diabetes or insulin resistance, several risk factors have been identified. Family history of diabetes, obesity, physical inactivity, older age and race/ethnicity are the most common risk factors. Certain ethnic populations are at particularly high risk, including African-Americans and Hispanics who are twice as likely to develop type 2 diabetes as Caucasians. An estimated 13.0 percent of African-Americans and 10.2 percent of Hispanic/Latino-Americans have diabetes in the United States. These populations also experience higher rates of diabetes complications, including cardiovascular disease (CVD), eye disease, kidney failure and amputation.

Is there a test for insulin resistance?

Currently there is no simple test for insulin resistance. People with diagnosed type 2 diabetes, however, are encouraged to take an A1C test two to three times a year to accompany their daily blood sugar monitoring. A1C testing measures how well a person's blood sugar levels are being controlled over time, providing a "big picture" view of a patient's long-term diabetes management.

Bold letters indicates that IR is still a mystery. So all possibilities are open.
 
One more similar case;

I was just discussing with one of my close relative who has more than 30 years of dibetic history. He told me that his BS was very high & uncontrolled prior to about ten months when he was taking very high dose of insulin(80-90 units)with other medicines. Due to some problem doctors was to reduce his insulin dose to 12 unit a day & after that he has also experianced similar effects as I mentioned i.e.Hypoglycemia shots & reversal of stomach blotting & other problems. He is now just taking 8/10 units daily & his blood sugar in very much controlled since last 7/8 months. Is it not a big ? mark?? :confused:
 
The number one cause of high glucose levels in insulin-dependent diabetics:

non-compliance

The Somogyi phenomenon (a.k.a. the "bounce"), something that is extremely hard to accurately document and the exact mechanism for which is still a bit controversial, is best treated by eating a light snack before bed or changing the type and/or dose of insulin used at night. Effective management can only be accomplished by discussing the case with a qualified internist (read that again... in other words, see a doctor). Measuring HbA1C (so-called 'glycosylated hemoglobin') levels only gives a long-term measure of treatment effectiveness, but should be done every four months as part of routine care.

The supposed increased insulin dosage/insulin-resistance phenomenon you described does not exist, Kumar. The best way to battle insulin-resistance, a problem in Type II diabetes with its so-called "metabolic syndrome", is to exercise and lose weight - exercising increases insulin sensitivity in skeletal muscle.

I will say this, however, that too aggressive of an insulin course can lead to weight gain. If a patient is having trouble controlling their blood sugar level on their regimen, is eating a lot, and is gaining weight, that points to a dietary management problem - not insulin resistance - in Type I diabetics, which is your friend's problem. Again, insulin-resistance is a problem in Type II diabetics, not Type I, and is mostly a result of a series of biochemical changes at the cellular level that we don't need to get into here (but, I would invite you to read more on... let me know if you need to be pointed in the right direction).

-TT
 
Kumar, once again you have stated a revolutionary new theory that flies in the face of all known and well-documented scientific information on the subject.

Once again you have been given the priviledge of being asked to supply all your evidence to support your wild new theory.

And ONCE AGAIN you have refuse to do so, ignore all requests, and provided nothing in the way of support by means of data or studies or whatever.

And finally, once again, you believe that if there is no response from the learned medical people here that can somehow fault your wild theories then you believe you must somehow be "right" and you are vindicated.

I do hope the poor people you refer to don't die before they realise YOU are seriously and horribly mistaken.
 
Third Twin, Zep,

Thanks for your advice. TT, I have not mentioned that both cases are Type1, they are type2 with Insulin Resistane(Metabolic Syndrome or Syndrome X are other name of combined disorders). Both cases have acquired diabetes at about 35 -40 years age and were not fully dependent on injected insulin. However, both are under proper medical treatments & doctors are happy with this development. IR can also be possible in Type1 if injected insulin is more than the required insulin. Actually, Insulin in the system should be exactly balanced as per the requirement(85-95% may be better) neither more nor less which may trigger both hyper or hypo glycemia. Both patients are not effected by the two possible conditions as under:-

Somogyi Effect(rebound)
A swing to a high level of glucose (sugar) in the blood from an extremely low level, usually occurring after an untreated insulin reaction during the night. The swing is caused by the release of stress hormones to counter low glucose levels. People who experience high levels of blood glucose in the morning may need to test their blood glucose levels in the middle of the night. If blood glucose levels are falling or low, adjustments in evening snacks or insulin doses may be recommended. This condition is named after Dr. Michael Somogyi, the man who first wrote about it. Also called "rebound."

Dawn Phenomenon
A sudden rise in blood glucose levels in the early morning hours. This condition sometimes occurs in people with insulin-dependent diabetes and (rarely) in people with noninsulin-dependent diabetes. Unlike the Somogyi effect, it is not a result of an insulin reaction. People who have high levels of blood glucose in the mornings before eating may need to monitor their blood glucose during the night. If blood glucose levels are rising, adjustments in evening snacks or insulin dosages may be recommended.

Both the above effects may be a temporary feature.

The supposed increased insulin dosage/insulin-resistance phenomenon you described does not exist,
Click to expand...
Insulin & sugar along with other enzyme,protien etc. are exposed to cells side by side & any of these can be a responsible factor for IR. My observation says, it can be insulin.

however, that too aggressive of an insulin course can lead to weight gain. If a patient is having trouble controlling their blood sugar level on their regimen, is eating a lot, and is gaining weight..
Click to expand...
It can happen if insulin is being properly & excessivily used by the target cells & still there is an excess of same. Diet,Exercise & other measures can also be related to lowering the level of insulin.

.. let me know if you need to be pointed in the right direction).
Click to expand...
I think I already studied a lot, but I will be happy to read more on this issue.

Furthur, I have just mentioned a observation to recheck/research a possibility for a 'yet to solve' issue, not a medical prescription or advice. We cann't know, any mistake at basic level may sometimes can lead to big problems specially in unsolved issues & all posibilities,opinions,observations should be properly checked specially when the involvements in recheking are least.
 
Kumar:
One more similar case;

I was just discussing with one of my close relative who has more than 30 years of dibetic history. He told me that his BS was very high & uncontrolled prior to about ten months when he was taking very high dose of insulin(80-90 units)with other medicines. Due to some problem doctors was to reduce his insulin dose to 12 unit a day & after that he has also experianced similar effects as I mentioned i.e.Hypoglycemia shots & reversal of stomach blotting & other problems. He is now just taking 8/10 units daily & his blood sugar in very much controlled since last 7/8 months. Is it not a big ? mark??
Click to expand...
Surely this is a mistake? 80-90 units is not just a "very high dose", it is a suicide dose unless the person is grotesquely obese.

The ony possible explanation I can think of is if he had severe insulin insensitivity. Then probably the change in medication included the addition of insulin sensitizing drugs, which lowered his insulin requirement to the ~12 units which is a very normal dose for an insulin dependent type 2 diabetic.

I might also suspect that he had some other disease/complication. Stomach bloating is not a typical symptom in diabetes.

But, lets be frank: Intensive diabetes research is going on in several countries, backed by billion $ industries and government funding and spurned by fierce competition. You have some thesis based on a patient you have given supplementary treatment and a relative you have chatted with. No journals, no tests, no statistics, no nothing. If you should try to be perfectly real:

1) What do you think researchers do with your paper?

2) Is there really any reason they shoud look twice at it?

As our mutual friend Tim says: I'm blunt. ;)

Hans
 
Found this too:

Although researchers do not know the exact cause of type 2 diabetes or insulin resistance, several risk factors have been identified. *snip*

Is there a test for insulin resistance?

Currently there is no simple test for insulin resistance. People with diagnosed type 2 diabetes, however, are encouraged to take an A1C test two to three times a year to accompany their daily blood sugar monitoring. A1C testing measures how well a person's blood sugar levels are being controlled over time, providing a "big picture" view of a patient's long-term diabetes management.

Bold letters indicates that IR is still a mystery. So all possibilities are open.
Click to expand...
Nonsense! --And more nonsense. Researchers do not know all about the factors that govern onset of type 2 diabetes, but once it has started, it is pretty well known. Certainly it is not a mystery. All possibilities are not open. There are a number of unmapped areas, but that is quite a different thing.

There is no simple test for IR, so what? You are a homeopath and you are asking for some simple scientific test to find some internal cause for a disease??

Hans
 
Mr.Hans,

Thanks for the postings as usual. Here I am going as per CMS system, still you are opposing.

I have posted these details which froms part of some articles on internet. I think there are test like S.Insulin & C Peptide which can assess the insulin in blood & if pancreas is still producing insulin or not. I have written to ADA that why doctors are not doing these tests before declaring a patient as type2 diabetes. But they informed that since these are costly tests & due to high variations in the results , these tests are not done in routine. However, It is bit surprising to me.

Insulin can be in differant concentrations of 40 & 100 i.u/ml. I just now reconfirmed again from my relative who is a most educated & caring big status person & is under the treatment of best doctors. He has told that he was taking 90 units divided in two times a day but his BS was never under well control at that time of high deses. He has only got this control when insulin doses are now substancially reduced. He has also told that he also feels that whenever his insulin doses were lowered there was a better control & comfort. His other symptoms are substancially improved like abd. blotting.

But there can be differant conditions in IR , but weight gain & persistant abd. bloating(pear/apple shaped) are good indications.

I have posted this topic(under some stress) just for the informations of doctors , known persons & for the benefit to humanity. It is just an observation which can be easily checked by doctors by taking the previous history of patient as I am taking from some of my known patients.

Good wishes.
 
Kumar said:
IR can also be possible in Type1 if injected insulin is more than the required insulin.
Click to expand...

Please support this with literature. To the best of my knowledge, you are describing a physiologic impossibility. If you give too much insulin to someone who is a Type I diabetic, they will go into insulin shock. This is not a medical mystery, as you seem to want to paint it. Either you are confused, or you are talking about something other than what you think you are talking about (e.g., some patients who developed antibodies to older formulations, such as horse and porcine based insulin, and had immunologic reactions, etc.). I'm willing to give you the benefit of the doubt if you'll just back up what you say with something from a legitimate website (WebMD, EMedecine, etc.) that supports what you are saying. Heck, I see at least 3-4 new (to me at least) diabetics every day. I'd love to learn something new.

Long story short, diabetes is one of the most studied and probably the best understood disorder in all of medicine. Until you can prove what you say, I'll go with what my teaching attendings and my extensive studies tell me. No offense intended.

-TT
 
Third Twin,

I don't understand why you are just opposing me. I have helped in giving one of my observation for a unsolved issue, a 'can be possibility' which if proved can do wonders to many but disaster to some(for good). I have mentioned this observation inspite under some stress just for the 'can be benefits' to many. Instead of praising me you are just criticising/doubting me. Just tell me what can be my interest in wasting this much time here other then just for the humanity. You are a doctor & looking after diabetic patients, why don't you go & take history from some old patients that if they ever reduced/discontinued medications and experianced a better control provided they are IR type cases as I mentioned. Moreover, I am mentioning a differant issue which seems to be not yet properly looked in to. and as such how litretures etc. as desired by you can be possible. I have sent this observation to most of the reputed authorities all over the world & they are working on this aspect, but no one has yet given any contradictary remarks as you are mentioning. Just try to learn or ignore but not oppose if you are a real doctor on these types of issuues.:(
 
I give below some details on movement of substances in & out of cells by passive & avtive transport mechnisms:-

Materials move into and out of cells through either passive transport or active transport. Passive transport includes diffusion and osmosis. Molecules tend to move from crowded to less crowded in order to achieve a balance or to reach homeostasis. The cell membrane is selectively permeable which allows the movement of substances, especially oxygen, water, food molecules, carbon dioxide, and waste products, into or out of the cell.

Passive transport : movement of molecules from a more crowded to a less crowded area without the use of energy. Movement occurs when there are unequal concentrations of a substance inside and outside of the cell.

diffusion : movement of molecules from a region of higher concentration to a region of lower concentration.

osmosis : diffusion of water through a membrane.

Active transport : movement of molecules from a less crowded to a more crowded area with the use of energy. Molecules are "carried" into or out of the cell using some of the cell's energy.

I want to know that under which mechnism out of above Sugar & Insulin moves into & out of the cells?
 
Kumar said:
You are a doctor...
Click to expand...

First off, I'm a third-year medical student - not yet a doctor - just so we're clear. I'm not trying to antagonize you; I'm simply trying to understand where you're getting lost and/or if you have information that I may not have yet heard of. It is my impression that you are confusing two separate entities here.

Kumar said:
... & looking after diabetic patients, why don't you go & take history from some old patients that if they ever reduced/discontinued medications and experianced a better control provided they are IR type cases as I mentioned.
Click to expand...

I think this is the problem. You are describing Type I diabetics and insulin-resistance in the same breath. Again, to the best of my understanding, this does not exist. Type II diabetics, by the nature of their disease, have insulin resistance if they are overweight, etc. There are complex physiologic reasons why this is the case, and is described (as you also mentioned) as the "metabolic syndrome" or "Syndrome X". I'm not arguing that insulin resistance in Type II diabetes doesn't exist. This is a well understood phenomenon. Some Type II diabetics do eventually develop beta-islet cell burnout and eventually require insulin. This is called insulin-dependent Type II diabetes, and is more likely what your friend has. These patients can come in with extremely high blood sugars, yet still not develop diabetic ketoacidosis. In fact, I saw a 25-year-old obese female just the other night who fit this description. The incidence of this particular entity is increasing proportionately with the obesity epidemic in the U.S. The solution? Lose weight and exercise.

Now, as far as insulin resistance in a true Type I diabetic goes, I am not aware of this. As I stated above, if you give too much insulin to a Type I diabetic, only two things can happen: (1) they will go into insulin shock, or (2) they will eventually get fat. Again, the latter is a dietary management issue (e.g., the Type I diabetic who insists on eating a pint of ice cream every night and is forced to up their dose of insulin to keep their blood sugar down). This is not a result of "insulin resistance" (like in a Type II diabetic), though. Is the distinction clear? Type I diabetes has a completely different pathophysiology than Type II.

I recognize at this point that you may simply be trolling. This is okay, and I'm still happy to answer this question for the benefit of anyone else who may be reading this thread. But, until you can provide any additional sources that can - even in the most modest of ways - support what you are saying, I don't think there's any need for me to continue on this thread past this post. Like I said before, if this is a true observation my guess is that either a Type II diabetic has been misclassified as a Type I, or you have stumbled upon some new observation in an age-old and thoroughly studied physiologic process that warrants further investigation. My bet is on the former.

-TT
 
Kumar said:
I want to know that under which mechnism out of above Sugar & Insulin moves into & out of the cells?
Click to expand...

There are a family of glucose receptors, some of which are insulin-dependent, that shuttle glucose across the membrane. Insulin does not move "into and out of" the target cells. It simply facilitates the movement of glucose.

-TT
 
ThirdTwin said:

[...] Type II diabetics, by the nature of their disease, have insulin resistance if they are overweight, etc. There are complex physiologic reasons why this is the case, and is described (as you also mentioned) as the "metabolic syndrome" or "Syndrome X". [...] The solution? Lose weight and exercise.
[...]
Click to expand...

For the benefit of those who find anecdotes persuasive, let me say that the same advice really worked for me. In particular, regular aerobic exercise seems to be very beneficial.

Folks, if you think you might have diabetes, please go to your doctor and have it checked out. Don't be a chump like me and ignore the symptoms for months and months.

--Terry
 
Hello TT,

Thanks for your long & informative reply. First of I tell you(as repeated previously) none of the mentioned cases are Type1 or fully IDDM types. Reducing the weight, diet & excercise can be indirectly related to decrease in the insulin level to the target cells which may trigger the BS control as per my observation. However pls inform how diet,exercise & lose weight practices helps in correcting IR condition?

You just assume that suppose insulin toxicity (not gluco/lippo toxicity or otherwise) comes out to be the real cause of Insulin Resistance. Then whenever one is exposed to more insulin for long can get IR condition or not whether he is type1 or type2. I think in normal circumstances a person with type1 or2 should not become fat,obese pear shapped, gain weight etc. unless insulin is working more (or less?) then the required need. You mentioned>>
The incidence of this particular entity is increasing proportionately with the obesity epidemic in the U.S. The solution? Lose weight and exercise...,if you give too much insulin to a Type I diabetic, only two things can happen: (1) they will go into insulin shock, or (2) they will eventually get fat.
Click to expand...
What does it mean> they will eventually get fat<?

You just reframe all your mentiongs in the light of my assumption or observation i.e Insulin toxicity instead of Gluco toxicity.
There are a family of glucose receptors, some of which are insulin-dependent, that shuttle glucose across the membrane. Insulin does not move "into and out of" the target cells. It simply facilitates the movement of glucose.
Click to expand...
I was also finding something like that. Can you bit explain this process in some detail for me. I think it is called 'facilitated transport'.If all sugar moves into & out of cells by this system only. I think receptors are effected(reduced) in IR conditions. Suppose if IR condition is reversed then these receptors can be corrected to their normal level or will remain permanently damaged.
Hi Terry,

I think I explined the reson in the above reply.
 
TT,

Please link the following article with this concept;

Dr. Atkins describes insulin as "the hormone that makes you fat" and also talks about a "carbohydrate-induced metabolic disorder". He contends that overweight people produce too much insulin, which lowers their blood sugar and results in hunger. Also, they have been advised to eat more calories from carbohydrates and he feels that carbohydrates feed into this excessive insulin mechanism.

à Insulin, and more precisely the insulin to glucagon ratio is very important in the control of body weight as well as in the supply of fuels for the body's functions. It is true that coma can result from a blood glucose level that is too low since the brain requires a certain amount of glucose at all times. Insulin is an integral part of calorie homeostasis and blood sugar control. Dr. Atkins takes a very simplistic view of this very sophisticated and highly regulated control system.

There is no solid evidence that high insulin levels make you fat. It is true that obesity is associated with an increased number and/or size of adipose (fat) cells. These cells contain fewer insulin receptors and thus respond more poorly to insulin. This leads to higher fasting blood sugar levels and higher levels of circulating insulin. However, this is not caused by increased carbohydrate intake but is most likely due to the decrease in the number of insulin receptors.
 
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