Facts About Insulin Resistance in Type 1 Diabetes. I was diagnosed with Type 1 diabetes in 1. Since then, I have dedicated my life to researching Type 1 diabetes and to helping people with any form of diabetes maintain better control. I suffered from insulin resistance in Type 1 diabetes (after diagnosis) until I committed myself to improving my insulin sensitivity. Many people have fallen prey to the myth that people with Type 1 diabetes cannot have insulin resistance. This is absolutely not true. It is very common for people with Type 1 diabetes to also have insulin resistance. Carla Greenbaum, MD, who is a Member of the Benaroya Research Institute and serves as Director of the Diabetes Research Program and the BRI Clinical Research Center(1), has conducted multiple studies related to insulin resistance in people with Type 1 diabetes. An abstract from one of those studies states: “Insulin resistance plays a larger role in the type 1 diabetes disease process than is commonly recognized.”(2) It is estimated that one in three people with Type 1 diabetes also has insulin resistance.(3) One study estimated that 2. US have Type 1 diabetes and insulin resistance; and that insulin resistance plays a large contributing role in the complications associated with Type 1 diabetes.(4) The phenomenon of people having both Type 1 diabetes and insulin resistance is sometimes referred to as “double diabetes” or “Type 1. Sadly, many people with Type 1 diabetes do not believe it’s possible for them to have insulin resistance. This lack of knowledge and refusal to accept the truth can greatly inhibit their ability to control their blood sugars. Their lack of knowledge stems from the insistence that Type 1 diabetes and Type 2 diabetes have nothing in common.
Although the causes of each type of diabetes are different, Type 1 and Type 2 have more in common than many people realize. Before I go further, let’s review the three basic types of diabetes. There are others, but these are the most common: Type 1 Diabetes: An autoimmune condition characterized by insufficient insulin production due to the body attacking the beta cells in the pancreas which produce insulin. Type 1 diabetes used to be known as “juvenile onset diabetes” or “insulin dependent diabetes.” Neither of those terms is accurate in today’s world where adults are often diagnosed with Type 1 diabetes and where people with Type 2 diabetes often require insulin to maintain normal glucose levels. Type 2 Diabetes: A chronic condition characterized by the body’s inability to properly use insulin. The body’s inability to correctly absorb and use insulin results in high blood sugars and many of the same side effects as Type 1 diabetes. Type 2 diabetes has many other names, most of which are outdated and inaccurate. Latent Autoimmune Diabetes in Adults (LADA): A slowly progressing form of diabetes in which the beta cells in the pancreas are slowly destroyed due to an autoimmune attack. Destruction of the pancreatic cells usually occurs much more slowly than it does in Type 1 diabetes, with the patient often not needing insulin for months or even years. Type 1 diabetes and LADA are very similar and have very similar control protocols once someone with LADA progresses to the point of needing insulin. It is very true that insulin resistance is a characteristic of Type 2 diabetes, but it is also a characteristic of Type 1 diabetes. People with Type 2 diabetes develop insulin resistance before they are diagnosed with Type 2 diabetes; people with Type 1 diabetes usually develop insulin resistance after they develop Type 1 diabetes. Insulin resistance in Type 1 diabetes is very common, but there are ways to reduce its effects. Symptoms of Insulin Resistance in Type 1 Diabetes. The following symptoms may indicate insulin resistance in someone with Type 1 diabetes: Elevated cholesterol and triglyceride levels. My eating habits have changed, my cooking habits have changed. GOLO is not a diet, but a lifestyle. High blood pressure. Weight gain not associated with an increase in food or decrease in exercise. Needing increasing amounts of insulin to maintain normal glucose levels. Elevated liver enzymes: High insulin levels are known to impair the liver’s ability to metabolize glucose, which may result in elevated liver enzymes in blood work.(4)Coronary artery disease. It is somewhat interesting that many of the complications we associate with Type 1 diabetes may actually be caused by excessive use of insulin. Maintaining blood sugars as close to normal as possible is imperative, but there are things we can do to help reduce our need for insulin. My goal in my own control and when I work with clients who have Type 1 diabetes is to improve health by living a lifestyle that improves glucose control, lowers A1. C levels, and requires less insulin to maintain normal glucose levels. Important scientific information about insulin resistance in Type 1 diabetes. Provides possible symptoms, causes and potential solutions. Potential Causes of Insulin Resistance in Type 1 Diabetes. The following reasons explain why people with Type 1 may develop insulin resistance: Stress and illness: Stress and illness can cause temporary insulin resistance in anyone, but the effects may be much more noticeable in a person who has Type 1 diabetes and is checking blood sugars frequently. This is one of several reasons people with Type 1 diabetes typically need significantly more insulin during times of illness or stress. Large insulin requirements: A healthy pancreas produces 2. Many people who are clients of mine were taking 1. I was taking more than 1. I began making lifestyle changes to control my blood sugars better. I now take 2. 0- 2. A1. Cs below 6. 0. The high amounts of insulin my clients took were required to maintain blood glucose levels as close to normal as possible. The problem is that high insulin usage can have many negative side effects and can cause the body to become “overwhelmed” with insulin and stop absorbing it properly. This results in insulin resistance. Sadly, insulin resistance is very common in people with Type 1 diabetes. For more information in insulin, please read: Surprising Facts About Insulin. The challenge is that maintaining normal blood glucose levels is essential, even if it requires large amounts of insulin. I’ll share more about effectively addressing that challenge later in this post. Ethnicity: People with Type 1 diabetes who are African American, Eskimo, Asian or Hispanic typically have higher rates of insulin resistance than Caucasians with Type 1 diabetes. This is why people of the above ethnicities often require much higher amounts of insulin. High levels of insulin- binding antibodies: It is common for people with Type 1 diabetes to have higher levels of insulin- binding antibodies than people who do not have any form of diabetes. This causes people with extremely high levels to require more insulin to maintain normal blood glucose levels. Amounts of insulin- bining antibodies vary greatly from person to person. More research is being done about how to control these antibodies.(3). Obesity: It is a well- known fact that obesity reduces insulin sensitivity. Unfortunately, insulin is a hormone that stimulates the body to store fat, so people with diabetes who are on large amounts of insulin often find it very difficult to lose weight. Potential Ways to Reduce Insulin Resistance in Type 1 Diabetes. Although insulin resistance can make it very difficult to control Type 1 diabetes, there are certain lifestyle habits that can greatly improve insulin sensitivity in people with Type 1 diabetes. Those habits include: Reducing carbohydrate consumption and eating mostly low- glycemic carbohydrates: Reducing the amount of insulin the body needs is a first step to helping cells “reset” and restore insulin sensitivity. Exercise: As little as ten minutes of exercise improves insulin sensitivity for up to six hours. One study found that people who engaged in exercise and who followed a low- glycemic eating style had improved insulin sensitivity within just a week. Heavy weight lifting can improve insulin sensitivity for up to 4. I engage in aerobic exercise and heavy weight lifting at least three times a week. If you are not currently exercising, start out slowly and increase your activity very gradually. Limited use of supplements: There are some supplements known to improve insulin sensitivity. I am not mentioning then here because they should be used with caution and because each person’s personal physiology needs to be considered when selecting an appropriate supplement. There’s nothing healthy about taking handfuls of pills every day, so I am very cautious when recommending supplements and rarely recommend more then two. I’ve seen A1. C levels drop in some clients by as much as 3. Working closely with your physician or endocrinologist: As lifestyle and dietary changes are made, it is imperative to work very closely with one’s physician and to monitor blood sugars very closely so insulin dosages can be adjusted as needed. Medication: Although it’s not my first choice, some people with Type 1 diabetes and insulin resistance find that using medication such as Metformin helps them maintain normal glucose levels. Some also find a short trial of Metformin helps them lose enough weight that their physician can then very slowly wean them off of their Metformin dose. There are no “easy fixes” for insulin resistance in Type 1 diabetes, but a combination of dietary and llfestyle changes can help. I know, because I’ve been able to reduce my insulin resistance and improve my health dramatically using a variety of small changes. After almost 5. 0 years with Type 1 diabetes, I have no complications and live abundantly with ample energy. It is possible! References: (1) https: //www. Diabetes Metabolic Research Review. May- Jun; 1. 8(3): 1. Wien Klin Wochenschr. Apr 1. 2; 9. 7(8): 3. The Interplay of Autoimmunity and Insulin Resistance in Type 1 Diabetes, Nokoff, Rewers, Cee Green; University of Colorado School of Medicine, 2/1. Diabetes Insulin Pump: How It Works. Insulin pumps are small, computerized devices that some people with diabetes use to help manage their blood sugar. They wear their pump on their belt or put it in their pocket. The pump releases rapid- acting insulin into your body through a small, flexible tube (called a catheter) which goes under your belly's skin and is taped in place. How It Works. The insulin pump works nonstop, according to a programmed plan unique to each pump wearer. You can change the amount of insulin delivered. Between meals and overnights, the pump constantly delivers a small amount of insulin to keep your blood sugar in the target range. This is called the . You can calculate how much of a bolus you need based on the grams of carbohydrates you eat or drink. When you use an insulin pump, you must check your blood sugar level at least four times a day. You set the doses of your insulin and make adjustments to the dose depending on your food and exercise. Why Use an Insulin Pump for Diabetes? Some doctors prefer the insulin pump because it releases insulin slowly, like how a normal pancreas works. Another advantage of the insulin pump is that you don't have to measure insulin into a syringe. Research is mixed on whether the pump provides better blood sugar control than more than one daily injection. Sources. SOURCE: American Diabetes Association. All rights reserved.
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July 2017
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