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I'm confused, again this time about IR

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clairemm

clairemm

Member
Relationship to Diabetes
Type 2
Hi, sorry times two, because i'm sure this has been discussed elsewhere already.

but i really cant get my head round insulin resistance. i've been reading Gretchen Beckers "the first year .." and its great, really well written and very helpful but i just cant get my round how insulin resistance is different to diabetes (type 2)

from what i'm reading you can have one without the other, but i cant find an explanation (that sinks in anyway) on what the difference is.

its probably very obvoius, but i just get such a mental block on somethings. could someone explain the difference please.

Thanks
 
Well, this isn't a scientific explanation, but the way I would see it is this:

A healthy pancreas will produce about 20 units of insulin a day. A healthy person's cells will have lots of insulin receptors on it so that they can make use of this insulin to transport glucose from the blood into the cells to be used as energy. When a person develops insulin resistance, the number of these receptors decreases, or they become 'damaged' so that they cannot easily be used to transport the glucose - this results in the body/brain believing that there is insufficient insulin available as blood glucose levels are higher than normal, so it prompts the pancreas to produce more insulin. This extra insulin may for a time succeed in stabilising blood glucose levels, but it is now becoming a constant battle to produce sufficient insulin for bring levels of blood glucose down - as a result, levels remain high and at this point it is likely that they will start to regularly exceed normal levels to the point where a diagnosis of diabetes may be made.

It's possible that you can have insulin resistance when your pancreas is struggling to produce sufficient insulin to bring levels into a normal range, but it is when those levels exceed a certain point (above 7.0 mmol/l fasting, above 11.0 mmol/l after an OGTT) that diabetes can be diagnosed.

Hope that helps! 🙂
 
thanks, the cogs are turning slowly,

so if IR normally developes into diabetes is it possible to have diabetes (type 2 or otherwise) without having insulin resistance?

sorry to get bogged down in detail but my inability to make sense of IR is stopping me be able to consentrate on and learn from the rest of the book and other things i read on the 'blessing' that is diabetes :D
 
My thoughts on it are that Diabetes is the inability to produce sufficient insulin whilst IR is the inability to use the insulin produced effectively.

I'm sure someone will correct me, but that's how I think of difference between the two!
 
clairemm said:
thanks, the cogs are turning slowly,

so if IR normally developes into diabetes is it possible to have diabetes (type 2 or otherwise) without having insulin resistance?

sorry to get bogged down in detail but my inability to make sense of IR is stopping me be able to consentrate on and learn from the rest of the book and other things i read on the 'blessing' that is diabetes :D
Click to expand...

I think you have to look at it as a spectrum rather than one thing of the other. People may vary widely in the amount of insulin resistance they have, and how well (or otherwise) their pancreas can counter this by producing more insulin. It is thought that eventually the pancreas will begin to lose the battle and begin to produce declining amounts of insulin as the beta cells die. This is normally when symptoms become more apparent, and also the reason why it may take many years fr a person to suspect they have diabetes. It is possible to have Type 2 and little insulin resistance - for example, some of our Type 2 members who are injecting insulin need only small amounts, whereas others need up to 50 times more.

Insulin resistance can be improved by modifying the diet so that the pancreas has less glucose to deal with, and by exercise which increases the numbers of insulin receptors of cells thus making them more sensitive to it. People may be able to overcome the insulin resistance and improve their control to non-diabetic levels - they will still have diabetes, but they will be controlling it by not overloading their bodies with carbs and by keeping active.
 
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