PCOS Messages for December, 2001: Re: Stupid question!

Re: Stupid question!

From: Belle (anonymous@obgyn.net)
Sun, 30 Dec 2001 15:08:23 -0600 (CST)

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Yes, if you have ADULT onset diabetes, you *probably* have insulin resistance. The cause of adult onset or Type II or NIDDM diabetes is inappropriate insulin secretion or delayed response to a glucose load, this would be what we consider insulin resistance.

There is a difference between insulin resistance and high insulin levels (hyperinsulinemia). *None* of us have been tested for insulin resistance unless we are one of the very few who had this testing as part of a research project. The IGTT does *not* test for insulin resistance, it tests for higher than normal insulin levels. You can also have cells that are resistant to insulin but have normal levels of insulin.

First, just a refresher. In order for our cells to use the glucose that is in our bloodstream that comes from the food that we eat in the form of carbohydrates or sugars, insulin is required. Glucose attaches to the insulin and the insulin has a special ability to connect to the cell allowing the glucose to enter. If the glucose does not enter the cell, we are unable to use the energy from the food that we eat.

The *majority* of adult (NIDDM - Non insulin dependent diabetes mellitus) patients are overweight. This can come from simply overeating, not from insulin resistance. The result of this abuse on the body can cause the insulin receptors on the cell to distort in size so that the insulin cannot properly work. This is very much like a key and lock system. You know that if you have a old or damaged lock, the key will wiggle around and you have to have it in *just* the right spot before you can unlock the door or start the car. Since the insulin has difficulties assisting the glucose into the cell, this can result in higher than normal glucose levels.

In our case, we have a genetic pre-disposition that causes our cells to reject insulin. We do not have to be abusing our bodies to cause our cells insulin receptors to become unwilling to accept insulin.

If you have a pancreas that simply does not put out enough insulin, you can have high blood sugar levels. There are a number of reasons why you would not have sufficient output from your pancreas as an adult. Accidents and disease process are probably the most common. In this case you may need to take insulin shots.

How scary that this woman has decided not to treat her insulin problem. If you are insulin resistant, you cells are not allowing insulin/glucose in, your body detects that too much glucose is in the blood. Your pancreas then releases more insulin to compensate for the excess glucose. This causes the pancreas to work harder than necessary. The pancreas can eventually wear out and quit! At this point you have to take insulin shots.

By taking Glucophage, you are simply helping your cells take in the insulin/glucose, you are not going to be detrimental to your pancreas. Glucophage may help your pancreas work longer putting off insulin injections.

It is the excess glucose and insulin that causes damage to your body. By this woman encouraging her daughter to allow her body to continue in a disease state, she could actually be killing her daughter which would be contrary to her original intent. Diet and exercise should be a part of the daughter's daily regime but if she is "on the verge of becoming a diabetic", she should do *everything* in her power to ward this off. I have worked with many patients who have had to have limbs or appendiges removed because of diabetes. Their sight has diminished or gone. They have difficulty getting up to go to the bathroom and usually end up having a port-a potty next to their bed. They generally regret not taking their medicine.

At Sun, 30 Dec 2001, anonymous wrote: >
>This made me think of a question that pops into my mind from time to
>time.. If someone has high blood sugar levels does it automatically
>mean that they are insulin resistant? Like, are all adult onset diabetes
>patients insulin resistant first? I have a friend who found out that she
>is on the verge of becoming a diabetic and her doc gave her glucophage.
>Her mother talked her out of taking it because it will "cause her
>pancreas to be lazy and not pump out enough insulin." I disagree with
>her not taking the medication, but she wants to try diet and exercise
>first - which is fine and hopefully that will keep everything in check.
>But is there any truth to this pancreas thing? And does Type II Diabetes
>always start with insulin resistance? I am so confused!

-- Hope this helps,

Belle

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