Insulin Resistance and Effective Treatment of Diabetes Type 2. January 10. 2019

 Comparison of type 1 and type 2 diabetes. Similarities and Dissimilarities in Etiology, Pathogenes, and Complications. 
Edited by Mladen Vranic, Charles H. Hollenberg, and George Stiener.
Plenum Press. New York and London. 1985.

Insulin Resistance is a characteristic feature of non-insulin dependent diabetes mellitus (NIDDM) due to target tissue defect in insulin action. Abnormalities can be divided into receptor and post-receptor defects. Patients with impaired glucose tolerance are insulin resistant due to decreased insulin receptors resulting in decreased insulin sensitivity and rightward shifted in veto correspondence curves. Patients with NIDDM are insulin resistant due to a combination of receptor and post-receptor defects. The greater the severity of the diabetes )greater fasting hyperglycemia) the greater the post-receptor defect, and in those patients with more significant fasting hyperglycemia the post receptor defect in the predominant abnormality leading to the insulin resistant state.

        This is what behind the common presentation of diabetes type 2: insulin  use. In NIDDM, Insulin Resistant diabetes type 2 insulin does not used properly. At the same time every one diabetic know very well, there are no test for the insulin level in our blood or out tissue. There is no any info how mach insulin secreted by diabetic's pancreas. So, there is no any prove that there are insulin in tissue. Probably there is no insulin at all, and this is why level of sugar is very high. All this sound rather speculation then medical diagnose. To see if there is right or wrong insulin use it is better to run some tests. Not possible in present time.
       What else very important in this quotation? "The greater the severity of the diabetes (greater fasting hyperglycemia) the greater the post-receptor defect".  Now the question is, why it is not present in diabetics type 1? Insulin resistance present in IGT or as it is diagnosed in present time, in pre-diabetes state. It is greater in diabetes type 2, NIDDM state. It is not present in type 1 IDDM. Looks sort of confusion. Is there some tests or clinical diagnostic if type 1 or type 2 do have post-receptor defect? No, there are no any tests. It is just assumed.

 Insulin resistance also exist in poorly controlled IDDM patients, due to a post-receptor defect in insulin action. 

Now I fully confused. As I do remember from the definition of type 1 diabetes it is state when there is no insulin secretion. If so then to what diabetic type 1 resistant?
       There are many pages one after another what type of diabetes and how all diabetic population must be classified. Really, why do I need it?  Why do I need to know due what defect and where is that defect my body ill? I do not need this. What I really do need is how to fix this defect regardless what it caused and how to keep it off in incoming future. Is there are some possibility for me, NIDDM  Insulin Resistant Diabetic type 2 who takes over 400 units of insulin daily dose? Highest dose of insulin I injected was 720 units. I am OK with that. But I need to know if I am in right wagon?

This defect in glucose transport, is not expressed in cultured fibroid-blasts, indicating that the abnormality in glucose  disposal seen in vivo and in glucose transport seen in freshly isolated cells is an acquired phenomenon.  Consistent with this, the post-receptor defect is partially reversible by insulin therapy, which leads to 50%-70% reversal of reduced rates of vivo glucose disposal and in vitro glucose transport.

       This is what really important for me. I do have very high insulin resistance. My dose of insulin in daily injections is very high. I do not have fancy to listen that it is insulin why I am so wide. Insulin keeps me alive and partially functional.    What about Metformin? Would it help me to live? Not at all. Even I will take it for granted that Metformin increases sensitivity to insulin in muscles I still do not get, why do I need increased sensitivity to insulin? Would it reverse defect of post-receptors in glucose transport? Not at all. It is not task of Metformin. But still it is goal for me. If there is some defect it is better to fix it before jump on the surgery table to get weight loss surgery.
     I need insulin in injections. I need insulin therapy. Insulin work for me perfectly. The level of sugar in my blood dropped from 599 mg/dl down to 76 today. My A1c dropped from 9.4% down to 4.5%. Also it is very very good. This support the point that Insulin Therapy reverse Insulin Resistance. No one medicine, and practically I took all what was on market before 2010, done the job. Sugar got higher and higher. Now it drops constantly. All what I need just put needle into my wide tummy.

via Ravenvoron