Why insulin given from external source helps in controlling blood sugar in diabetes type 2.

[patliputra]

It is generally believed that DM type2 is caused due to insulin resistance and cellular insensitivity to insulin.

[Hidden]

Very relevant question.

How come, the cells are not insulin resistant to external insulin, but are resistant to the insulin made within the body ?

Is there a possibility, that supply of external insulin to the body, may lead to diminishing capacity of the inbuilt insulin producing cells & in turn lead to total failure of the concerned insulin producing cells, leading to insulin dependency ?

Thanks

[norreal in reply to Hidden]

recyan: These (and similar) thoughts have been haunting me for over six months but I did not find satisfactory answers as yet.

[patliputra in reply to norreal]

There are a few plausible explanations . You know that ,just focus and put your thoughts to paper. Good luck.

[shrisamarth Volunteer in reply to Hidden]

If person is insulin resistant then it is immaterial weather it is endogenous or exogenous.

Mostly insulin is prescribed when there is deficiency. External insulin will rest the existing beta cells, it won't make them dysfunctional.

[patliputra in reply to shrisamarth]

In type 2 dm there is never insulin deficiency ,rather there is hyperinsulinemia . It is circulating glucose which is responsible for insulin secretion and not insulin,so external insulin does not give rest to beta cells directly. Yes, it does,give rest indirectly by lowering circulating insulin .

[shrisamarth Volunteer in reply to patliputra]

Not always type 2 is insulin resistant. I myself do not have IR. Low fasting insulin (less than 2) and low TG/HDL (0.69) ratio.

[patliputra in reply to shrisamarth]

Thanks . If you volunteer to put details about you ,I will be an interesting study .

[patliputra in reply to shrisamarth]

Then why and how exogenous insulin controls blood glucose in type 2 diabetes ?

[shrisamarth Volunteer in reply to patliputra]

Using exogenous insulin for insulin resistant person is nothing but overdosing him with insulin. If the person has IR then the problem has to be addressed with diet, exercise and drugs which help in increasing sensitivity.

[patliputra in reply to shrisamarth]

Very valid points.

[patliputra in reply to Hidden]

Recyan , Interesting thoughts. Our body does not differentiates between the insulins,whether from endogenous or exogenous source. As all know insulin is produced in response to circulating glucose ,so level of circulating insulin does not influence the inbuilt insulin producing mechanism . It is HYPERGLYCEMIA over a long period of time which is toxic to beta cells.

[patliputra]

True,but the point is why an insulin resistant diabetic respond to insulin. Any thoughts.

[patliputra]

Once a person is on insulin therapy, measurement of blood insulin becomes irrelevant .

[patliputra]

You have basically valid points. It all comes back to insulin resistance,how and why it is caused and how to deal with it .but our subject matter ,though related,still it is different. Let us try to find out answer to current scenario .

[patliputra]

Well said. It is genes which load the gun and environment and life style which pulls the trigger . So it is always external factors which is within our reach and can be addressed.

[Hidden]

I have posted questions not statements.

Thanks

[patliputra]

A very logical answer, beautifully said.

[Hidden]

An alternative look :

As received via Email :

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Deccan Herald Oct 7 2014 :

New drug may help root out type 2 diabetes soon

WASHINGTON, PTI: A modified form of a drug used to eliminate intestinal parasites may treat the root cause of type 2 diabetes and not just its symptoms, scientists have found.

In type 2 diabetes the body does not produce enough insulin or the body’s ability to use that insulin is degraded.

According to Victor Shengkan Jin, an associate professor of pharmacology at Rutgers Robert Wood Johnson Medical School, a major cause of insulin resistance is the accumulation of excess fat in the cells of the liver, as well as in muscle tissue.

The fat disrupts the process where, ordinarily, insulin would cause body tissues to correctly absorb glucose — blood sugar — and use it as a fuel.

Much of the excess glucose remains in the bloodstream, where in high concentrations it can damage tissues throughout the body - potentially leading to blindness, kidney damage, cardiovascular diseases and other severe health problems.

“Our goal in this study was to find a safe and practical way of diminishing fat content in the liver. We used mice to perform proof-of-principle experiments in our laboratory,” said Jin. “We succeeded in removing fat, and that in turn improved the animals’ ability to use insulin correctly and reduce blood sugar,” he said.

The modified medication — niclosamide ethanolamine salt (NEN) — burned the excess fat in liver cells through a process known as mitochondrial uncoupling.

Getting rid of the interference of fat in liver and muscle tissue is the key to restoring the cells’ ability to respond to insulin properly, which would allow the right amount of sugar to be taken up by cells and ultimately reverse the diabetes entirely.

That outcome is far from certain, but Jin said the positive changes he saw in the mice are encouraging.

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Thanks

[patliputra in reply to Hidden]

Meetu and Recyan, I liked very much to interact. I am avoiding it as topic is a bit different, though related . Insulin resistance , fat and gut flora all are very interesting subjects and need separate thread for discussion. Thanks.

[Hidden in reply to patliputra]

@patliputra,

You lost me.

I posted the Email content, as it is related to Insulin resistance & that was one of the words in the post that you started.

Thanks

[patliputra in reply to Hidden]

Recyan , I did not loose you . That post did contain some interesting observations and those can be discussed in detail but that will take time and some preparation . In diabetes all things which are talked are interrelated ,so you are very much within the topic .thank you .

[patliputra]

Researches do point that fat is one of the major cause of insulin resistance . But question remains , from where this fat is coming ? Please it should be taken up in another thead .

[Hidden]

@indiacratus,

Sorry, my mistake.

When I typed "An alternative look", what I meant was, Perhaps for some of us, we could perhaps look at alternative methods to reduce or eliminate fat around the liver to reduce Insulin resistance.

How can we come to know whether a person has fat deposits around his / her liver ?

I am aware that way long back, this as one of the cause (sympotom ) has been found and was and still is being researched upon.

AFAIK, Abdominal fat has a greater role to play than other fat in diabetes. I know of many fat people in their sixties who are non-diabetic. Perhaps in their case, the fat around the liver is less or non-existent.

Till such time, the cause is found, we will all be treating the symptoms.

Thanks

[patliputra]

WF law , never knew . Will try to read it. A agree that physical dependence and resistance are two entirely different things.

[Hidden]

Is Gut Flora connected to Insulin resistance ?

Can I request you to post the link as & when you find it ?

Thanks

[Hidden]

AFAIK, could be to get at the bone marrow. But then we will discuss it in another post as it may create a diversion from the current topic.

Thanks

[patliputra]

Indiacratus and Recyan , I can only say " PLEASE ".