What causes Insulin resistance? Is it Insulin injections, Diabetes tablets or Diabetes itself?

Recently a patient who is on Insulin injections for long time got his Serum Insulin tested on my instruction. He as well as me were surprised (rather shocked) to see that the result was more than 200 when the reference range is only (2.6 - 24.9).

I was diabetic from 2006 to 2009 & no more diabetic afterwards. During Jan 2010 I made a poster presentation (Day 1: picasaweb.google.com/115840... , Day 2: picasaweb.google.com/115840... , Day 3: picasaweb.google.com/115840... ) on my diabetes experience at the backyards of Indian Science Congress at the University Campus & one of the visitors who had Doctorate in bio-chemistry remarked that only with a Serum Insulin test one can confirm that the Pancreas is back to normal working condition & that HbA1c/OGTT tests do not suffice. Hence I got my Serum Insulin tested on 25.03.2011 along with my quarterly Cardiology check-up. The result was "Ser. Ins: 10.03 micro U/ml" with "Ref. range(2.6 - 24.9)".

I have heard many experts talking about Insulin resistance; have read in web articles as well. I had & have never used Diabetes tablets or Insulin injections. Hence arose the above question in my mind "IS IT THE INJECTED INSULIN OR THE SWALLOWED TABLETS OR THE ILLNESS (or syndrome according to the modern medicine) DIABETES ITSELF THAT CAUSES THE INSULIN RESISTANCE IN DIABETES PATIENTS?".

More over if the high value of Serum Insulin in my friend/patient is not due to Insulin resistance, what else could be the cause?

I very earnestly solicit the opinion of every one, especially the numerous experts on this forum.

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33 Replies

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  • I was trying to find out the reason for an abnormality. What the science or scientists have accepted/recognised till this day is not what matters to me, but what appears logical & convincing to me is what matters to me. Human society, science & scientists have passed through centuries or millenniums accepting that Earth is STATIONARY & Earth is A FLAT DISK.

    But we know now that their acceptance or firm belief did not make earth neither stationary nor flat; earth was spherical, rotating on its imaginary axis & revolving around the Sun. Please correct me if I am wrong or ignorant.

  • Hope the statements will remain invariable,for ever.

    Good luck to you too.

  • Hi indiacratus,

    You are very much (or completely) right in telling that all of us have to die; but the problem is that we have to live till that & as far as possible comfortably, peacefully etc.

  • Hi indiacratus sir,

    I have checked with the patient again. Blood sample is drawn in Fasting condition.

    The lab is the same where I get my blood tested for Cardiology reviews every quarterly for nearly a decade now.

    The lab has NABL & ACHSI accreditation & the attaching hospital has NABH accreditation.

    The lab as well as the hospital are fully computerised.

    Hence I do not see any possibility for a human error.

    Any how I have requested him to verify with the lab, keeping a copy of the printout with him.

    The report says:

    Serum Insulin (ECLIA) 262.7 micro U/ml

    Ref: 2.60 - 24.90

  • Analtycal errors are different. Insulin measurements is non linear,i.e. It is not like 1,2,3,4,5,6,7,8,9,10. Estimationof insulin by immunoassay (ELISA)is always on log scales, like1,10,100,1000 10,000 . Hence the analyist must be carefull to actually note extact colour and plot in logathimic scale. There are graph sheets which are semi logarthimic and also log log scale. Any error would lead to, not double of values but differ by magnitude of logarthimic exponents. Thus 20 can easily read as200.

    This is the reason that I emphsising qualified bochemical analyist should supervise the lab before releasing results.

    Dr.M.KJSarma,

    Molecular Endocrinologist

  • True I am medical scicentist.

    There are very many details which is beyond the scope of this blog. Like I pointed out about measurement technique of insulin. We teach lots of students on analytical errors.

    Regarding insulin resistance there is basic agreement on the definition of insulin resistance.It is simply stated that" inability of insulin to push glucose into targeted tissue."

    But what casuses is question that is being addressed by many.

    For better understanding of the molecular basis of glucose clearance.you should know the kinetics of glucose absorption,insulin release,mechanism of action of insulin action,insulin receptors, signal transduction, types of glucose transpoters. Insulin sensitization,insulinogogues, ketosis dangers etc

    I am ot computer expert to document all details.But if you find good endocrinolgy book or website please go through and educate others.

    I wish to educate , but too tired after extensive teaching for the five decades.

    Dr.M.K.Jsarma,

    Molecular Endocrinologist.

  • Kindly go through glucose wikipedia on the isomers indetails it is very exhaustive

  • You both are forgetting the fact that the patient who tested 200, was on insulin medication. So I think one should stop speculating about the number. Molecular endocrinologist should know better .

  • share your mobile number that will be helpful for me. i am from kollam.

  • @ShooterGeorge,

    Interesting reading at below in the attachment.

    forums.dlife.in/threads/ins...

    Unfortunately, Healthunlocked does not allow attachments in post. Otherwise would have posted the PDF along with the above link as well.

    Thanks

  • Hi Recyan,

    Unfortunately it could not be accessed because logging-in is a precondition there (like here); I am fed up of log-ins. :-)

  • @ShooterGeorge,

    Sorry. I had clicked on the link & found it to open without any log-in. Had not checked clicking on the pdf attachment link at that time. Now on trying, found that the article attachment needs log-in.

    Will try & find the web path for the article & post.it asap.

    Thanks

  • @ShooterGeorge,

    The link below :

    articles.mercola.com/sites/...

    Thanks

  • Okay, thank you.

  • very interesting, thanks for the information

  • For me it is not surprising. Hyperinsulinemia precedes by many years before development of diabetes. As a matter of fact hyperinsulinemia is supposed to cause many chronic diseases.

  • Sorry for delayed reply. My net was down.

    Before coming to main topic, I must confess that I am unaware of your diabetes history. So I will try to Clear your dilemma based on the information contained in the mail.

    Diabetes is a very complicated and human body is much more complicated than the most advance and sophisticated computer. Having said that let us review the available facts .(1) no record of serum insulin estimation prior to 25/3/11. (2) Duration of diabetes unknown (3) diabetes cured,as per your own version since August/September 2009.

    It is well known that Diabetes manifests clinically long after certain changes have occurred in the body relating to glucose homeostasis. One of the earliest change is development of insulin resistance,which over a variable period of time leads to hyperinsulinemia. If bs is brought back to within normal or non diabetic range,without any medication,and maintained for a variable period of time,it can easily be inferred that there is no more insulin resistance and hence no hyperinsulinemia.

    Your case perfectly fits.

    Thanks.

  • You are absolutely right.

  • why basal insulin levels remain high ? A very complicated issue.Different explanations are given by different researchers and involves a lot of very technical details,not fit to be discussed here.But crux of the matter is that there is no unanimity on the issue,so can be safely said that it is still very poorly understood.

    Obesity is cause or effect of this phenomenon , it is still being debated.

  • Thank you @patliputra for the explanation :-) .

  • My fasting insulin level is 4.04uU/ml, what does it mean to me? (reference rang 2.6-24.90).

  • 4.04 micro units/Milli liter.( Reference range 2.6-24.9). Thanks.

  • Before putting forward any explanation, it is pertinent to know whether you are on Insulin therapy?

  • If your FBS is normal then you are not insulin resistant.

  • Method USED IS C.L.I.A.

  • It is neither external insulin or hypoglycemics tabs which causes Diabetes. Diabetes is not the cause of insulin resistance rather insulin resistance leads to diabetes.

  • No i am not on Insulin Therapy.

  • Rksk, body always needs some insulin circulating in the blood,otherwise the liver will go on dumping glucose in the circulation,whether you eat or not. Circulating insulin should never be zero. But some times it does happen in untreated type 1 diabetes.

  • Yes insulin has multi dimensional role as far as metabolic functions are concerned. Each aspect of insulin can be discussed,but I don't think we should do it because it gets too technical and will not serve any purpose. We should confine ourself to basics and try to educate people to understand diabetes and related issues in simple non technical language. In the past we have done this and let us start afresh again.

  • Investigating people say that there will be the signature of God on something remaining at the crime site that will lead the way to the culprit.

  • Dear SG, I am following LW roti made it grinded powder and made roti since 5 months i am having but skipped sometimes for week and continued again . Will this hinder the cure. I am looking for cure not control bs

  • Hi Niranjan_Kanna,

    Occasional skipping of LWM may not hinder the cure, but the items that you take instead of it (LW based) MAY - if those are fruits, root vegetables, sweets, liquor, bakery products etc.

    Be systematic; you will hit cure for sure - if the dry-heating/static-charge accumulation do not spoil the curative ability of LW.

  • @cscon, yes.

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