Gods, that Star Trekkie phrase is overused, but any excuse to post a picture of Jerri Ryan in that skin suit will make up for the poor, hackneyed pun.
Anyway, a Type I diabetic doesn’t produce insulin; his or her pancreas has beta cells that are destroyed or plain not working. A Type II does produce insulin on his or her own, but have become insulin resistant and can’t produce enough extra insulin to overcome the resistance. Over time, the type II’s pancreas loses more and more of the ability to produce the ever higher amounts of insulin while at the same time, the body being drenched in insulin, he or she becomes more and more resistant; a vicious circle. It’s conventional to think of type II’s as both insulin resistant and incapable of producing insulin even if they are still producing more insulin than a non-diabetic.
The argument is made, too often in my opinion, that because both the I’s and II’s need to manage their blood glucose, especially the spikes, they are pretty much the same. I disagree. I think that the treatment and prognosis is going to vary considerably. For example, once a type II goes on insulin, their insulin resistance can reasonably be expected to increase. Therefore it may pay dividends to postpone insulin as long as other methods of controlling blood glucose levels can be successful. A type I, meanwhile, may need to go on insulin as early as possible to reduce the demands on his remaining Beta cells. Type I’s are often thin, so exercise, while always generally helpful and specifically helpful in using up excess glucose, isn’t going to push a type I back to homeostasis. Nothing can. But type II’s are often overweight (80% of T2’s are overweight), and so if caught early enough and having a diet and exercise plan that is done effectively enough, and perhaps with some luck as well, they may reach and remain closer to a normal level of glucose homeostasis without insulin, slowing the progression of this chronic disease.
There is a school of thought that most of the remaining 20% of thin to normal weight individuals diagnosed with type II are actually misdiagnosed type one and a half’s. A one and a half is generally a diabetic with an autoimmune disease that is, or has, destroyed his or her Beta cells, reducing and eventually eliminating their ability to produce insulin. Effectively they are a type I, they just got to the party a lot later since they took a much longer road to get there. One and a half’s are usually over thirty-five while one’s are diagnosed in childhood.
Anyway, a Type I diabetic doesn’t produce insulin; his or her pancreas has beta cells that are destroyed or plain not working. A Type II does produce insulin on his or her own, but have become insulin resistant and can’t produce enough extra insulin to overcome the resistance. Over time, the type II’s pancreas loses more and more of the ability to produce the ever higher amounts of insulin while at the same time, the body being drenched in insulin, he or she becomes more and more resistant; a vicious circle. It’s conventional to think of type II’s as both insulin resistant and incapable of producing insulin even if they are still producing more insulin than a non-diabetic.
The argument is made, too often in my opinion, that because both the I’s and II’s need to manage their blood glucose, especially the spikes, they are pretty much the same. I disagree. I think that the treatment and prognosis is going to vary considerably. For example, once a type II goes on insulin, their insulin resistance can reasonably be expected to increase. Therefore it may pay dividends to postpone insulin as long as other methods of controlling blood glucose levels can be successful. A type I, meanwhile, may need to go on insulin as early as possible to reduce the demands on his remaining Beta cells. Type I’s are often thin, so exercise, while always generally helpful and specifically helpful in using up excess glucose, isn’t going to push a type I back to homeostasis. Nothing can. But type II’s are often overweight (80% of T2’s are overweight), and so if caught early enough and having a diet and exercise plan that is done effectively enough, and perhaps with some luck as well, they may reach and remain closer to a normal level of glucose homeostasis without insulin, slowing the progression of this chronic disease.There is a school of thought that most of the remaining 20% of thin to normal weight individuals diagnosed with type II are actually misdiagnosed type one and a half’s. A one and a half is generally a diabetic with an autoimmune disease that is, or has, destroyed his or her Beta cells, reducing and eventually eliminating their ability to produce insulin. Effectively they are a type I, they just got to the party a lot later since they took a much longer road to get there. One and a half’s are usually over thirty-five while one’s are diagnosed in childhood.
I’ve always been thin to normal in weight. 5’ 10” in the middle 180’s with a waist line bopping around between 32” and 34”. Many one and a half’s don’t have a family history of type II. I don’t. You can go back four generations, no diabetes at all. I have overweight relatives, some significantly overweight, but no diabetes. I don’t have high blood pressure, which is another common sign for type II that is missing in one and a half’s. So maybe I’m among those misdiagnosed. The way to be sure is to get a test for the GAD antibodies.
I think it’s worth my finding out, while it makes little difference in my short–term planning, since I’m at an early stage, knowing if I am, or am not insulin resistant may save my life in the medium to long term by changing how I expect the disease to progress. It will also change my expectations.
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