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type 1 and insulin
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DoloresTeresa posted:
I know nothing about T1 (I'm T2), but I am curious. I often read of people with T1 increasing their insulin dose. I can understand this with T2 because more and more beta cells could possibly stop producing insulin over time. But with T1, I thought that there are no working beta cells (except maybe early on) so why would one have to increase insulin doses? I am assuming that the diet remains relatively the same--that is, if you are eating so many carbs, so much fat and so much protein, why would some have to increase insulin?

Dolores
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mrscora01 responded:
You could be thinking of T1s in the honeymoon phase of diabetes. Don't forget that many adults get diagnosed with T1. That's why they don't call it "juvenile" anymore. The honeymoon phase can last for years. This is the period where the pancreas still sporadically produces some insulin and only eventually fails. During this period insulin consumption goes up and down. Also, people's bodies change all the time. I know that my insulin sensitivity changed with the seasons (I took more insulin in the summer than in the winter). So my dose was always changing. Many T1s are very insulin sensitive so the dosing can change quite radically with only small changes in environment (temp, mood, food, exercise, etc). Insulin doseages, especially if you are testing a lot and trying to keep good control, are always changing either up or down.

In addition, I know of a couple of folks that have their insulin requirements change based on their level of autoimmunity. So their pancreas seems to work a bit when things are quiet, but poops out again when the immune system kicks in. These folks have other autoimmune disorders in addition to the diabetes.

Basically there are a ton of things that will affect insulin requirements and so things are never stable, Hope this clears things up a bit.

Cora

Cora
T1 1966, Dialysis 2001, kidney transplant and pump 2002, pancreas transplant 2008
 
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DoloresTeresa replied to mrscora01's response:
Thanks, Cora, that was informative. I have never thought of the term insulin sensitivity with respect to t1 diabetics. I thought it only applied to t2 diabetics.

Dolores
 
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mrscora01 replied to DoloresTeresa's response:
Dolores, don't forget that there is something called "double diabetes". It is T1s who are also insulin resistant and take something like metformin to increase their sensitivity. I have a friend who weighs less than I do and yet takes double the insulin that I have taken. She is less sensitive (maybe even a bit resistant) than I am. So you see the full spectrum among T1s also.

Cora
T1 1966, Dialysis 2001, kidney transplant and pump 2002, pancreas transplant 2008
 
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DoloresTeresa replied to mrscora01's response:
Double diabetes is another new one. I do remember reading that Dr. McDougall who takes his patients off meds said that he always uses insulin for t 1's and also uses insulin for what he calls t 1 1/2. He says this is because they do have some working beta cells but still need insulin.

Does metabolic syndrome go along with the insulin resistance of t 1's or is that strictly a problem for t 2? The more I read the more I believe that there are many different illnesses of this sort but they are all lumped together under the term diabetes simply because out of control blood glucose is the primary symptom.

Didi
 
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mrscora01 replied to DoloresTeresa's response:
You've got it exactly. It's all called diabetes because of the blood sugar, but I believe that it is actually a spectrum of diseases. There is nothing as a T1 that will stop you from also getting metabolic syndrome. PCOS, another culprit, can also be found in T1s, so again met can be used. You are right that insulin is a requirement for T1s and T1.5s, but some folks are also on oral meds. It certainly is a weird disease.

Cora
T1 1966, Dialysis 2001, kidney transplant and pump 2002, pancreas transplant 2008
 
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DoloresTeresa replied to mrscora01's response:
Yes and I think part of the weirdness comes from the fact that it most likely is not "a" disease, but possibly several.

Dolores


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