Yesterday my husband & I went to our Infertility appointment (as we have been since July, 2006). Anyways, I am a Type 2 Diabetic & Insulin Resistant with PCOS. My actual meter readings for my sugars have been pretty good actually, but apparently my INF. Dr. says they (insulin levels) are too high - like in the 90's, which doesn't keep my actual sugar readings from being high. The way she explained it to me, or how I understood it was there's SO much insulin floating freely in my body, my cells aren't doing something to the insulin or whatever. (I do not understand that part, lol)
Anyways, my question is ... What in the world is she talking about? What exactly does Insulin Resistance mean as when I search & read about it, I really do not understand. She and the Head Dr. sat my husband & I down before we continue more fertility meds, she wanted my insulin levels to come down & I continue my "diet" (lifestyle change)! I'm just confused!!
Every cell in the body has receptors for insulin. The receptors are kind of like locks, with insulin being the key to open the lock. The locks need to be open to allow the blood glucose to enter the cells.
"Normal" versus "insulin resistant" could be compared to people who live in the burbs versus people who live in New York City. Those of us in the burbs usually only have one lock on our doors (normal) versus people who live in New York City and may have 5-6 locks on their doors (insulin resistant). It takes much more insulin to get the glucose through the "door" in insulin resistant people.
I think I am even more confused, lol. You explained that very well and I kind of understand, but my question is what does it mean if the cells aren't "doing their job" as my Dr. stated? We didn't go too much into that!
.... what does it mean if the cells aren't "doing their job" as my Dr. stated? We didn't go too much into that! ....
Here is my take on it. I think what your doctor was refering too is that there are not enough insulin receptors on the cell surface for insulin to be able to poke glucose into these cells. The cells aren't "doing their job" and the result is that blood glucose goes up. The beta cells respond by producing more insulin in an effort to keep blood glucose down at normal levels. This is what causes insulin levels to rise. And it starts a vicious cycle. As insulin levels rise, the number of insulin receptors on the cell surface is down-regulated. This is how cells keep unwanted glucose out. But the excess glucose left hanging around in the blood stream causes insulin levels to rise even higher. And you have to find a way to break the cycle.
The only way to reduce insulin levels is to improve insulin sensitivity. And you can do this in two ways : increase the demand for glucose and reduce the supply of glucose. The net effect is that the cells make more insulin receptors available to effectively attract the glucose they need. In other words, insulin resistance declines and insulin levels drop. Supply of glucose can be reduced by eating low-carb. And the demand for glucose is increased by getting exercise. Building muscle is particularly beneficial as muscle is more insulin sensitive than the rest of the body. So there are things you can do to improve the situation. Insulin sensitising drugs can also be considered.
Just to put this into context for you, consider that the fasting insulin level for a healthy young adult should be below 10. If your insulin level is in the 90's, this would be a problem for the baby. You would be giving the baby 9 times as much insulin as it needs. The baby would have to quickly become as insulin resistant as you are to avoid very low blood sugar levels. I suspect that this is why your doctor is concerned and wants you to get that insulin level down.
Type 1 since 1977. On Lantus, Novorapid and Actrapid.
Glucose is the necessary fuel for all the cells in the body, and there are receptors in the cells where glucose (sugar) must enter so the cells can use the glucose for energy. Glucose provides energy for the cell.
The glucose cannot enter the cells without insulin. Somoneone once told me that "the insulin takes the glucose molecule by the hand and leads it to the cell."
In insulin resistance, the receptors are not working (simplfied explanation), and the cells cannot get enough glucose.
The body produces more and more insulin to correct the situation, and at the same time there is an excess of glucose in the blood.
This is insulin resistance, and eventually there may be full blown diabetes.
When the body is producing more and more insulin to "get rid" of the glucose in the blood, then sometimes the blood sugar readings do not reveal the fact that there is too much glucose in the blood.
And many of us know that in diabetes, the excess of glucose in the blood is damaging to all the organs in the body, the eyes, the heart and other arteries, the kidneys.
What does INF mean?
To summarize, I think your Doctor is saying that because your body is producing so much insulin that blood tests do not show the true readings for glucose, and that your situation is worse than the tests show. And when she says your cells "aren't doing something to the insulin", she means that: the glucose is not entering the cells, and the insulin is not doing its job.
Thanks you so much Dilly & Mark. You both had excellent explanations & really helped me to understand what my Dr. was telling me. I am a full blown Type 2 Diabetic but I also have PCOS (my husband & I are trying to conceive), and I'm Insulin Resistant. I am taking Fortamet (extended release form of Metformin b/c the regular kept me sick), Januvia, and Tricor (for my cholesterol).
I am on a diet, or should I say lifestyle change. I can't remember who put it that way but I liked it, and it's definitely a lifestyle change. I have my snacks during the day and my breakfast consists of Kashi or yogurt, and my lunch & dinner is almost always a Lean Cuisine. As you mentioned, I need to keep my carbs down in order to bring my insulin levels down, so are eating the Lean Cuisines ok? They aren't outrageous in carbs! I also exercise daily; Advanced Tae Bo and I am about to start switching it up by walking at least 30 minutes every other day! Is this a good plan? Will it help my insulin levels to come down?
And, I didn't realize by getting pregnant my insulin levels could affect the baby! Wow. Diabetes & Infertility really do play off of each other, so I am treating 2 different problems (Diabetes & PCOS) with the same treatment. Awesome! LOL! I am so motivated to make this work, to lose a few pounds, and rid of these problems ... and of course to get pregnant. Thanks so much!!
Hi again Kris. Mark, I think our posts crossed in the posting. Good explanation.
Kris, You asked about exercise, and I have to tell you my short story. I am a diabetic for 10 years. (I am 70). Diabetes can affect the arteries, and the result is hardening of the arteries. I cannot walk far, but regardless I was really stupid, and could have gone to the pool on a regular basis, but I did not. The result is that I had a heart attack. The cardiologists tell me that even with the diabetes, I could have kept my arteries in better condition with regular exercise.
I don't want to scare you too much, but if you are able, concentrate on exercise, exercise, exercise. Diet also of course---out with all the cookies, cakes, pies, ha ha. I hope my little story, helps you at least a little. Take care.
Thanks a lot Dilly I do not eat cakes, pies, or anything like that - I stick to my 1,200 calories per day and try really hard. I do exercise (Advanced Tae Bo) and I'll start walking at least 30 minutes every other night to increase the weight loss.
I am sorry to hear of your condition! Heart attacks/heart disease runs early in my family (my Papa is in his early 70's; going strong but he's been through A LOT) so I want to nip it in the bud before it's too late! I am *trying* to take care of that. Thanks so much for your help & tips. You have been very helpful & motivated me even more to continue doing good!
Good for you, keep up with the diet. All crazy junk we eat (including a lot of the grains) is causing a diabetic epidemic, so I have read.
Good luck with the pregnancy. Ps: I am doing fine, as the heart attack did not damage the heart muscle, so am treating with medication, and have high hopes for a good recovery. Also going to the pool almost every day now!! ha haha. Even now it really helps my blood pressure and will help blood flow.
Hi again. Not swimming fast or anything, but slow dog paddle, and no overhead strokes. Cardiologist said swimming is excellent, so long as my pulse rate does not go up more than 15 points beyond my resting pulse (heart rate).
Forgot to say, on the subject of swimming and exercise, I understand that any large muscle exercise will help "drive the glucose" into the cells. Swimming therefore, is probably better than walking. My sister is a diabetic, and she has been going to do aquatic exercises 4 days a week for several years and she does not have to take meds.
Sounds like you're getting lots of good advice about excerise - remember, it doesn't really matter what you do - just do something EVERYDAY.
I just wanted to comment on your diet.. oh, excuse me, lifestyle change. I have recently went through the same thing, drastically changed my diet and have lost almost 50 lbs. You mentioned eating Lean Cuisines, although this is a good choice for low calorie/low fat, these are NOT a good choice for a diabetic. Go to your freezer and read the label - check out the sodium! It is outrageous! Being diabetic means not only a low carb diet, but low fat and sodium, these decreases your chances of other complications such as heart disease. If possible stay away from any processed foods. This is really the hard part and where "lifestyle" change is most applicable. No more popping stuff in the microwave, you actually have to prepare and cook meals. Eat three sqaure meals a day and eat vegetables as much as you can. Doing this with excerise, and you'll be one skinny lady! lol
Thanks for the advice, Canada! I really don't have a lot to lose but I would like to lose some, and become more healthy! I've mentioned in other posts on Health Boards that I like simplicity. I cannot prepare & cook meals with a lot of ingredients, and count every part of a label. It just doesn't work with our lifestyle. I do, however, cook for my husband every night but as I've also said before, our eating styles are different!
I like the fact I can eat & go ... and still lose the weight. I am not concerned about the high sodium at this moment as long as I can lose a little weight. Those meals, while they are high in sodium, offer more than what I was doing by not counting anything at all! Simplicity is what I also need in my life right now as many other parts are complicated & sporadic/busy!
Thanks for your tips, though! I really do appreciate it
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