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RE: [IP] Insulin Resistance (?)

Thanks Natalie.
My question which David added to was based on something my endo said at my
last visit which through me off guard.  Over the past year I have halved the
amount of insulin I was taking without changing much in my daily life.  As
you can guess this got rid of my predictable swings.  However, at my last
appointment she said that I was "awfully insulin resistant for my size and
age." Although that was all she said it started me thinking.

My doses are still all up in the air and I think I am still on too much NPH,
but since I am going on the pump in a few weeks they stopped trying to
figure it out.

I take a total of 23 units of NPH a day, and anywhere from 20-50u of H a day
depending on how carb crazy I go. :) I have a 1:9 ratio at breakfast, 1:12
ratio at lunch, and 1:10 at dinner.  Although I think the breakfast should
be 1:10.  My diet is primarily carbs with some protein and a little fat.
Not the 50/30/20 that is recommended more like 80/15/5.  Anyways...my weight
is ~58kg so 1.0u KG would put me at 50u/day.  So in that sense I guess that
would make me a little insulin resistant. Hopefully going on the pump will
help with that some more.

Thanks again,
-----Original Message-----
From: Natalie A. Sera [mailto:email @ redacted]
Sent: Tuesday, November 16, 1999 4:02 PM
To: email @ redacted
Subject: Re: [IP] Insulin Resistance (?)

David L. Dougherty wrote:
> It is a confusing term to me also. The "official" definition of being
> insulin resistant is needing more than 200 units of insulin per day to
> maintain normal blood sugars.

NOT! According to Arturo Rolla, MD who teaches endocrinology at Harvard,
doses over 100 units a day are considered insulin resistant, BUT

a lot also depends on the size of the person. If you're using about .5
to 1.0 units per kg. per day, you're probably not insulin resistant. A
larger person is going to need more insulin than a smaller person --
that should be obvious from the fact that small children use so little!!

So a man who weights 100 kg. (220 lb.) could easily use 100 units a day
without being insulin resistant, but if *I*, at 65 kg. used that much, I
WOULD be insulin-resistant. (actually, I use about 25 units a day, which
is even less than .5 units per kg.) 

Also, there are varying degrees of inborn insulin resistance -- it's a
bell-shaped curve, with only a few people on the ends, and most people
somewhere in the middle. 

AND (you knew there was more) there is a difference between inborn,
biological insulin resistance and immune-mediated insulin resistance,
which sometimes happens to Type 1's who suddenly require MASSIVE doses
of insulin where they once used small ones. Fortunately, that type of
insulin resistance goes away after a bit, but it's hell to deal with
until it does!

 ._c- ._c- ._c- ._c- ._c- ._c- ._c- ._c- ._c- ._c- ._c- ._c- ._c- 
 Natalie A. Sera, with all her ducks in a row!
 Type Weird, pumping!
 mailto:email @ redacted
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