Hormones are the body's mechanisms for adapting its functions to changes in the environment. Insulin is a hormone.Only the body itself, when in balance, can properly determine the correct amount of hormones to release.One should note the controversies in recent years concerning other hormone replacements. Insulin does two things: 1.Lowers blood glucose. 2.Promotes fat storage. Although these two functions are related, it is better to view them as independent and separate, for the sake of understanding diabetes. When exogenous (bottled) insulin is used in type 1 diabetics it promotes fat storage.When endogenous (human source) insulin is released from the pancreas, through the action of an oral medicine used by type 2 diabetics to stimulate extra insulin release, it promotes fat storage.When endogenous insulin is released due to an increase in blood glucose concentrations from a food intake in normal non-diabetic persons, it promotes fat storage.The more insulin in the system, the more fat is stored.The more fat is stored, the more insulin resistance there is.The more insulin resistance there is, the more insulin is required to lower blood glucose concentration.This is also a vicious self-compounding circle. I have only been overweight while on insulin.I wonder if overweight people don't have too much insulin in their bodies, which is a sign of a heavy glucose load, the cause of which has not been properly identified yet. The only reason that the pancreas releases insulin is in response to a glucose (sugar) load, or an increase, or a sudden increase in the amount of glucose (sugar) in the system.Glucose stimulates insulin release.The goal should be to use the least amount of insulin that will keep blood sugar normal. Therefore, in order to control the amount of insulin released, one needs to control the glucose entering the system, which stimulates insulin release.A long fast should stop most glucose concentration increases in the blood, as well as most insulin release from the pancreas.Fasting may be difficult if not impossible for some bottled insulin users because of insulin peaks (period of time when insulin is more active).Insulin peaks necessitate food intake.Ketosis will occur when fasting, increasing blood glucose levels slightly.Then the cause of hyperglycemia can be narrowed down to other things such as infections. Frequent fasting to control blood glucose levels is not recommended because it messes up the digestive system and basically makes one sick.Instead, a low glycemic (low sugar content) diet over the long term is a better goal.Always keep blood glucose in the normal range.If necessary gradually decrease the dose of insulin, or oral agent that promotes insulin release, accordingly.When using an oral agent that promotes insulin release, think of it as taking insulin. If an insulin user stops using insulin suddenly, the absence of that insulin will result in ketosis (breakdown of fat to glucose), then increasing blood glucose levels, resulting in diabetic ketoacidosis, a life threatening condition. The glucose lowering function of endogenous insulin and of exogenous insulin may or may not lower blood glucose levels efficiently or effectively due to the multiple compounding factors causing blood glucose levels to rise, as listed above.The main factors are sugars, carbohydrates, and infectious diseases, but these are not all inclusive. What this means is that for a given glucose concentration load, the amount of insulin that is needed to control that blood glucose load to normal levels (80-120 mg/dl) may be either small, large, fixed, variable, routine, or ever-changing, due to the blood sugar raising factors listed above. Most diabetics on insulin that I have met have reported having had a cold-like infection, and losing a lot of weight prior to diagnosis for diabetes. I will explain this: An infection causes the blood glucose concentration to rise above the capacity of the pancreas to produce enough insulin to lower it.This sends the body into a condition of ketosis, which is the breakdown of fat into glucose.This is why weight loss occurs.This glucose (from fat) increases blood glucose levels even further, resulting in diabetic ketoacidosis. One factor that should be considered in Juvenile Diabetes is growth.A child is growing all the time, the body is always changing, and the amount of fat stored in the body is changing.Think of an older person, who has a poor diet, doesn’t exercise, and gains weight: that person becomes a type 2 diabetic.This is because of insulin resistance and perhaps disease.Some pregnant women temporarily get type 2 diabetes.This is attributable to the changes in weight.Stress is also known to be a cause of temporary type 2 diabetes. Why should a child be any different?The insulin producing capacity of the pancreas in relation to the size and fat content of a child's body is always changing.At certain points in the growth development of the child, the system may be taxed to the limit.Sugars, carbohydrates, inactivity, and particularly infections trigger diabetes.Just as in an adult, if a child is started on insulin at a young age, the child's body will develop and adapt itself to the extra insulin in the body.Not all diabetics on insulin are obese, but I would attribute this to diet and to demeanor.A person using insulin who is calm, who is not emotional, who eats conscientiously, routinely, and with moderation will probably have excellent blood glucose control and be a thin diabetic.Insulin use and growth may be the reason why the true nature of type 1 diabetes has eluded doctors and researchers for so long. The main problem I have had using insulin over the years was that I took two shots of NPH insulin a day.This insulin starts to peak 2˝ - 3 hours after injection; the peak lasts up to 8 hours, and then drops off somewhat but lasts up to 23 hours.By taking two shots a day, the tail end of activity of this insulin overlapped with the next shot of NPH insulin.I also used Regular insulin for meals, which begins to peak 1 hour after injection and lasts 6-8 hours.Because of this overlapping, slight daily changes in timing of when I took the injections, unforeseeable varied physical activity, changing work load, and ever-changing meal menus, it made the whole scheme unpredictable and therefore unmanageable.It also served to conceal the true nature of my condition.
Every single day of my life for the last 21 years has been a guessing game of how much insulin to take.I have learned how to be right most of the time, but when I was wrong, the cure was either to eat when hypoglycemic or to suffer when hyperglycemic.In the first case, I loved to eat so it was easy.Hypoglycemia causes an instinctive knee-jerk reaction to want to eat more than is necessary to correct the problem, resulting in increased blood glucose.I recall having had hypoglycemia often in the first few years of the condition.
I have rarely had severe hypoglycemia (low blood glucose levels) due to insulin reactions but the few that I had have filled me with vigilance and fear about passing out.I intentionally ran my blood glucose on the high side so as to avoid any chance of public embarrassment.Also low blood glucose makes me feel light-headed and so I ended up saying dumb things.I trained myself to bite my tongue when I suspected hypoglycemia.Occasionally, I have said things that I still regret due to hypoglycemia and also to hyperglycemia. < PREVHOMENEXT >