[Bigpete757]

Hello,
I am a new member with a few questions. I recently went to the doctor because I thought I had a low testosterone problem, which I do, but I also found that I had a glucose level of 95 (65-99) and an insulin level of 17 (5-18). I think the insulin level measured was the fasting one and free level was also on the very high range. The labs were done at Quest. My doctor said that the insulin levels were very high and that I have a serious problem with insulin resistance.

I also am 6'0, 305 pounds with a good amount of body fat. I recently started testosterone medication which has given me heart problems and I am very concerned about my situation. I am no longer on the testosterone medication and are now focusing on my insulin resistance issue and controlling my blood sugar because I think it is causing me alot of problems. I am constantly hungry, go to the bathroom very frequently, and have a few other signs of pre-diabetes such as elevated triglycerides, over 40 inch waist, low "good" cholesterol levels, etc. I eat a well-balanced diet and try to workout hard lifting weights/cardio at least 3-4 times a week, and I have been unable to lose a pound or feel any healthier for the last 3 years. I also might have a low iron issue which is contributing to my heart problems.

A few tests that were recommended were the glucose tolerance test, and leptin test, H1AC, and maybe HOMA. One of my questions is what are the best tests to measure insulin resistance, would it be smart to test everything mentioned above, and anything else you want to add in regards to this issue would be great. Advice, suggestions, etc.

Another question what kind of medication is used to treat insulin resistance. I know that diet and exercise are important, but I have read about things like metaformin, actos, and a few others, but are not sure how they would relate to my situation. Here is a link that talks about various kinds of medication, but since I am new I am not sure what route to go if indeed I do end up needing meds. I don't think anything is made specifically for insulin resistance, but I am probably going to need a combo that would not lower blood sugar too much I am assuming.

Other Medications for Type 2 Diabetes - American Diabetes Association


In regards to weight loss, I am hoping that getting my glucose/insulin levels in more balanced range will make it much easier to lose weight. Do any of you have experience with this or success stories to share.

I was recommended to get a blood glucose meter and check my levels every once in a while to see how I react to certain foods. My doc said I should try to keep my levels below 110-120, I think. Does this sound right. Also what is good meter to use. I am going to check with insurance first, but I am not sure if I am covered yet.

Sorry for the long post, I am just really struggling medically and I am trying to figure out what is going on. I know pre-diabetes and diabetes can affect your heart and I am fairly confident this is what is causing my heart/health problems and are trying to fix it. If there is anything else that you think I should know or might be worth taking a look at, please let me know. Thank you and god bless.

[princesslinda]

Welcome BigPete! Insulin resistance, if left untreated, will most likely lead to T2 diabetes. Treatments for insulin resistance include weight loss, excercise and metformin. Metformin is a medication that works by helping your body better use the insulin you're making.

I occasinally struggle with the constant hunger as well, and it is frustrating to eat and 30 minutes later feel as though your stomach is going to growl, knowing full well that you can't be hungry. I've found that limiting carbs and exercise helps the most with this.

Get a meter, test 2 hrs after your first bite of food (post meal #s are the first to become abnormal)....you'll learn which foods to avoid and make smarter food choices. Avoiding "white foods," such as potatoes, rice, pasta and bread is a good start. Eat lots of green veggies, lean meats, seafood (unbreaded), salads that type thing. If you want to lose weight, watch the calories as well. I lost weight with low carbing alone at first, but now I have to watch the calories too, as my weight loss dwindled.

Start walking...get a pedometer and see how quickly those extra steps add up. Take the stairs, park further away from your destination..anything to add more steps.

A great book: "The First Year, Type 2 Diabetes," by Gretchen Becker.

Hope you post often. There are lots of friendly, encouraging people with good advice here.

[sumi]

Hi Pete, welcome
Good for you and your doctor. It seems too many people wait until the problem is extremely serious before taking action. Your doctor's advice sounds reasonable to me, however it is certainly not what we normally hear. Yes get a meter. Test before each meal, then 2 hours after first bite. This will tell you which foods your body can handle. Personally, I like my pp (post prandial) reading to be 120 or under although 140 is likely good enough to prevent damage. As you may know by now, that high insulin level makes weight loss tough. Most of us find that low carbing (much much lower than the ADA guidelines) has several positive effects. Carbs are mainly what affect your bg levels, so by limiting them, you will limit your pp spikes.
I sympathize with the constant hunger, that was me for several years before diagnosis. It didn't matter if I had just finished a big meal, I was ready to eat again. Although my weight hit 212, I feel that it could easily have been twice that if I had completely given up. By drastically lowering my carbs, for the first time in years, I could finally be free of that constant desire to eat. In my case that number was 50 carbs a day, I am now able to handle up to about 70-75 some days. This is definitely individual. Some people can handle only about 30, others perhaps 150. Diabetics on insulin can eat very normally as long as they don't have significant insulin resistance.
Your exercise regime will pay off as much as your diet. You will find that a 20-30 minute walk just before or after a meal will lower your bg level - something to keep in mind if you overindulge. You might also try eating smaller more frequent meals to smooth out your bg levels.
As far as meds go, probably the fewer the better. All meds of course have side effects. Since your fasting bg is already pretty good, you certainly don't want to take a chance on going too low which is extremely unpleasant (not that I have any first hand experience) as well as dangerous. Metformin is usually the first drug of choice. Some people have trouble tolerating it. The dosage should be built up slowly, or the extended release type used.
Please visit Jenny Ruhl's website Blood Sugar 101 for lots of info including most common drugs and side effects. You should also read through lots of old threads for tons of advice on how to proceed. Of course, you will have to make up your own mind as to what feels right for you. One thing that we are very aware of is how individual D is. And remember, most of what you read is simply our own individual experience and may or may not apply to you.

[Ronin]

Hi Bigpete!

Welcome to the club you never wanted to join. You are lucky to have caught the condition during the warning phase. Your personal description says that you already know you have difficulties and that the process of regaining your health is going to take time.

Weight loss is quite difficult and it is also quite simple. Reduce caloric intake so that your body has to use up the stored calories. Right now you are 70 pounds heavier than I was at my max weight (and we're the same height). I dropped 70 pounds you probably need to double my accomplishment. It took a long time and a lot of effort.

The only way to lose weight is a combination of eating modification and exercise. I realize that exercise at 305 pounds can be dangerous if not done with some caution. However, something as simple as a daily walk will use calories and if you manage your eating your body will demand some of the stored calories.

There is one caution -- don't even attempt to starve yourself. The starvation response is bad for you in that your body will try to protect the stored calories if it feels it is about to starve. You need to provide just short of the required calories to meet your targeted weight and then add that daily walk. Simply moving that 305 pounds around takes a lot of energy so the caloric demand will be high.

I used a modified Atkins type of eating to lose weight. I rode a bicycle (actually a tandem) as the exercise part. I also do three BowFlex sessions weekly to develop upper body strength.

Your Blood Glucose (BG) levels should fall as you lose weight and it might be possible to overcome the insulin resistance you are showing.

Daily testing of your BG levels is helpful and well worth the investment in a meter and strips.

The bottom line is that you have to make a decison for the rest of your life. The reward for the effort is a great life, not a big meal. Celebratory food is no longer a reward -- that is backsliding. A nice long walk or other form of activity (once you have strengthened your cardovascular system) will be the reward as well as the cure.

We're here to help as long as you need our assistance. Many of us have changed our lives for the better. It isn't easy but the rewards are great.

[Bigpete757]

Thank you very much for the replies. I have learned alot from looking around on the forums and the people here are great. I am now focusing all my attention on insulin resistance. My main goal is to try learn about this issue and make the necessary changes in my diet.

PLEASE give me some advice on how to treat insulin resistance. I googled it and read info for hours and have good idea of what it is, but there are alot of different things about how you can treat it or become more insulin sensitive.

I have read that eating soluble fiber can help and I have looked in to a few fiber supplements. The problem is I don't want to be on the toilet all day, so I need to find something that does not make you go. For example, when I eat oatmeal, which has fiber in it, it doesn't seem to make me go. I looked into oat bran and oat bran concentrate which seems promising, but would like to hear other opinions.

I have also looked at things like benefiber, but don't know if this would be good. If you know of any good foods that have alot of soluble fiber in it or could benefit insulin resistance, please let me know.

There have been numerous supplements listed to help insulin resistance, but it hard to figure out what really works or not. If you have had some good results with anything or could mention something that I might want to check out, please let me know.

Due to my insulin resistance, my appetitie is often out of control at night for me and I am thinking that taking an appetite supressant or something similar might help me in the short term. This is not something I want to do, but I also want to survive and I feel like if I am eating myself to death right now. I do have a ADD problem, so I was considering adderall, but I also have heart problems right now and that is a stimulant, so I am little worried. If you know of anything, that would be great.

If you would like to include anything else related to treating insulin resistance, I would be grateful. Thank you.

[sarahspins]

Originally Posted by Bigpete757

PLEASE give me some advice on how to treat insulin resistance. I googled it and read info for hours and have good idea of what it is, but there are alot of different things about how you can treat it or become more insulin sensitive.

Honestly the most effective thing is to just lose weight - carrying excess weight causes insulin resistance in both types of diabetes, not just for those with T2 (or more prone to developing T2).

Past that, try to be more active.. if you aren't already exercising regularly, that would be the place to start.. it doesn't have to be high-impact, even just a brisk walk for 20 minutes can make a big difference. The more active you are, the more excess glucose your body burns up rather than storing it as body fat.

[ShottleBop]

Blood Sugar 101 recommends reducing your carb intake, so as to reduce the amount of insulin you have circulating in your blood, in order to lose weight more easily. Also, controlling your blood sugar levels will assist in reducing insulin resistance--if you routinely run high blood sugars, insulin resistance can be exacerbated.

[1Lollygagger]

Originally Posted by Bigpete757

PLEASE give me some advice on how to treat insulin resistance.

If you would like to include anything else related to treating insulin resistance, I would be grateful. Thank you.

Honestly, Bigpete, there is no "magic bullet", pill, or supplement that you can swallow which will just make the insulin resistance go away! It has developed in you, and in most type-2s, over a period of years and can only be reduced over time.

Originally Posted by sarahspins

Honestly the most effective thing is to just lose weight - carrying excess weight causes insulin resistance in both types of diabetes, not just for those with T2 (or more prone to developing T2).

Past that, try to be more active.. if you aren't already exercising regularly, that would be the place to start.. it doesn't have to be high-impact, even just a brisk walk for 20 minutes can make a big difference. The more active you are, the more excess glucose your body burns up rather than storing it as body fat.

Sarah is right on. Significant weight loss over a period of months, coupled with reasonable exercise, will do more to help than anything else! Many of us benefit from the use of the generic drug metformin. It has been shown to reduce insulin resistance somewhat. But I can't recommend any other oral drugs because of significant short and long-term side effects.

Bigpete, if you're not already doing this, please cut way back on the number of carbohydrate grams you eat with each meal. Test two hours after each meal to see if your BG levels are below 120 (preferably) or 140. If not, continue to reduce your carb intake with meals. That, coupled with moderate exercise will, over time, reduce both your weight and with the weight loss, insulin resistance. I can't emphasize enough that you have to deal with the insulin resistance by weight loss and by reducing the amount of insulin that your body has to produce. High levels of circulating insulin, needed to keep your BG levels reasonable if you eat a high-carb diet, works against your efforts to reduce insulin resistance, so try to get your carb intake down so that you won't need as much insulin.

P.S. Eating a low-carb diet will greatly reduce your hunger! Your size and weight are similar to mine. I found that the hunger tends to go away with a low-carb diet--trust me on this.

You can do this! Best wishes

[Ronin]

Hi Bigpete!

I have to join the chorus on the issue of IR. While there are lots of companies that want to sell you a pill that will "solve all your problems" the reality is IR is that between your eating and exercise you produce more insulin than your body can use in a effective manner.

Exercise is the proven method for countering IR. Why does this work? Simply because muscle cells use glucose/glycogen to produce energy. Muscle cells have sites where the insulin attaches and acts like a key in a lock to let the insulin in. Over time these locks get stuck and don't work as they should. Exercise makes the muscle cells create more receptor sites and also produce more muscle cells which consume more energy.

Over eating produces a weird reaction. Excess glucose goes to the liver where it is stored. If there is still excess floating in the blood stream, that is sent to fat cells for more storage. If there are not sufficient fat cells, the body makes even more of them and puts them wherever they will fit.

Exercise makes the muscle cells demand more energy thereby clearing a lot of the glucose/glycogen from your blood stream. Therefore there is less to re-stock the liver and then the fat cells have to give up their stored energy to replenish the liver and mucsle cells.

As I noted in my previous repsonse the good news about your current weight is that it takes a lot of energy to move around the weight you carry. So, even moderate exercise will consume a lot of calories. Example: a 30 minute walk will consume a lot of calroic energy as well as put demands on your muscle cells. Of course as you lose weight it will take longer and longer to consume the same number of calories. However, by then you should actually like getting out an moving around and it will be easier.

[Bigpete757]

Thank you for the continued advice and support. There have been a few changes going on in my life lately that have been been for the worse. I have been testing my bg levels throughout the day and they have ranged from 67 to 93. This could be after I eat or a few hours eat, etc. I also have been having terrible anxiety, chest pain, jitterry feeling, headaches/brain fog that most likely is the result of hypoglycemia (low blood sugar). After doing some research, I have found that the anxiety is coming from by body releasing adrenaline and cortisol to raise my blood sugar as a natural defense mechanism. The problem is, that I have been releasing the adrenaline every day for the past 1-2 weeks or maybe alot longer, and the anxiety is getting worse each day, which is not a good sign. And this adrenaline release cannot go on forever.

One of the main issues I am having is hunger, mostly from early evening until night time. I read that hypoglycemia is related to hunger, but I haven't seen to much in terms of treatment. It was mentioned that you can take some glucose tablets or something for a quick fix, but that does not address the long term solution. It seems like long term the best bet is to change your diet and exercise regimen. I already exercise fairly well so I am going to need your advice on how to change my diet. If diet is the only solution to treating or managing hypoglycemia, then what is best way to go. I have came across a lot of websites saying a higher complex carbohydrate diet with good amount of soluble fiber and protein, and to stay away from refined sugar.

I also have a serious insulin resistance problem and I think I need to tailor my diet for an hypoglycemic and insulin resistance diet. However, since I am having the hypoglycemic problems a lot right now, it needs to be more in line with a hypoglycemic diet. I have run through hundreds of web pages all saying various things and I would love to hear your opinions and advice.
My current diet is something like this.

1st meal—bowl of cereal (cherrios, life, or frosted mini wheats) and 2% milk.
It used to be non-fat milk, but I read that this causes a higher insulin spike than whole milk and I am thinking of switching to whole milk.

2nd meal—tuna or ham sandwich on stone ground wheat bread.
I was thinking of switching to rye bread because I heard it better for you, but are not sure. I am still searching for bread that might be good for HG diet, if stone ground wheat and rye are not.

3rd meal—It used to be a French bread pizza and chicken soup. I have stopped eating the pizza and do not eat the soup because it used to go hand in hand. I need to find a healthy replacement for pizza. I could incorporate a salad, but I whatever I choose I like to make it not complicated and would like to be able to put in the oven for a little while or not have to really make the meal.

4th meal—Five egg whites, one whole egg and oatmeal.

5th meal—Boston market or chicken burrito. The burrito was always healthy without extra toppings, etc., but boston market was bad and now I am going to be choosing healthy sides.

6th meal—It used to be steak or chicken and white rice with bread. Now it is steak or chicken with a good vegetable like asparagus, zucchini, etc. And now maybe a complex carbohydrate like pasta or a sweet potato. Not too sure what I should eat here because I don’t want to eat a bunch of carbs before I sleep, but at the same time, when I don’t eat enough, I can’t sleep and I wake up in the middle of night starved which disrupts your sleep.

Snacks—I used to eat pretzels, crackers, and granola bars.
I now am just eating granola bars. I am looking for some more good snacks I could use to eat in between meals or as meals themselves. I like fruit, but eating too much of certain kinds causing digestive issues.

I usually don’t eat all these meals in one day, but these are just examples of what I might have give or take a meal or two. I am open to any suggestions.

I am used to eating a lot of protein in my diet, but may have to cut back a little because I read that this increases insulin production. Which means, that I am going to have to increase carbs I think.

Here are a few other questions I have and issues that are related to my situation.

I could have a low cortisol issue and that could be making my hypoglycemia worse. I read that cortisol is connected with glucose processes and this could be a major factor in my hypoglycemia. I just did a 4 point saliva cortisol tests and will get the results soon. I also have a pituarty adenoma and few other hormone levels off in my body, has anyone had a hormone issue that affected their blood sugar.

What do people do who have severe reactive hypoglycemia. How is this treated. If I went the hospital, what could they do for me. From what I read, it seems like a doctor couldn’t do much for me besides advise me on my diet and tell me too exercise.

What does reactive hypoglycemia signal in your body. Meaning what happens after this and maybe why has this happened. Does it lead to type 2 diabetes. My medical consultant said that this is first stages of pre-diabetes, and that my blood sugar will be low for awhile and then it will start to get high and stay high. And how long could people have reactive hypoglycemia for.

What happens when the adrenaline stops being released to balance your blood sugar and what does this signal.

Another main problem I having is terrible brain fog, almost to the point where I want to lay down and close my eyes. I know this can’t be good. If this continues to get worse, should I go to the hospital.

Due to my insulin levels being pretty high and me having an insulin resistance problem, I am going to ask my doctor if we should do a mri to check for a insulin producing tumor. I know they are rare and my symptoms are more in line with reactive hypoglycemia, but you never know. Does anyone know of any more mri or blood tests I should mention to my doctor or reasons why I could be having this hypoglycemia issue. One blood test that I have seen mentioned is glucose tolerance test that measures insulin as well. I was scheduled for a 3 hour glucose tolerance test, but are not sure it tested insulin too, so I decided to wait. Have any of you taken this test..

Here are two good links talking about hypoglycemia.



Hypoglycemia


If anyone has some more good ones I would greatly appreciate it.