[angelic]

I need some help understanding what insulin resistance means. I have been diagnosed Type 1.5 MODY. My post-prandials are ridiculous and come what may it won't lower. I started with 5 units Novolog before meals, worked for 1 week again post-meal started shooting.. That way I have been increased from 5 to 7 to 9 to 10 units every week. Does this mean I have insulin resistance and after a while the body doesn't respond to insulin ?
What is in the future for me ? Will the units keep getting increaded by 2-3 every week. If so even 40 units in 2years will be less. Is there an alternative to this condition?
Kinda depressed, need some support from u all...

[Funnygrl]

I would be willing to bet it's not insulin resistance to blame, but something more like a different amount of carbs, less exercise, or illness.

A more effective approach than a set dose of novolog would be to use carb ratios to figure out how much to take at meals, and to add in corrections if needed.

[Simon]

I believe MODY's will need more insulin than a "typical" type 1. I doubt the amount will keep going up forever though. You will reach a level that's right for you but you are going to need to count carbs to make any sense of your post prandials. MODY's can usually control their diabetes better than type 1s simply because there are able to adjust there insulin levels with a working pancreas (at least for a few years).

Since MODY is a form of type 2, you might find some good anvice to be had in the type 2 forum as well.

[4519]

I don't know how insulin resistance works in your case. I do know that insulin resistance is when the receptor in the cell that allows insulin in the cell stops doing that or restricts it to some extent. It is on the cell level. In a type 2 it does get worse as time goes on and/or the medications that help with the resistance are less or not affective at all. Type 2's who become insulin dependent usually inject very large amounts because the cells just won't let the insulin in - why more insulin is needed - I don't know why more of something that won't work is better.....

[RickLV]

Angelic,

You might want to take a look at:

Glucose Homeostasis and Fuel Metabolism

[snip]
defects in signal transduction: defective tyrosine phosphylation (?), reduced IRS-1 level, decreased phosphatidylinositol-3' kinase, decreased activity of key enzymes such as pyruvate dehydrogenase or glycogen synthase
[snip]

[Simon]

I believe phosphylation takes place during liver dumping in everyone, it does also cause the inhibition of insulin which is what make liver dumping such a pain when you're diabetic.

[butterflykisses]

Originally Posted by angelic

I need some help understanding what insulin resistance means. I have been diagnosed Type 1.5 MODY. My post-prandials are ridiculous and come what may it won't lower. I started with 5 units Novolog before meals, worked for 1 week again post-meal started shooting.. That way I have been increased from 5 to 7 to 9 to 10 units every week. Does this mean I have insulin resistance and after a while the body doesn't respond to insulin ?
What is in the future for me ? Will the units keep getting increaded by 2-3 every week. If so even 40 units in 2years will be less. Is there an alternative to this condition?
Kinda depressed, need some support from u all...

Hello, I'm new here but hope no one minds me jumping in and adding my two cents...probably not worth that much. I just don't understand why doctors are prescribing a set amount of a fast acting insulin like Novolog with meals? I also don't understand why only fast acting insulin is adjusted and not long acting...but I'm not a doctor either so maybe I'm missing something here. A type 1.5 is progressively becoming more insulin dependent. The same destruction of beta cells happens in type 1.5 as in type 1, the progression just takes longer...up to 4 years, to happen. You could be losing beta cell function and that's why your insulin needs are rising. And because your fast acting insulin is all that's being upped you can't keep up. It's also possible that you are gaining weight. Extra weight is associated with insulin resistance and is why type 2's can lose weight and need less medications...even go off all medications and control with just diet and exercise. If you indeed have insulin resistance exercise is the best medicine. It will help your body use insulin more efficiently and help control weight issues.

[lottadata]

High blood sugars (over 180 mg/dl) will make you insulin resistant, even if you normally don't have IR.

I'm supposed to have a form of MODY and my insulin ratio when I have good control is roughly 1 unit of R/10 grams. Humalog is 1/3 stronger than R insulin.

However, there are a bunch of different MODYs and people have different strengths of MODY too, ranging from IGT to something that looks just like Type 1.

So you may have to up the does until you get good control and then, when that insulin resistance is dealt with, you may have a better ratio.

Did you get testing for the MODY, or are they just guessing based on symptoms? (my situation.)

I wasn't IR until hitting menopause, now I do take 1500 mg/dl of metformin. It helps with my blood sugars and most importantly, curbs hunger and maintains my weight. But when I go off it I don't need more than 1/2 unit more per meal.

--Jenny
http://diabetesupdate.blogspot.com