Insulin resistance and external insulin

[mktsgm]

TL;DR

If natural insulin is not working, how come drug induced insulin is working in type 2 diabetes

In your 2 diabetes insulin secretion is present, but it is ineffective. It means that the circulating insulin is unable to push all the glucose into cells. They call it insulin resistance.

But at the same time, if synthetic insulin is injected or insulin-secreting drugs are given, they seem to work.

How come the body's internal insulin is not working effectively but external insulin or drug induced insulin is working?

Are they giving more insulin dosage to do the job?

I am unable to understand the missing link here. Can someone clarify it to me?

Thanks.

 

[berkeman]

I'm no expert in DM or T2DM, but these articles may help you:

T2DM Pathophysiology:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7503727/

T2DM Treatment Options:
https://www.mayoclinic.org/diseases-conditions/type-2-diabetes/diagnosis-treatment/drc-20351199

 

[mktsgm]

I'm no expert in DM or T2DM, but these articles may help you:

T2DM Pathophysiology:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7503727/

T2DM Treatment Options:
https://www.mayoclinic.org/diseases-conditions/type-2-diabetes/diagnosis-treatment/drc-20351199

Thank you for the response. It discusses the pathophysiology and mechanism, but I am afraid they don't answer my questions.

Hyperinsulinemia is normal in type-2 diabetes condition, especially in the early periods. I understand that both hyperinsulinemia and hyperglycemia can exist at the same time in the same person.

So when high amounts of insulin produced by body itself is not effective enough, how externally injected insulin could respond, is my question. Why not body resist this externally injected insulin also?

 

[berkeman]

So when high amounts of insulin produced by body itself is not effective enough, how externally injected insulin could respond, is my question

I only skimmed the articles, but I think they were saying that in T2DM the insulin that is produced can be defective in some ways. I'll have to read the articles in more detail...

 

[Vanadium 50]

Is this not arithmetic? If your body processes 100% of its internal insulin, you're fine. If it processes 50%, you need twice as much - i.e. an external source.

 

[mktsgm]

Is this not arithmetic? If your body processes 100% of its internal insulin, you're fine. If it processes 50%, you need twice as much - i.e. an external source.

Precisely my question. Is it simply arithmetic only?

Suppose, if 50 units of insulin is required at a particular instant for a person. If 40% insulin resistance is present, we may need to replenish with extra 20 units of insulin. But again this extra 20 units also would undergo 40% resistance. So we may need to raise it to 28 units and so on. It may recursively increase too.

Here we presumed that the body treats internal and external insulins equally. Is it so? I wanted to knw, is the resistance to insulin is same for both internal and external insulin?

Or if the body reacts differently to these two categories. Do we have any study/paper in this regard? This is the crux of my question.

Thanks.

 

[gleem]

T2D and insulin resistance are not the same, You do not treat insulin resistance with more insulin. With T2D the pancreas does not produce enough insulin so blood glucose levels must be managed with lifestyle changes, medication, or supplemental insulin. Insulin resistance the inability of tissue to absorb enough glucose is generally treated with lifestyle changes but it can be caused by other factors such as inflammation or hormone imbalance which may include medical intervention. Uncontrolled insulin resistance can lead to T2D.

Regarding the difference between one's own insulin and injectable insulins see:
https://dtc.ucsf.edu/types-of-diabe...-2-insulin-rx/types-of-insulin/human-insulin/