fallenstar0201

i am waiting on test results for insulin resistance and a metabolic panel. (impatiently waiting!!) is insulin resistance type 2 diabetes or is there a difference? What symptoms of insulin resistance do you have if any at all?

melgp

No insulin resistance is not necessarily type 2 diabetes, but it can progress to type 2 if you don't get it under control - eg. with exercise, healthy diet, insulin-sensitising medication such as metformin.

I was diagnosed as insulin resistant & at pre-type 2 diabetic stage late in June 08. this was discovered after high reading came back on fasting glucose level, than they did a glucose tolerance test to see how my body reacted to a measured dose of glucose over a 2 hr period - these levels also came back high.

My symptoms are PCOS, overweight, high glucose levels, high blood pressure. I got pu on metformin 500mg twice a day and lost around 10-12 pds since July 08, so it is helping things. I'm following a low GI diet which targets insulin resistance (slow energy-burning foods that help your metabolism work more efficiently) & trying to exercise more - exercise is the key, but I'm still struggling with this part of it!!

If you want to know more about insulin resistance, a great book I got recently is "The Low GI Guide to Managing PCOS" - it has a lot of specific info on PCOS & i.r & how to get it under control through low gi foods & exercise. I think I saw it listed under a books section on c.systers somewhere as available in other countries (my copy was published in Australia).

Hope this has been of some help!! Good luck with your test results!

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melgp

A definition for you re insulin resistance:
- a condition where the body 'resists' the normal actions of the hormone insulin, that is, the body's response to insulin is defective. To ocvercome this resistance, the body secretes more insulin than normal. The vast majority of women with PCOS have severe insulin resistance & may have high insulin levels. Being overweight or obese increases the degree of i.r, but you can be very lean & still have PCOS and be insulin resistant. (from the book I mentioned above).

There are also more serious complications/risks that i.r can cause (not to scare you or anything) which include:
* the insulin resistance/metabolic syndrome
* type 2 diabetes
* thyroid disease leading to under or over active thyroid
* coronary artery disease
* stroke
* early miscarriages
* multiple pregnancies
* pre-eclampsia
* uterine cancer
* depression
* alzheimer's disease
So getting insulin resistance under control is really important in helping with PCOS symptoms, but could also help prevent the above conditions.

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fallenstar0201

Thank you so, so much for the information!! I dont have insulin resistance - i finally got the results - so i have pcos and hypothyroidism (which i have been aware of since 06)

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melgp

Mandy, you're more than welcome for the info!! It can be very daunting when drs. are telling yu all this stuff - I know I was bombarded with a lot earlier in the year - blood pressure was high, was testing to confirm PCOS, then my glucose tests came back high... so the more info you have, the better!
I'm glad your tests came back ok re; the insulin resistance, one less thing to worry about, eh?! good luck!

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NicoleAKAColie

Wow!! This has been really informative. Thank you!

melgp

No problem, I am happy that I can pass on some of the knowledge I am gaining to other cysters, as I myself know how daunting it can be when you don't know what's going on with your body. This web site has provided me with so much more information than I could find anywhere else - it's so hard to come by books relating specifically to pcos wher I live, but I think you can learn so much more from people who are also living through it.
Glad to have been of help!

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OrganicAmy

My body has insulin resistance, but I do NOT have Diabetes. Definitely two different things.

BRbangle

Melgp, I'm just wondering what it means to have normal-high fasting glucose readings and low fasting insulin readings. I've always assumed IR was associated with high insulin; but, mine is below the normal range on two different readings. Is this still IR?

melgp

brbangle- i'm not sure about the low fasting insulin level, I haven't had a test done for that. But insulin levels (I would think) would be high if you are ir, as your body secretes more insulin because the body is not responding properly to insulin. (does that make sense..?!)
Ummm, all I know is that I had a high fasting glucose level, so they then wanted to see how I responded to glucose, so I did a glucose tolerance test, where they take blood at intervals after you drink a glucose drink. I think when my tests came back, it was high after the first hour, then even higher after the 2nd hour, but I don;t think they looked at the insulin level, although thinking about it, that would be what was high possibly? Sorry, I am not much help on this one, but I will have a look in my little pcos book to see if it sheds any light!! (Believe me, I don't claim to be an expert, I am just going by what I am learning along the way!)
Mel

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BRbangle

melgp, any information is very helpful! It makes sense that insulin levels would rise in response to the elevated glucose. The only scenario I can think of which would prevent that from happening is something like Type 1 diabetes, where your glucose levels remain high because your body doesn't make enough insulin.

For over 2 years now, I've been on 2000mg metformin, originally prescribed by my endocrinologist after normal-high fasting glucose readings alone--no insulin readings. However, a few months ago, I started seeing a RE, who tested my fasting insulin levels--as well as my fasting glucose levels-- and wants to decrease my metformin dosage after seeing the low insulin. What is the logic behind decreasing the metformin dosage? Could he possibly be thinking that the metformin is preventing my body from producing enough insulin, or is that even possible?

melgp

Hi brbangle,
I have been trying to figure out what is happening with your low fasting insulin levels. I am inclined to think that you could still have a low insulin level when you fast but still be ir, so it depends on what your results came back like after eating or doing glucose tolerance test. Here's a bit more info from the pcos book I have:
"Our glucose & insulin levels rise and fall whenever we eat, over the next few hours. Carbs & proteins in food stimulate the secretion of insulin, and insulin drives the transport of glucose & amino acids into our cells, as well as the storage of glucose in the liver and our muscles.....
Like a lock and key mechanism, most body cells have special 'receptors' for insulin. Once the lock is engaged - insulin attaches itself to the receptor- the gates open, allowing glucose to flow into the cell. The higher the concentration of insulin receptors, the more insulin sensitive you are.
If the no. of ins. receptors is lower than normal or they are compromised in some way, then the cells are said to be 'insulin resistant'. The pancreas, the organ that secretes insulin, responds to this situation by secreting more insulin in an effort to overcome the block and achieve normal transport of glucose. One of the hallmarks of insulin resistance is therefore an inappropriately high level of insulin in the blood both before and after meals.
Unfortunately, in many people, the pancreas has a limited capacity to secrete large amts of insulin. It is only a matter of time before the cells burn out and they can't supply enough insulin to meet the demand and the person develops pre-diabetes or the full-blown diabetic state. On the other hand, reducing insulin resistance can delay these states".

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melgp

sorry, I had to post that so i could continue!! So, according to that, if you are insulin resistant, you should have high insulin levels both fasting and after meals, so it doesn't make sense that you had a low fasting insulin level. However, if I am reading it right, it could be that you have gotten to the stage where your body can't keep up with producing enough insulin, so maybe it stays low when not stimulated (eg when fasting) but then gets high again after eating??
Could it be that the met has been so effective that you may have actually reversed your insulin resistance? That to me seems possible, but what did your fasting glucose level come back like when they did that test along with the fasting insulin test? You have been on met over 2 years, and I'm guessing you would be exercising and following low gi or similar diet to combat ir? so maybe your body has actually started working properly again and is more insulin sensitive, meaning that you are not insulin resistant anymore? Which would be why they would want to take you off the met, becuse you wouldn't need it anymore. That makes sense, but it depends what your glucose levels are like, if they are still high fasting and after taking glucose, then that to me would make me think that there is still insulin resistance which might mean you should stay on met, but maybe at a lower dose? Maybe your doctor wants to take you off the met and do the tests again to see how your body reacts without met to determine whether you still are insulin resistant & therefore whether you still need to take the met. This is in no way a diagnosis, I am just going through some possible ideas as to what your dr. is thinking - you need to ask a few ?'s as to what he/she thinks is going on and why taking you off met.
Sorry for long-windedness, hope some of it may help in some way!

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melgp

Just reading in my trusty little book about metformin and it's action: "met works by reducing glucose production by the liver & increasing the uptake of glucose by the body (ie it increases insulin sensitivity). It has recently been found to work through a key enzyme essential to insulin action and cell growth. this is why it is so useful in treating women with pcos. In fact, even before a woman with pcos has achieved any significant weight loss, metformin can be effective in improving her other symptoms".

i was just reading a case study in the book, and got the idea from this. How did your low fasting insulin level compare to your glucose level taken at the same time, or was glucose level taken at the same time? The insulin level needs to be compared to the glucose level, as they are dependent on each other. so it could be that stand alone, the insulin level looks to be low, but how does it compare to the glucose level?
In regards to low gi diet:
"low gi diets have been proven to reduce blood glucose levels in people with diabetes. just like women with pcos, most people with diabetes are severely insulin resistant. If glucose levels come down in diabetes, then it's likely a low gi diet will bring down both glucose and insulin levels in anyone with insulin resistance".
Congrats, you may have reversed your insulin resistance!!!! But make sure if they take you off met they check your levels again soon to see what happens just in case your body goes back into ir mode. i hope this makes sense and has helped a little!

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BRbangle

melgp, I really appreciate your help! This information is very valuable to me. I thought it might be a little more helpful if I posted my most recent lab results. The first set of numbers was taken on Day 3 of my menstrual cycle in August, pre-bcp. The second set of numbers was taken just 2 weeks ago--four months after starting bcp and six weeks after decreasing my Fortamet dosage to 1000 mg. Both times, I was fasting.

Taking:
2000 mg Fortamet
100 mcg Synthroid
vitamins (multi, B-complex, calcium/magnesium, fish oil)

Glucose 97 mg/dl (range: 65–100)
Insulin 3 UIU/ml (range: 6-27)

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Taking:
Ovcon 35
1000 mg Fortamet
112 mcg Synthroid
vitamins (same as before)

Glucose 79 mg/dl (range: 65-100)
Insulin <2 UIU/ml (range: 6-27)

Without much change in diet or exercise--both of which leave a lot to be desired, to be perfectly honest-- it appears that starting bcp alone has decreased my fasting glucose level rather significantly. (And, that's even with me taking half the amount of Fortamet I was previously taking.) But, it has also decreased my fasting insulin level, which is now even farther below the "normal" range. I still do not know if this is a real issue, or not; but, my RE who performed these tests now wants to decrease my Fortamet to 500mg, then retest in 6 weeks. I suspect that I may be able to go off the Fortamet completely.

If I have somehow "reversed" the IR, I do believe it is because of bcp. When I started taking Fortamet years ago, it initially seemed to work wonders. But, over time, my testosterone level kept creeping up and the Fortamet seemed less effective at controlling my PCOS/hyperandrogen symptoms. I have not had my testosterone level rechecked since starting bcp, but a lot of my nagging symptoms (hirsutism, acne, scalp hair loss, anxiety) have significantly improved. Maybe there is more of a connection between elevated androgens and IR than I thought...

Any other feedback you have is much appreciated! Sounds like I need to get my hands on a copy of this book you have, too. What is the name of it, melgp?