March 29, 2008
Hyperglycemia and DKA, Insulin
Question from India:
I understand that hyperglycemia is considered dangerous. As I also follow a medication program, I am confused about whether or not enhanced or added insulin is causing the down-regulation of insulin receptors and persisting hyperglycemia. It looks like my pancreas is secreting a lot of insulin and this, along with added insulin, is causing insulin resistance by down-regulating insulin receptors. It may also be causing decreased satiety resulting in increased cravings to overeat. Still, I consider myself a bit lucky by not having hyperlipidemia and maintaining hyperglycemia without serous diabetic related complications. Can this be correct?
Answer:
Even though the use of insulin in type 2 diabetes is associated with some down-regulation of insulin receptors, it is usually potent enough to overcome this. Only those patients taking mega levels of insulin have such down-regulation that the insulin does not work. We occasionally see this in the hospital with patients on TPN (total parenteral nutrition) and in the face of another overwhelming medical problem.
JTL