Which Diabetes Is Insulin Dependent

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Diabetes: Differences Between Type 1 And 2 - Topic Overview

In general, people with diabetes either have a total lack of insulin (type 1 diabetes) or they have too little insulin or cannot use insulin effectively (type 2 diabetes). Type 1 diabetes (formerly called juvenile-onset or insulin-dependent diabetes), accounts for 5 to 10 out of 100 people who have diabetes. In type 1 diabetes, the body's immune system destroys the cells that release insulin, eventually eliminating insulin production from the body. Without insulin, cells cannot absorb sugar (glucose), which they need to produce energy. Type 2 diabetes (formerly called adult-onset or non-insulin-dependent diabetes) can develop at any age. It most commonly becomes apparent during adulthood. But type 2 diabetes in children is rising. Type 2 diabetes accounts for the vast majority of people who have diabetes-90 to 95 out of 100 people. In type 2 diabetes, the body isn't able to use insulin the right way. This is called insulin resistance. As type 2 diabetes gets worse, the pancreas may make less and less insulin. This is called insulin deficiency. How are these diseases different? Differences between type 1 and type 2 diabetes Type 1 diabetes Type 2 diabetes Symptoms usually start in c Continue reading >>

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  1. Liang-Hai Sie

    Very nice answers, given from two different viewpoints, very well documented.
    I thought the different approaches described by Scott Hanselman and Bob Holman were due to the different type of diabetes they would have, Scott Hanselman having type I diabetes while Bob Holman I thought had type II diabetes mellitus.
    Alas, I was wrong, since in his first sentence Bob Holman stated that he too had type I diabetes, and I didn't read it right.
    Bear with me developing my thoughts on the different reactions in these two types of diabetes:
    As you may know type I and II diabetes are different diseases, the only common thing being a high blood sugar needing treatment.
    Pertinent to this question is that in type I diabetes due to auto-immune destruction of the beta cells in the islets of Langhans in the pancreas, after a short time from onset there are no more insulin producing beta cells left, so no "own" insuline production anymore; while in type II diabetes for a very long time after the onset insulin production is still more or less present, no auto-immunity here, but lowered sensitivity to your own insulin, the levels of which in the beginning are even higher than normal to try to compensate for that. Of course there are more differences not relevant to the discussion here.
    So in theory, since the proteines are slowly converted to glucose in the liver (and from there getting into the blood circulation) slowly after many hours can be taken care of by the insulin still produced if someone has type II diabetes, but a type I diabetic needs the extra insulin from his pump since he doesn't make any insulin himself. Why Bob Holman doesn't need this extra insulin, I don't know, perhaps his blood sugars between meals are already so low that he needs no extra insulin for a slow glucose producing protein meal.

  2. Steve Rapaport

    The carb-free but protein-rich large meal would create a significant but very slow rise in blood sugar. Bolus insulin is usually a fast-acting insulin, specifically designed to match a fast rise in blood sugar. So this wouldn't be a good match. Depending on the individual, the best insulin response would be as Scott Hanselman says, to take some extra longer-acting insulin such as NPH, or to take a bolus insulin a few hours later, or perhaps just to let your existing basal dose take care of the slow rise and slow fall.

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