Insulin Toxicity Case Study 7 – Insulin Profile in Diabetes Type 2B

Insulin Toxicity Case Study 7

Insulin Profile in Diabetes Type 2B

Majid Ali, M.D.

Doctors often raise their eyebrows when I speak about the need for insulin testing for patients receiving long-term insulin injection for the presumed diabetes Type 1 after years of treatment for diabetes Type 2.

Tables1 presented below, I illustrate underscore the need for insulin profiling in such cases. Table shows a healthful insulin and glucose profiles of an individual with physiological glucose tolerance for comparison.

Case Study

A 77 yr-old 5’8″ man weighing 145 lbs presented with a 44-year history of diabetes. He had received insulin injection therapies for ten years. Other significant aspects of the case included: osteoarthritis, sleep apnea, allergy, hypothyroidisn, neck boils.

Table 1 below displays his insulin and glucose profiles.. His last insulin dose before beginning the insulin measurements was taken about 26 hours before the insulin study. The fasting insulin level of <2 uIU clearly shows that the rising subsequent insulin levels represent insulin response to 75 gram standard glucose load.

Table 1. Insulin and Glucose Profiles of a 77 yr-old 5’8″ Man Weighing 145 lbs. Who Has Been Treated for Diabetes for 44 Years and Insulin Injection Therapies For Ten Years. Last insulin dose taken about 26 hours before the insulin study. Osteoarthritis, sleep apnea, allergy, hypothyroidisn, and Neck boils.  A1c,  5.1

4.8.2013

Fasting

1 Hr

2 Hr

3 Hr

Insulin

<2

38

14

13

Glucose

92

272

300

248

Note that insulin peak in the patient with “diabetes Type 1” is more than two times higher than two profiles of healthy subjects (Tables 2 and 3. The fasting insulin level of <2 uIU clearly shows that the rising subsequent insulin levels represent insulin response to 75 gram standard glucose load.

Examples of Excellent Insulin Profiles

Table 1. Ideal Insulin Profile

6.8.2013

Fasting

1/2 Hr

1 Hr

2 Hr

3 Hr

Insulin

Glucose

52

Table 2. Ideal Insulin Profile of a 51-year-old 5’2″ Woman Weighing 120 lbs. She Consulted Me for Hypothyroidism and Allergy.

Fasting

½ Hr

1 Hr

2 Hr

3 Hr

4 Hr

Insulin

3.2

11.8

2.4

1.9

1.5

Glucose

85

110

75

70

52

91

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