Reply #16: insulin again [View All]

[Celebration]

Since your pancreas makes no insulin, I will assume that you were being facetious when you suggested that you were going to stop taking it and try an unproven alternative.

It is interesting that insulin resistance can actually be a big problem in Type 1 diabetes, though (no insulin producing islet beta cells). Agents that lower insulin resistance may either decrease the amount of insulin needed or improve glycemic control, as was shown in this study.

"Eur J Endocrinol. 2003 Oct;149(4):323-9.


Metformin as additional therapy in adolescents with poorly controlled type 1 diabetes: randomised placebo-controlled trial with aspects on insulin sensitivity.

Sarnblad S, Kroon M, Aman J.

Department of Paediatrics, University Hospital, Orebro, Sweden. [e-mail]

OBJECTIVE: Metabolic control often deteriorates during puberty in children with type 1 diabetes. The aim of the present study was to investigate whether addition of metformin for 3 Months improves metabolic control and insulin sensitivity. DESIGN: Twenty-six of 30 randomised adolescents with type 1 diabetes (18 females, eight males) completed a double-blind placebo-controlled trial. Their mean age was 16.9+/-1.6 (s.d.) Years, mean glycated haemoglobin (HbA(1c)) 9.5+/-1.1% and daily insulin dosage 1.2+/-0.3 U/kg. The participants were randomised to receive oral metformin or placebo for 3 Months. HbA(1c) was measured Monthly, and peripheral insulin sensitivity was assessed by a euglycaemic hyperinsulinaemic clamp at baseline and at the end of the study. RESULTS: HbA(1c) decreased significantly in the group treated with metformin, from 9.6 to 8.7% (P<0.05), but was unchanged in the placebo group (9.5 vs 9.2%). Peripheral glucose uptake divided by mean plasma insulin concentration was increased in the metformin group (P<0.05) but not in the placebo group. Initial insulin sensitivity was inversely correlated to changes in HbA(1c) (r=-0.62; P<0.05) and positively correlated to changes in insulin sensitivity (r=0.77; P<0.01). CONCLUSIONS: In this double-blind placebo-controlled study we found that metformin improves metabolic control in adolescents with type 1 diabetes. The effect seems to be associated with an increased insulin-induced glucose uptake."


So, if cocoa, or some other agent, was shown to increase insulin sensitivity, its benefits might not be limited to those diabetics who are still producing insulin (although it certainly would not be a substititute for insulin).