February 1, 2023

#Diabetes #BloodGlucoseRegulation #Insulin

You know i’ve forgotten about that i’m taking  a class uh i’m looking at your hair and   yeah you are beautiful here  you are beautiful here anyway   focus on your question yes what’s your question   yes in the early stages how do you distinguish if  a person has insulin resistance or is it insulin   deficiency so that

We can treat appropriately yeah  it’s very it’s yeah of course number one is the   number one reasons even though clinical reasons  are there right that usually type 1 diabetes in   younger age and type 2 diabetes is little age  but i will go to direct and hit the bullseye   blood right c peptide if it is very low   or

You check the level of insulin so simply in  the blood check the level of insulin or check   the level of c peptide which is co-secreted with  insulin you know insulin granules have three types   of important sense number one they are having  insulin with pro insulin plus insulin granules   have of course insulin plus they have

A myelin and  they are having yes c peptide again i will repeat   insulin granules when beta cells are functional  when they release insulin they not only release   insulin in equimolar amount right with insulin  they release c peptide and they also release   some pro insulin they also release a myelin right  and so because

Insulin levels in the blood can be   if c peptide levels are very low now result   very carefully if c peptide level is very low it  means endogenous production of insulin is very low   now here i want to clear clear one concept that  sometimes would happen someone is on exogenous   insulin someone is taking insulin by injection

But  in their patient who take the exogenous insulin   their blood does not have c-peptide their blood  does not have c-peptide if insulin is not being   produced by pancreas so we can say that whenever  insulin is present and if it is pancreatic origin   it will be accompanied by the c-peptide which can  be measured in the

Laboratory test in the blood   but if you come across a patient who has insulin  in the blood right but c peptide is very less   exogenous it is not his own insulin right   now we again come another way to look at it if  you feel there’s a patient who has insulin level   more than normal now listen very carefully manuel 

Manuel james yes if if you come across a patient   normal and that person is having diabetes and all   clinical features of diabetes and in the blood he  has hyperglycemia and hemoglobin a1c is high right   for on different parameter if person is diagnosed  and diabetic diabetic but if insulin is normal   that along with the

C peptide in equimolar right  then it means he’s producing insulin very well   hyperglycemia why he is having uh why he’s having   a1c the answer is that this hyperglycemia is   and glucose which is present in the blood   number two when you have low now again it   does not work on the cells cells perception  

Right and other counter regulatory hormones will  be produced and they will activate lot of gluco   glucose right so again i will repeat in short if  you say i want in one sentence answer answer is   that that if someone has diabetes and you want  to be sure that diabetes is due to deficiency   that’s it thank you very much for your question

Transcribed from video
Insulin Deficiency vs Insulin Resistance & C-peptide By Dr. Najeeb LecturesliveBroadcastDetails{isLiveNowfalsestartTimestamp2021-12-27T144510+0000endTimestamp2021-12-27T145242+0000}