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Author: Nuna Alberts
Source: Diabetes Focus, October-December 2003

Turns out that those with type 1 diabetes are as likely to develop insulin
resistance as those who have type 2

THE MYSTERY:  Having type 1 diabetes automatically raises your risk of heart disease, just as type 2 does. But why? Unlike type 2 diabetes, which is linked to obesity and physical inactivity– two leading risk factors for developing heart disease– type 1 diabetes occurs when the pancreas does not produce insulin.

The surprising explanation: Researchers have discovered  that people with type 1 diabetes often have insulin resistance– a hallmark of type 2 diabetes and something that dramatically raises the odds for heart disease.

Insulin resistance happens when cells throughout the body lose their ability to respond to insulin, explains the study’s lead researcher, epidemiologist Trevor Orchard, M.D., a professor at the University of Pittsburgh School of Public Health. “In the past, it was assumed that since the bodies of people with type 1 diabetes didn’t produce insulin, they wouldn’t have insulin resistance. We now suspect that insulin resistance occurs in people with type 1 diabetes in the same way as it does in those with type 2, essentially giving these people ‘double diabetes’ and greatly increasing their risk of heart disease,” he says.

Dr. Orchard’s team analyzed ten years of data from 658 patients with type 1 diabetes. They found that high blood sugar alone was not a predictor of heart problems. Instead, they discovered, more of the men and women with heart-related health problems, such as angina and heart attack, also had insulin resistance. In addition, the most severe heart problems were seen in the people with the most severe insulin resistance.

What this means is that those with type 1 should  be screened for insulin resistance and counseled in how to prevent or reduce the condition by:
* Losing weight. This helps cells regain the ability to respond to insulin.
* Being active. Brisk walking for at least 15 to 20 minutes a day boosts insulin response

The good news: “We found that not all people with type 1 diabetes are insulin-resistant,” Dr. Orchard says. “And for those who are not, the risk of heart disease now appears to be lower than previously thought.”