No kidding Einsteins

A recent article in Endocrine Today discussed a “study,” in essence, that proved the speedier action of insulin when injected into warm skin.  All I could think of was no kidding you bunch of Einstein’s. 

It took the cost of a study to prove what the experts (diabetics) have been saying for years.  If we take insulin and go work outside in the sun (for example), insulin works faster.  It is not the increased temperature of the insulin; it is the temperature of our skin that is the variable. 

Another long-timer and I have discussed the fact that if we do a particular gardening activity in the sun, Humalog tends to peak in say 15-30 minutes, instead of 90-105 minutes.  However, if we do the same activity in the shade or on a cloudy day, there is no increased speed.

It has become clear to us have repeated “studies” of our own, that the speed of insulin action increases separately from increased insulin sensitivity.  After my 30 plus years and his 40 plus years of real experience, we do not need expensive and unrealistic lab tests to prove what our slightly skilled brains have already proven.  Though lab tests (even those using humans, not animals) can maintain “controls,” they cannot replicate actual conditions.

For instance, my “studies” include planting flowers or vegetables in flower/vegetable beds.  Since I cannot alter the weather, I perform this activity in whatever conditions God has handed me that day.  However, since I keep a detailed log, I can write down the conditions as well as food, insulin, blood sugar, energy expended and duration variables and make fairly, accurate observations especially when the same result occurs over and over again. 

Some might say that it is the increased activity and increased insulin sensitivity but it is not.  We can fairly easily replicate the activity level.  In my case, I do much of the activity sitting to avoid bending, since I have a herniated cervical disc, a bad lower back, left knee, tendonitis in my hips and often dizziness (if I bend) from lisinopril.  What changes is whether my skin feels warm to the touch and sweaty from the outside temperature and sun.  What also changes is how fast the insulin peaks NOT necessarily how many points my blood sugar lowers.  I have already taken that into account.  So, what often happens is I eat a snack (and take insulin) but the insulin peaks long before the food digests, thus, requiring juice but then the food digests and surprise, surprise the insulin is gone – long before it normally is and my blood sugar rises uncharacteristically.

So guys, I have two things to say 1) stop reducing our real world experience as nothing more than anecdotal aka garbage you refuse to hear because we're usually right and 2) it is impossible to reproduce real world patient activities to very expensive in office/lab tests because you want to make sure you maintain proper scientific controls.