Thank you for these words and the sentiment, b-boy! I'd never call you an idiot because I at least try to be in the right neighborhood when I make a judgment like that (an unkind one).
Luki's not one either by any stretch of the imagination even though I disagree vehemently with his posts, like here, that seek to demonstrate that insulin improves insulin sensitivity. Rather than stupid, luki's posts on this topic are merely stubborn (because they refuse to flex or bend in the face of reason), ignorant (because he is motivated by animus rather than valuing factual information on the basis of obviously adequate & pertinent education and experience), and egotical (because he presumes that any reader should "of course" view insulin as totally harmless if not healthy because of his own risk tolerance).
I feel like I've been beating this drum here on ProM for a while now, that insulin (slin; exogenous insulin) inherently worsens insulin sensitivity (increases insulin resistance). But I will use the rest of this reply to try to explain it clearly and simply for anybody that cares to read or understand this:
It can be very confusing to those familiar with these concepts from bodybuilding discussions that
hyperglycemia (elevated blood glucose) is but one factor that is
associated with insulin resistance, but is
not actually synonymous with insulin resistance (
hyperglycemia =/= insulin resistance). Yes, reducing blood glucose to normal levels is very important in order to improve insulin sensitivity while using exogenous growth hormone (rhGH)
because glucose is toxic to the pancreatic β cells.
Insulin Sensitivity is multifactorial & comprises systemic (e.g., QUICKI) and peripheral (e.g., GLUT-4) components, and is regulated centrally by GLP-1 & GIP. Hyperglycemia, i.e., high blood glucose, is but one factor (the other being insulin) that serves as a proxy for systemic
Insulin Resistance (the reciprocal of insulin sensitivity). There are other aspects, including carbohydrate tolerance, etc.
Exogenous insulin reduces blood glucose and thereby
prevents this
glucotoxicity but actually causes insulin resistance.
Endogenous insulin is secreted in a pulsatile (quick bursts) fashion to regulate growth and metabolism, unlike testosterone that is secreted in a more steady-state fashion (gradual release into the blood; but subject to diurnal variations, e.g., more secretion in the morning than midday/evening). Chronic insulin elevations, e.g., those that are germane to the release profile of a daily low dose of insulin glargine (Lantus), possess a relatively large area-under-the-curve (AUC) due to the release profile (high concentrations on long time frames) vs. normal-healthy endogenous insulin release profiles (comparable to regular insulin pharmacokinetics, e.g., Actrapid, Novolin or HumuLin -R). That
large AUC of Lantus and/or moderately-high & frequent exogenous regular insulin doses are described as chronic hyperinsulinemia.
This resistance does
not occur by negative feedback at the β cell level.
Instead, what occurs with
chronic hyperinsulinemia that causes insulin resistance is multifactorial and includes:
1. Increasing HOMA-IR & decreasing QUICKI (biochemical measures of insulin resistance)
2. Impaired insulin signal transduction due to receptor (IR) dysfunction & diminished autophosphorylation of the IR, thereby blocking GLUT-4 translocation to the cell surface in muscle & fat cells, meaning more glucose in blood:
View attachment 179201
3. Increasing sn-1,2-diacylglycerol (
DAG) levels and activity due to
de novo synthesis.