Thought I’d share this article, based on research, explaining why T1D is so difficult to manage. Hint: insulin can’t do the job of 6 hormones!
Thanks for sharing the article!
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This was interesting:
Amylin - Co-secreted with insulin in equal concentrations. Amylin has several functions, including binding to brain receptors to stimulate feelings of fullness when eating.
Does that mean a T1 might not feel full after eating?
I wonder if @Chris, @T1Allison, and @daisymae have ever witnessed anything like this in an alleged T1 they ate with. 
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Whatever is “gifted” about you goes WELL beyond the “hollow leg” that my mother always complained about me having…
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I often feel hungry after eating a full meal. But I try hard to pace myself bc I have read on many different Websites that the body doesn’t acknowledge your food until 20 mintues+ from the time you put the first bite in your mouth. So I eat very slowly. Sometimes it takes me an hour just to eat a bowl of oatmeal!
and if I am still full bolus more and continue eating 
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Until I tried Symlin, never got full after a meal, and was always always hungry.
Always, had to fight the hunger, constantly.
But with semaglutide (and liraglutide before that), it’s amazing how I feel hunger only when I’m hungry. Such a relief.
So its the Amylin AND the uncontrolled ghrelin at issue.
Glad you got something out of the article!
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This is really interesting to me. I would like to see some studies on glucoregulation in a cohort of pancreatogenic type 3c DM, who have lost total pancreatic endocrine function due to pancreatitis, disease or surgery.
I think having an ultra low C-Peptide would indicate that the other Islet cells are no longer functioning.
Insulin has been a wonderful thing, giving life to those who were sure to die. However, I think a closer look at the interrelated functions of all 6 glucoregulatory hormones. As an example, insulin secreted by the Beta cells communicates with receptors or on the glucagon secreting Alpha cells and vice versa. I think exogenic (injected) insulin does not.
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Thanks for the feedback, @CarlosLuis!
The focus of Dr Levetan’s work has been understanding, in depth, the inner workings of the pancreas to find a cure. (Btw, she’s one of the inventors of Symlin). She’s written papers on why mice trials don’t translate to humans: their pancreases are structured differently internally.
I’m unaware of any similar T3 studies in this realm. I might look it up.
While I focused only on the hormones in this article, beta cells also produce GABA, a neurotransmitter, the communicator between the islet cells. So beta cells die, don’t produce GABA, insulin, amylin, then the whole chain breaks. That can be a whole other article - research on the role of pancreatic GABA, and its replacement, is ongoing.
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Found this paper,
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@MsCris Thanks a lot for this article. Would that more information went into depth on the fantastic capabilities of a working pancreas! Though parts are disheartening (“anything above 5.5% A1c [that’s a BG of ≈100, my avg is 120 and I thought I was doing pretty good] significantly increases complications”), the prospects of further research, application of GLP-1’s with insulin, and [interpretted] the likelihood of treatments balancing the various hormones provides hope for the future and those that follow us down the T1 path, until there’s a cure ala Vertex or similar.
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You got it exactly right.
And like you pointed out, exogenous insulin literally has no means to communicate with the other islet cells, and vice versa, because it’s not being secreted from within the islet. We inject it, and it’s all “um, ok, where do I go?”
Thank you for such a wonderful discussion!
I am grateful to Dr. Levetan for being a great teacher at my diagnosis, her kindness and empathy to her T1 patients. And her Reg gene protein therapy research may very well be a functional cure someday.
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You’re very welcome. I’m humbled by the kind comments I’ve received.
We as T1s need to advocate more to our treating physicians and the FDA to approve these therapies for ALL those living with diabetes, while we wait for a cure.
Please share - including with doctors!
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Love this! Thank You!
I found this article interesting.
I know I don’t have a glucagon response to going low. My liver loves to dump uncontrolled glucose sometimes in DP, FOTF or both. (Knock on wood, relatively behaving itself right now) When it decides to dump glucose in response to fueling energy needs as in swimming, it doesn’t have a clue it’s not being used and will keep dumping it. At least I solved that one by some food and insulin before I swim. (Eric’s help) I had a horrible time with menopause and had to work on numerous hormones to end up feeling okay. This might explain some of it!
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Never feel full nor really hungry. I eat by the clock and BS#s.
Tried Symlin but felt low and hungry even though numbers were good.
Great article to why I can’t get good control even though I work so hard at it. 6.8A1C🥴
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@Marie yep, all the signaling breaks down, and exogenous insulin can’t communicate with the other islet cells! It’s such an inefficient delivery, floating around like “where am I, where do I go?”
And this article is just inside the pancreatic islet cells - all the other hormones in the body, whew! That’s a lot of discussion. Especially for female menstrual cycles for 30+ years, perimenopause, menopause…ugh. what havoc.
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@Peep I used to eat by the clock, macro measuring per meal, too! Never full, always hungry. Drove me insane. Symlin did work for meal satiety, but lasted only those couple hours. But like you, it just didn’t work well for me overall.
Hang in there, you’re doing what you can. Ask about the GLP-1s, can’t hurt to try! Have your Dr justify it for insurance coverage.
I still eat by the clock, measure my macros, but I’m not going insane. That in itself is worth it for me.
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Googled GLP-1. One thing I don’t need to do is lose weight. 5’4” 115#s .
Like I said I’m neither hungry nor full. I really wish there was a pill and I didn’t have to eat at all.
Type 1 diabetes has ruined the entire experience.
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Yeah, the trend to use GLP1s for weight loss, when you don’t actually need the hormones, has even caused a shortage.
But they don’t always cause weight loss. If there’s anything I learned, it’s that:
Every T1 is different!
What works for one…doesn’t work for another. 
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