Why Not Insulin

[ringi]

Remember most people with Type2 at least in the first few years have bodies that ignore the insulin our pancrese makes and our pancrese makes more insulin then is normal. A few people will Type2 (more often in later stages) have pancrese that make less insulin then is normal. Yet as insulin levels are not tested for, both sets get the same drugs!

 

[Mep]

I understand this but then given that some T2 end up on Insulin why not allow them to take long acting as lets face it if you were stable for many years then your pancreas might not give up and complications would also be kept to a minimum.

My levels reside around 4.5 - 6 and 7 - 8 30 mins to 1 hr after meals - When my fasting goes closer to 7 on average I will consider surgery or Insulin or a GLP4 Inhibitor. I think pushing the pancreas to make more is the wrong approach and after all its my body and my life. My doctor probably wont live with the complications I have form this disease and as such is not qualified to tell me what I feel is best.

I agree do what's best for you. If I had my chance over again I would've preferred to be put on insulin sooner than I was. Those oral drugs I believe are what destroyed my insulin production. They also waiting until I couldn't control with diet as well so I was probably already in trouble with insulin levels when I was put on oral medications. The thing with T2 is that they do not do diagnostic tests first before they make a decision about medications. You have to request the tests to be done yourself... that was my experience anyhow. In 2010 I literally said look I don't think all these drugs and different dosages are making any difference and I've been having a good couple of years with not getting much result and I need for you to find out why. So rather than having a stressed out pancreas I personally wonder about my health if I'd been put on insulin sooner. As you can see by my signature I'm not in good health at all. Most of my health problems started in 2008 which is about the time I wasn't getting results with my diabetes either despite being on oral meds for 3 years at the time.

 

[lindisfel]

One wonders what the relative survival rates of diet controlled and insulin controlled diabetics are? How many men on average reach 79 and women 82...The said life expectancy in the uk now that has stopped increasing! That non diabetics usually have less cardiovascular disease has been claimed as established fact by some medics. However, Dr. Kraft who made a long study of insulin production in humans, (see youtube) claimed due to excessive insulin in non diabetic/prediabetic/diabetics arterial inflammation was a major cause of CVD. So one wonders what the long term effects of additional insulin is in T2D? Of course for diabetics gumming up the system with high blood glucose is another issue and insulin, though not ideal, has to be weighed in medics/patients balance. D.

 

[ringi]

One wonders what the relative survival rates of diet controlled and insulin controlled diabetics are?

Remember that if we control well with diet we are removed from the diabetes register or not added to it in the first place. There are now large scale fasting and low carb programs in the USA that are being track over the long term, so we may start to get good data on this.

 

[Art Of Flowers]

There is a blog by Jason Fung on insulin and heart disease. ... https://intensivedietarymanagement.com/not-treat-diabetes-t2d-38/

With type 2 diabetes there are twin risks of excess glucose and excess insulin in the system. It appears that Metformin reduces the risk of CVD, but taking insulin has no benefits of reduced CVD, despite lowering blood sugars more. This is probably because too much insulin is toxic causes inflammation and increases the risk of heart disease and cancer. Insulin also causes weight gain, which is a problem with 80% of type 2 diabetics who are already overweight or obese.

Lowering blood sugars is good provided you don't increase insulin in the body to toxic levels.

 

[ringi]

Lowering blood sugars is good provided you don't increase insulin in the body to toxic levels.

It is very likely that most people with Type2 are already producing so much insulin themselves that it is at toxic levels without increasing it even more with drugs etc.

 

[Mep]

There is a blog by Jason Fung on insulin and heart disease. ... https://intensivedietarymanagement.com/not-treat-diabetes-t2d-38/

With type 2 diabetes there are twin risks of excess glucose and excess insulin in the system. It appears that Metformin reduces the risk of CVD, but taking insulin has no benefits of reduced CVD, despite lowering blood sugars more. This is probably because too much insulin is toxic causes inflammation and increases the risk of heart disease and cancer. Insulin also causes weight gain, which is a problem with 80% of type 2 diabetics who are already overweight or obese.

Lowering blood sugars is good provided you don't increase insulin in the body to toxic levels.

That really depends on whether or not the T2 person has sufficient insulin themselves. Diagnostic tests should really be done before changing treatment. Those of us that don't produce insulin we need have no choice. I'm sure my insulin to carb ratio is higher than most type 1's would be because of insulin resistance I already have. I've worked out I need an average of 5 units of bolus per 10g of carb.

 

[Art Of Flowers]

That really depends on whether or not the T2 person has sufficient insulin themselves. Diagnostic tests should really be done before changing treatment. Those of us that don't produce insulin we need have no choice. I'm sure my insulin to carb ratio is higher than most type 1's would be because of insulin resistance I already have. I've worked out I need an average of 5 units of bolus per 10g of carb.

There is a follow-up blog by Jason Fung from the one quoted earlier ... https://intensivedietarymanagement.com/medications-actually-work-type-2-diabetes-t2d-40/

Basically, what he is saying is that Type 2 diabetes is a problem where there is too much sugar in the body (not just the blood), Drugs like sulphonylureas and insulin lower blood sugars, but don't remove these sugars from the body. Hence they tend to increase weight as the excess glucose is stored as fat by insulin. This then causes long-term health problems such as heart, liver and kidney disease. Drugs which help eliminate this excess sugar have significant benefits to life expectancy.

However, the simplest way to get rid of this excess sugar is to reduce the amount of carbs we eat and to burn off the excess sugar (fat) by intermittent fasting. Lowering blood sugars will lessen the likelihood of diabetic complications such as blindness and neuropathy. However, most type 2 diabetics die of heart disease and the just lowering blood sugars does not reduce the likelihood of heart disease, but reducing the amount of accumulated stored sugar in the body (e.g. liver fat) does significantly increase life expectancy.

 

[Guzzler]

A daft question, I expect but here goes. How can they diagnose T2 on the basis of HbA1c if this test is just an indication ?
Shouldn't there be a definitive test given after the HbA1c for everyone with higher readings than normal as per course?

 

[Bluetit1802]

A daft question, I expect but here goes. How can they diagnose T2 on the basis of HbA1c if this test is just an indication ?
Shouldn't there be a definitive test given after the HbA1c for everyone with higher readings than normal as per course?

Didn't you realise .... one size fits all ..... as per usual.

 

[Guzzler]

Didn't you realise .... one size fits all ..... as per usual.

@Bluetit1802
Ah, so. But... Yeah, I forgot about the £/time/common sense versus NHS practise. Oh, silly me.

 

[Bluetit1802]

@Bluetit1802
Ah, so. But... Yeah, I forgot about the £/time/common sense versus NHS practise. Oh, silly me.

In this case I think it is the WHO that insists on the HbA1c. But of course, that doesn't prevent the NHS from doing other tests in addition.

 

[sheepie123]

See this is what I project is a concern is it possible for a Cell to become 100% resistant to Insulin? What is more concerning is that Type 2 people diagnosed young could have a worse time than their Fellow T1 as like some have mentioned here that they take more Bolus than their T1 counterparts.

We need then to cure how the cell works and not necessarily all these medications and treatments. People say T2 is the lesser of the two evils but I would say given that a T2 has the potential to become 100% resistant this could lead to very bad outcomes.

Though I would rather take a little insulin than hammer my pancreas. Heck when my Metformin / Diet stop working I will be telling the doctor to make my liver work harder and also consider me for insulin. If he doesn't I will buy it online.

I know many here dont condone taking healthcare into their own hands but seriously Doctors really dont care. They learn over years of so many people dying that you cannot build that relationship any more than a farmer builds it with his cattle.

 

[bulkbiker]

I know many here dont condone taking healthcare into their own hands

Seriously?.. from my reading of the site I would say that is exactly what most of us do.. I do for sure..

But in answer to your main point .. if you can get rid of insulin resistance by changing what you eat so your pancreas can repair itself you won't need exogenous insulin. By taking exogenous insulin you won't do this so from my reading it would be counterproductive.

 

[sheepie123]

Seriously?.. from my reading of the site I would say that is exactly what most of us do.. I do for sure..

But in answer to your main point .. if you can get rid of insulin resistance by changing what you eat so your pancreas can repair itself you won't need exogenous insulin. By taking exogenous insulin you won't do this so from my reading it would be counterproductive.

I agree completely - Its about finding the balance as some have said they wished the Acted Earlier and I really feel for them but it also means I should pull my finger out and head these peoples warnings!

 

[Mep]

There is a follow-up blog by Jason Fung from the one quoted earlier ... https://intensivedietarymanagement.com/medications-actually-work-type-2-diabetes-t2d-40/

Basically, what he is saying is that Type 2 diabetes is a problem where there is too much sugar in the body (not just the blood), Drugs like sulphonylureas and insulin lower blood sugars, but don't remove these sugars from the body. Hence they tend to increase weight as the excess glucose is stored as fat by insulin. This then causes long-term health problems such as heart, liver and kidney disease. Drugs which help eliminate this excess sugar have significant benefits to life expectancy.

However, the simplest way to get rid of this excess sugar is to reduce the amount of carbs we eat and to burn off the excess sugar (fat) by intermittent fasting. Lowering blood sugars will lessen the likelihood of diabetic complications such as blindness and neuropathy. However, most type 2 diabetics die of heart disease and the just lowering blood sugars does not reduce the likelihood of heart disease, but reducing the amount of accumulated stored sugar in the body (e.g. liver fat) does significantly increase life expectancy.

Yes, although not all type 2's have weight issues. My own family is proof of that. I'm the only one that has been both slim and fat in my life... the others are super slim and have never had weight issues. Go figure. So the theory of excess sugar and insulin causing weight gain isn't necessarily correct in all cases. All diabetics in my family have type 2 also.

 

[kokhongw]

There has been various studies that shows early short term insulin therapy does give the pancreas its much needed rest...
http://care.diabetesjournals.org/content/36/Supplement_2/S190

When one considers initiation of insulin therapy in a type 2 diabetic patient with the intention to preserve β-cell function, the level of evidence supporting this decision is relatively high.

For the subgroup of patients with severe symptomatic hyperglycemia, there is strong evidence, in addition to guideline recommendations (American Diabetes Association/ European Association for the Study of Diabetes, International Diabetes Federation, American Association of Clinical Endocrinologists, Canadian, and National Institute for Health and Care Excellence [12–16]), to support initiation of short-term insulin therapy. Insulin therapy is an effective way to reverse short-term glucotoxicity and lipotoxicity and shows evidence of midterm β-cell preservation. Short-term insulin treatment is safe, with low incidence of hypoglycemia (23–25) and less concern for weight gain. However, the best method for insulin treatment in such cases—basal insulin, premix insulin analogs, MDII, or CSII—and the length of insulin therapy should be further studied.

This study had some interesting results...may be even better to have followup comparing it with ketogenic diet as intensive dietary intervention...but even as a keto supporter, I doubt a 2 weeks keto diet would have the same success rate. Many may need a longer time for keto adaptation.
https://www.ncbi.nlm.nih.gov/pubmed/18502299?access_num=18502299&link_type=MED&dopt=Abstract

FINDINGS:
More patients achieved target glycaemic control in the insulin groups (97.1% [133 of 137] in CSII and 95.2% [118 of 124] in MDI) in less time (4.0 days [SD 2.5] in CSII and 5.6 days [SD 3.8] in MDI) than those treated with oral hypoglycaemic agents (83.5% [101 of 121] and 9.3 days [SD 5.3]). Remission rates after 1 year were significantly higher in the insulin groups (51.1% in CSII and 44.9% in MDI) than in the oral hypoglycaemic agents group (26.7%; p=0.0012). beta-cell function represented by HOMA B and acute insulin response improved significantly after intensive interventions. The increase in acute insulin response was sustained in the insulin groups but significantly declined in the oral hypoglycaemic agents group at 1 year in all patients in the remission group.

 

[kokhongw]

Early Use of Insulin to Improve Beta Cell Preservation
September 27th, 2011
http://www.diabetesincontrol.com/early-use-of-insulin-to-improve-beta-cell-preservation/

Several clinical and experimental studies have clearly shown that even minimally preserved beta cell function is metabolically beneficial. This leads to lower HbA1C levels, lower insulin dosage and lesser metabolic decompensation after insulin withdrawal.

 

[mrbee]

Oh. So that explains how none obese sufferers can be interferred with IR too.
So why all the emphasis on it being internal and external fat which causes IR?

My specialist believes IR improves on fat/BMI weight loss. Muscle and fat. I guess.
Weight loss specialist (surgeons and dieticians) believe the same.
Well, for me.

https://scholar.google.co.uk/schola...ved=0ahUKEwjOofbw4M3VAhUKYlAKHaPQCHoQgQMIKTAA

 

[ickihun]

Having fat on the liver reduces how much glucose the liver can take up, external fat is a predictor of this. Losing the fat from the Liver improves insulin resistance.

It is very hard for anyone with insulin resistance to lose weight without breaking the cycle of insulin resistance hence if someone loses weight then IR is very likely to have improved. The actions you have to take to lose weight are the same as the actions to break the cycle of IR.

Increased muscle mass improves IR, but most people lose more in fat then they gain in muscle, hence once again losing weight is a good predictor of outcome when you study a large group of people.

Insulin resistance effect different parts of the body in different ways, I expect there will be some Nobel prizes given out when someone works out all the details........

All I did was eat low carb to get excellent bgs with the correct amount of injected insulin.
I reduced my insulin need by half. No extra exercise or smaller portions.