Blimmin heck Sid, that's a war story that is.
Referring to the point NewDestiny has raised about visceral fat/slim T2s. I'm been on Gliclazide for about a week and a half now - I was running blood sugars in the teens for last few weeks and a couple of mornings woke up with readings at 18 and 20 (and this was 6 days after finishing anti-biotics for a newly discovered fungal infection in my throat!)
So one day I felt very ill and naseaus all day and I skipped lunch (I'm not on any other meds bar B12/Complex supplements and a vit D daily) The GP sent me down to the hospital and I was tested and tested but they were scratching their heads and couldn't explain my readings. No Ketones (I never ever get Ketones and one doc said this is a sign I'm still producing insulin, my c-pep in the past showed norm range).
My sugars were 12 on admission (I hadn't eaten a thing for several hours at this point) then 15.7 midway through the night (4 hours after eating half an NHS sandwich) They called the Diabetes clinic where I normally attended to get advice and I got the usual comments about being an unsual case etc etc.
All of this pales in comparison with your story by the way!
Despite questioning the lovely doctor about why Gliclazide (he said he was given some complicated explanation that he didn't really understand! But it is quicker acting than Metaformin) I was put on 40mg and my reads dropped down to about the 11-14 mark but to be honest, it's not made the radical difference I was expecting. I assume they didn't bother with insulin as my sugars were not in the high 20s on?
I've added an extra Glic at night 3 days ago - so 80mg per day, and still it's not really budging my readings. I actually decided not to eat anything for 5 hours and I went from a morning fast read of 13.9 to just 8.2... RUBBISH! So the insulin is even more resistant?
My BMI is now 22.5 (I was 23) I've lost 18 pounds overall (over 10mths so not drastic or significant), and I've got leeway only to lose 7-8 more but then after that I will be classed as underweight....I've restricted carbs to 100-150/day and continue to exercise at least 3 times per week.
So I'm doing all I can but nothing's working. The Diabetologist did say last time insulin will be the inevitable course of action for me, I declined Gliclazide back then stating I'd put on weight, but I've since found out it's because extra unsused insulin in the body causes hunger pangs and if someone is not exercising or moderating their diet on Glic then they will gain weight. (I wonder if this is why typical T2s i.e insulin resistent so insulin in the body but not getting used up tend to gain weight so are classed overweight on diagnosis?).
I've got a horrid feeling they're going to up the Glic but my concern is why are they deliberately allowing my beta cells to become knackered on this drug? I've read that Glic does wear down beta cells over time...what is the point of this drug if that's the case? So this is where I'm thinking along NewDestiny's line that insulin should be introduced earlier especially in slim T2s or those who don't have excess internal body fat to help perserve the Pancreas. Infact, I'm now wondering how do they test for internal body fat anyway? I'm slim but not skinny (now 27.5inc waist but I do have a 'pooch' but my arms and legs are always skinny!
Any thoughts?