PARADOX about treatment of D2DM with Insulin and Metformin

[Mars1946]

PARADOX about treatment of T2DM with Insulin and Metformin

The disposal of glucose after meals depends on the ability of insulin to increase peripheral glucose uptake and to simultaneously decrease endogenous glucose production. Although studies have suggested that the kidney can contribute up to 25% of endogenous glucose production. The defect in T2DM is primarily in defective regulation of glucose production from the liver. Two routes of glucose production from the liver are glycogenolysis of stored glycagon and gluconeogenesis from two and three-carbon substrates derived primarily from skeletal muscle.

Hepatic insulin resistance plays an important role in the hyperglycemia of T2DM and the impaired suppression of hepatic glucose output appears to be quantitatively similar to, or even larger than, the defect in stimulation of peripheral glucose disposal. There is a direct relationship between increased hepatic glucose output and fasting hyperglycemia.

Insulin mediated suppression of hepatic glucose output is impaired at both low and high plasma insulin levels in T2DM; hepatic glucose production is elevated early in the course of the disease, but may be normal in lean, relatively insulin sensitive type 2 diabetics.

Treatment of patients with Metformin, which suppresses hepatic glucose production, results in improved glucose tolerance.

My opinion is the best treatment of T2DM is with Insulin and Metformin.

This treatment is equivalent to the Tertiary Prophylactic Therapy.

The purpose of this treatment is to achieve a stage of EUGLYCEMIA.

 

[Mep]

Whereabouts did you get this information from? Is this a suggestion when people still have their own insulin, or when they have insulin deficiency?

Metformin is usually the drug of choice for type 2's and it is used a lot. I was on metformin for 5 years and it had me sick the entire time. I'll never touch the drug again as I didn't tolerate it no matter the dosage and release type. I also have my suspicion about what long term use of it causes because prior to metformin I had no digestive issues.... absolutely none at all. Whilst on metformin I suddenly developed all these chronic digestive problems 3 years after continual use of it... I stayed on it another 2 years and it was not a great experience with the added problems I can tell you. It could just be coincidence maybe, but I've not really seen many studies about the the long term use of this drug and it's effects if any. I did see one stating that just 4 years use of the drug can cause neuropathy due to Vitamin B12 deficiency that it causes. I was on it 5 years. Anyhow just thinking about my own experience here... not saying anything about it being the truth for anyone else. Although the drug is highly promoted, I'd like to see more studies on long term use personally. I'd like to think patients have the option to say no to the drug if they have more information about it. You only ever hear about how good it is. I often wonder if I was only on it short term would I have developed all these digestive issues? But I can't worry about the "what if's" now as I'm living with it all... just have to deal with it. But there has been class actions on drugs in the past so that's why I'm saying I'd like to see more studies on long term use of this drug.

I'm on basal and bolus insulins though and it will stay that way.

 

[Indy51]

If you are quoting from research, it would be good manners to give the source of the quote. If you are giving your own opinion, which the wording of the third last paragraph implies, then what qualifications do you have to give medical advice?

 

[Dark Horse]

*glycogen (not to be confused with glucagon)

It appears to be from Williams textbook of endocrinology.
https://books.google.co.uk/books?id...als depends on the ability of insulin&f=false

 

[Mars1946]

If you are quoting from research, it would be good manners to give the source of the quote. If you are giving your own opinion, which the wording of the third last paragraph implies, then what qualifications do you have to give medical advice?

Hi Indy

All what I am writing about is a knowledge acquire from the same literature as the students on the medical faculty use. You can on your own buy it for example from ELSEWIR. As you can see, I have T2DM and it is the reason why I can write about it on this level. You can check every word I am writing for its relevance on the Google f. example ( or in the relevant literature if you can read and understand the text). The text is of my own, but do not believe I have aptitude for that. Every word I know I have learnt from the different members of the society. I understand seven languages.
I have feeling you are a person who rate another people according to the rules developed from your self, but not interesting for me. It is your problem.
I do not give medical advices, but I only inform about the problems.
My medical qualifications about the DM are the same as by specialist for DM.
Regrettably it is impossible for me to give you information's about every words origin.
You can trust for that I am writing or you can ignore it.
W.R.
Mars

PS I am not writing medical books.

 

[ladybird64]

Hi Indy

All what I am writing about is a knowledge acquire from the same literature as the students on the medical faculty use. You can on your own buy it for example from ELSEWIR. As you can see, I have T2DM and it is the reason why I can write about it on this level. You can check every word I am writing for its relevance on the Google f. example ( or in the relevant literature if you can read and understand the text). The text is of my own, but do not believe I have aptitude for that. Every word I know I have learnt from the different members of the society. I understand seven languages.
I have feeling you are a person who rate another people according to the rules developed from your self, but not interesting for me. It is your problem.
I do not give medical advices, but I only inform about the problems.
My medical qualifications about the DM are the same as by specialist for DM.
Regrettably it is impossible for me to give you information's about every words origin.
You can trust for that I am writing or you can ignore it.
W.R.
Mars

PS I am not writing medical books.

Can you please clarify whether you have medical qualifications or not? You seem to be contradicting yourself.
Regarding quoting verbatim from other sources, it is not a matter of trust but misrepresentation. The appearance of something being written by you when it is in fact copied from a book. I think there are possibly rules on this forum regarding giving sources when quoting directly from elsewhere.

 

[catherinecherub]

As the OP is not prepared to disclose any possible medical qualifications or provide any references to his text, then this thread is being closed.