I have a friend, who is gradually weaning himself off insulin via low carbing.
In discussion with him , it seems that having been diagnosed in 1999 and prescribed glycazide? and then metformin he was put on insulin because in 2003 his NHS doctor found ketones in his blood ( measuring around 5 as he recalls i.e. definitely single digits ) he also told me he had been fasting at the time in a bid to lose weight but the doctor had told him insulin was urgently needed because of the ketosis.
This week he decided to stop the insulin altogether for a a couple of days and see what happened.
He made himself a low carb lunch today - which was similar to the previous low carb lunches he has been eating all summer. I have been shaking my head at the size of his meals, but there is only so much one can say. ( seven chicken drumsticks for example !)
He had still been taking overnight insulin but no longer the pre meal dosage - ( I have myself been getting concerned that his likelihood of a hypo was getting very high with continuing with any insulin - though that is not the point here) .
Yesterday for the first time he stopped the overnight insulin as well.
The point I am posting about is this - He had made himself a lunch consisting of a 3 egg omelette, 2 small tins of mackerel in oil and a large portion of buttered broccoli and cauliflower. I looked rather askance as he was making it at the huge volume of food involved. He assured me that this was about the amount he needed to keep going during an average lunch in order to stop the hunger pangs in the afternoon. This is what he has been eating at this time of day for weeks.
Today he ate about 25% of the food, then sat back in total astonishment saying " I can't eat anymore" - what the hell is happening to me - yesterday I was ravenous. His blood sugars - which whilst on insulin veer around 8-10, have been sitting at 6-7 all day with no insulin.
I took the opportunity to explain portion control further and then divided the remaining meal into three new meals - each a similar size to the one that just satiated him.
In his own mind he had suddenly become a transformed person. If his experience is anything to go by, then actually there is no wonder that insulin causes weight gain - I had hitherto assumed that this was via some rather mysterious process . In practice for him, injecting insulin makes him totally ravenous leading to big blood sugar rises no matter what type of diet simply becaue of the volume, then leading to lows through overdosing to deal with the high - ad infinitum.
I am certainly coming round to the view that T2's should definitely be being tested for levels of circulating insulin before yet more of it is injected into them.