• Guest - w'd love to know what you think about the forum! Take the 2025 Survey »

IMURAN OR INSULIN?

JohnEGreen

JohnEGreen

Master
Messages
14,002
Location
Nottinghamshire
Type of diabetes
Other
Treatment type
Diet only
Dislikes
Tripe and Onions
It seems that Imuran (Azathioprine) may be useful in delaying the onset of T1 diabetes and may even bring about short term remission in some cases.

https://www.diabeteshealth.com/imuran-or-insulin/

"About seven years ago, Peggy Polopolus was identified by doctors at the University of Florida Health Center as a person “well on the road to insulin-dependent diabetes.” Her sister was diabetic and Peggy’s insulin was beginning to drop below normal levels. A newly developed test for cell antibodies showed that her immune system was attacking and disabling insulin-producing cells in her pancreas. Doctors gave Peggy twice daily doses of Imuran, and today Peggy is diabetes-free. As a result of Peggy’s success, her doctors are planning a nationwide trial of Imuran on 150 people at high risk for the disease hoping that “if we get people earlier, we may be able to prevent diabetes totally.”"

https://www.uptodate.com/contents/prevention-of-type-1-diabetes-mellitus

"Azathioprine — Azathioprine is an immunosuppressive drug that inhibits or prevents T cell responses to antigens. In one randomized, double-blind study of 46 patients treated with azathioprine and glucocorticoids, insulin could be discontinued in 10 of 20 treated patients as compared with 2 of 20 patients in the placebo group [3]. Endogenous insulin secretion (measured as the plasma C-peptide response to a liquid meal) also improved. However, only three treated patients remained in remission at one year."

Effects seem to be unreliable and short term at the moment but who knows things may improve.

My apologies this is an old article and I had not realized that but shall not delete as some may find it interesting

Not sure how up to date uptodate is.
 
Hi John,
On similar subject there was recent article in the bmj that supported a low carb diet to reduce insulin resistance. This guy reckoned if one's fasting blood glucose after 8hours was still above a certain level T2Ds should have a shot of insulin each day as required to help to rest the pancreas so it could recover from the previous hard work it did coping with carbs.
I will post it tomorrow if I get a chance.
regards
Derek
 
Last edited:
What if sugar is worse than just empty calories? An essay by Gary Taubes
BMJ 2018; 360 doi: https://doi.org/10.1136/bmj.j5808 (Published 04 January 2018) Cite this as: BMJ 2018;360:j5808

This was the original article John which is behind a paywall. It is a response that mentioned this use of insulin.

There are multiple responses to his article and not all full of praise by any means but I think the one below mentions the use of insulin to help the pancreas recover.

https://www.bmj.com/content/360/bmj.j5808/rr-0

Click responses, it is the one by Charles R. Fred

regards
Derek
 
It's an interesting hypothesis, but there's also the issue of an immunosuppressant. What's the risk associated with that in everyday life?
 
Abatacept (sp?) is another drug they are having good results with. I can find online articles showing it delayed progression in newly diagnosed T1s but my consultant tells me they are using it in the U.S. for high risk kids to try and prevent it.
 
lindisfel said:
Hi John,
On similar subject there was recent article in the bmj that supported a low carb diet to reduce insulin resistance. This guy reckoned if one's fasting blood glucose after 8hours was still above a certain level T2Ds should have a shot of insulin each day as required to help to rest the pancreas so it could recover from the previous hard work it did coping with carbs.
I will post it tomorrow if I get a chance.
regards
Derek
Click to expand...
Hi Derek
I was told by an endocrynologist recently that I had only 50% pancreatic functionality because of a distal pancretectomy in 2012 and that as soon as I reach an HbA1c above 48 I will go straight on insulin, no tablets. So...if you are able to send me a link to that BMJ article it would be very helpful to me. Thanks.
 
Hi @lindisfel,

I followed your link, the comments from Charles R. Fred are copied below. I hope he wont mind.


05 January 2018
Charles R. Fred
Electrical Engineer
New York

Fructose Does Not Cause Diabetes.

I disagree with Gary Taubes, whom I hold in the highest regard. Let’s analyze this physiologically rather than epidemiologically. The slippery slope between “associated” and “caused” is all too familiar.

Glucose:

Mr. Taubes speaks of “disassociating any deleterious effect of sugar from that of the calories it contains,” but is not alarmed by fructose’s seemingly amiable companion - glucose. After all, those beta cells done in by diabetes are designed to cope with glucose, not fructose.

Conventionally, type 2 diabetes is attributed to obesity and to insulin resistance. In fact, some go so far as to say that insulin resistance is type 2 diabetes. However, while insulin resistance does cause higher blood glucose, it is not the root problem; it is dead beta cells that are the irreversible and progressive essence of type 2 diabetes. Insulin resistance is just reversible adaptations to too much blood glucose, too often; causing chronically overstuffing of muscle cells and the liver’s glucose fuel tank. Insulin resistance was branded the villain in Type 2 diabetes because it seemed disease-like, while the ubiquitous consumption of dietary carbs (glucose) seemed natural.

Obesity so often catches the eye when seeing type 2 diabetes patients that the association seems causal, but many have tried to physiologically connect obesity to type 2 diabetes, without success. One does not cause the other, but they have a common progenitor, dietary glucose, both in quantity and in transient peak effects.

Human evolution expects almost all glucose to be released little by little from the liver, just as needed. So blood glucose never rises very much or very fast and our beta cells are never overtaxed. But, when you eat carbs, blood glucose rises massively and quickly, triggering massive and quick insulin secretion; and even transient peaks, unknown during evolution, seem like massive glucose loads to beta cells which then try to respond with excess insulin production. Insulin resistance in liver and muscles further aggravates this by requiring even more insulin to force in even more glucose.

This threatens the very survival of our beta cells. The main trigger of apoptosis is failure of a cell to perform its function, but requiring beta cells to massively and quickly secrete insulin tempts them into failure and triggers apoptosis. Most type 2 diabetes beta cells have suffered apoptosis - that is diabetes.

If, eight hours after eating, the pancreas is unable to supply enough insulin to push fasting blood glucose below 90, there must be few surviving beta cells - and each of those few survivors now are asked to secrete even more insulin. Thus an avalanche effect, fewer beta cells, more asked from each cell, faster apoptosis - progressively worsening diabetes.

Treatment: Over the course of one month, reduce carbs to near zero. Rescue failing beta cells by injecting insulin during their recovery.

Fructose:

This indictment of glucose in type 2 diabetes does not let fructose off the hook in NAFLD and atherosclerosis. Fructose causes de novo lipogenic production of VLDL (triglycerides) which cause fatty liver, and, with the help of CETP, produces small, dense LDL particles capable of piercing the arterial endothelium and, with contributions from the immune system, atherosclerosis.

Chronically excessive glucose may have a similar effect - stay tuned.

Adapted (with too little context) from my paper in progress, “Unified Physiology of Obesity and the Metabolic Syndrome.”

[email protected]

Charles R. Fred
 
tim2000s said:
It's an interesting hypothesis, but there's also the issue of an immunosuppressant. What's the risk associated with that in everyday life?
Click to expand...
Imuran does have some possible nasty side effects and regular monitoring is necessary when on them I have a blood test with every prescription now but if they can delay or even reverse T1 maybe the risk is out weighed by the benefits.

One thing worthy of note is that Imuran can take up to 12 months before kicking in and showing any effect.
 
JohnEGreen said:
Imuran does have some possible nasty side effects and regular monitoring is necessary when on them I have a blood test with every prescription now but if they can delay or even reverse T1 maybe the risk is out weighed by the benefits.

One thing worthy of note is that Imuran can take up to 12 months before kicking in and showing any effect.
Click to expand...
As an immunosuppressant, they may reverse effects of t1D while being taken, but long term use and the nasty side effects potentially outweigh the benefits.
 
Hi John,
There is a similar discussion on curing type 1 to what you started in the recent mag Healio Endocrine today.
But if one tries to post links you get pestered by joining the site.
Derek
 
tim2000s said:
As an immunosuppressant, they may reverse effects of t1D while being taken, but long term use and the nasty side effects potentially outweigh the benefits.
Click to expand...

I've been taking them (Imuran) that is for three years now no huge detrimental side affects to report so far.

I was put on them as a prednisolone sparing medication but has not worked out that way as now take both.
 
Back
Top