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T2D and insulin. Diet?

miahara

miahara

Well-Known Member
Messages
1,019
Location
Tayside
Type of diabetes
Type 3c
Treatment type
Insulin
It seems likely that after 3 years on Gliclazide and a LCHF diet that seems to have ceased having the desired effect, I'm quite possibly likely going to have insulin added to my meds.
I've a pal who is T1 and can more or less eat what he wants so long as he adjusts his insulin accordingly. My question is does this dietary flexibility also apply to T2D?
 
I have no experience of insulin, or any other diabetes med, but I do know that the more carbs you eat the more insulin you need. And vice versa. The more insulin you have circulating round your body, the more you are damaging things. High circulating insulin is the precursor to insulin resistance, so the more IR you become, the more insulin you need. Vicious circle. That is the issue with T2.
 
miahara said:
I've a pal who is T1 and can more or less eat what he wants so long as he adjusts his insulin accordingly. My question is does this dietary flexibility also apply to T2D?
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No. Type 1 is an autoimmune condition of insufficient insulin. Type 2 is a dietary disease of excessive insulin. For a while, perhaps years, you’ll be able to force more glucose into your cells with increasing doses. Your blood may appear clean but you’ll be making your diabetes worse if you attempt to adopt a similar approach to your T1 friend.

As an aside, not that I’m prying into your diet, but it’s a surprise that LCHF has led you to insulin. Normally it’s the other way around. Are you sure there’s no further dietary intervention that you can make in order to avoid insulin? It’s really not the best treatment for insulin resistance and should be avoided if at all possible.
 
Bluetit1802 said:
I have no experience of insulin, or any other diabetes med, but I do know that the more carbs you eat the more insulin you need. And vice versa. The more insulin you have circulating round your body, the more you are damaging things. High circulating insulin is the precursor to insulin resistance, so the more IR you become, the more insulin you need. Vicious circle. That is the issue with T2.
Click to expand...

I completely agree with @Bluetit1802 's post. That is exactly what happened to me when I was on insulin.
 
Good question. I would have thought that if your beta cells have finally given up, so you have no natural insulin, then yes your response to exogenous insulin would be the same as a T1. That is just me theorising though and I know nothing about how insulin resistance might affect things.
 
Diakat said:
Good question. I would have thought that if your beta cells have finally given up, so you have no natural insulin, then yes your response to exogenous insulin would be the same as a T1. That is just me theorising though and I know nothing about how insulin resistance might affect things.
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I would have thought the opposite (but as I'm another T1 I'm probably wrong). Insulin dependant T2s seem to need much larger quantities of insulin than T1s, which is presumably because of the insulin resistance.
 
Jim Lahey said:
No. Type 1 is an autoimmune condition of insufficient insulin. Type 2 is a dietary disease of excessive insulin. For a while, perhaps years, you’ll be able to force more glucose into your cells with increasing doses. Your blood may appear clean but you’ll be making your diabetes worse if you attempt to adopt a similar approach to your T1 friend.

As an aside, not that I’m prying into your diet, but it’s a surprise that LCHF has led you to insulin. Normally it’s the other way around. Are you sure there’s no further dietary intervention that you can make in order to avoid insulin? It’s really not the best treatment for insulin resistance and should be avoided if at all possible.
Click to expand...
Type 2 can be caused by low insulin production as well as insulin resistance.
 
EllieM said:
I would have thought the opposite (but as I'm another T1 I'm probably wrong). Insulin dependant T2s seem to need much larger quantities of insulin than T1s, which is presumably because of the insulin resistance.
Click to expand...

Having said that, I guess the insulin still gives you more flexibility for an occasional carb splurge, just take lots of insulin for it, whereas when you're on oral meds you have no choice but to restrict your carbs.
 
Mr_Pot said:
Type 2 can be caused by low insulin production as well as insulin resistance.
Click to expand...
Is that still T2, not MODY or one of the other non-standard (less common) forms of diabetes???
 
Mr_Pot said:
Type 2 can be caused by low insulin production as well as insulin resistance.
Click to expand...

Perhaps if double diabetes is setting in then yes. But in the first instance, you can’t become insulin resistant from a lack of insulin.
 
EllieM said:
Is that still T2, not MODY or one of the other non-standard (less common) forms of diabetes???
Click to expand...
Jim Lahey said:
Perhaps if double diabetes is setting in then yes. But in the first instance, you can’t become insulin resistant from a lack of insulin.
Click to expand...
No, but your pancreas can wear out, possibly from old age, and not be able to produce the amount of insulin it used to. Many people on here only developed Type 2 late in life.
 
EllieM said:
Is that still T2, not MODY or one of the other non-standard (less common) forms of diabetes???
Click to expand...
Sorry, I didn't mean to quote you in the previous post. Type 1 and LADA are an autoimmune desease not a stage of type 2. I don't know about MODY.
 
Mr_Pot said:
No, but your pancreas can wear out, possibly from old age, and not be able to produce the amount of insulin it used to. Many people on here only developed Type 2 late in life.
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Yes, hence double diabetes. But you’ll still be insulin resistant, and using exogenous insulin will not afford the same eating habits as a non-resistant type 1. At least not safely.
 
miahara said:
It seems likely that after 3 years on Gliclazide and a LCHF diet that seems to have ceased having the desired effect, I'm quite possibly likely going to have insulin added to my meds.
I've a pal who is T1 and can more or less eat what he wants so long as he adjusts his insulin accordingly. My question is does this dietary flexibility also apply to T2D?
Click to expand...

Hi I'm type 1 and unfortunately I can't eat what I like, if only it were that simple, as many foods can spike me considerably. Maybe you wont have to go onto Insulin, but whatever happens I wish you good luck.

https://www.diabetes.co.uk/forum/category/type-2-with-insulin.57/
 
miahara said:
It seems likely that after 3 years on Gliclazide and a LCHF diet that seems to have ceased having the desired effect, I'm quite possibly likely going to have insulin added to my meds.
I've a pal who is T1 and can more or less eat what he wants so long as he adjusts his insulin accordingly. My question is does this dietary flexibility also apply to T2D?
Click to expand...
I suggest you try and get some more testing done to get a proper diagnosis. Fasting insulin or C-Peptide to see what your endogenous insulin production is like.
 
miahara said:
My question is does this dietary flexibility also apply to T2D?
Click to expand...

My father is a type II and insulin dependent. I wouldn't consider him typical because he isn't good with diet, at 92 he says "why should I?" The frustrating thing is that his lack of care is affecting his health and he's seems to be doing everything in his power to die quite slowly. Having said that nobody has ever given him a c-pep or measured his insulin resistance. I do know that his insistence to eat muesli and toast and honey for breakfast isn't helpful nor is his chocolate eating. He's never been told anything about carb counting and his insulin dose seems to be fixed. In answer to your question I'd suggest "NO". As already suggested some additional tests would be helpful.
 
Would definitely be a good idea to have your c-peptide tested to see how much insulin your pancreas is still able to produce. Unfortunately sulfonylurea drugs like gliclazide can exhaust the pancreas by constantly stimulating it to produce extra insulin. It's one of the reasons that Dr Bernstein is very anti this class of drugs. From memory, you were always very slim, so it's possible you have an atypical type of Type 2 as well. The c-peptide test should be very informative and I hope your doctor has ordered the test before putting you on exogenous insulin.
 
My endo is having my c-peptide tested (I just have to go do it one morning) but he's having it tested 30-45mins post breakfast to see what the insulin response is like to food. Not to see what the fasting is because he said it doesn't tell him much of anything in my case because my pancreas doesn't produce enough insulin. If you are low carbing, then the fasting test isn't going to show much if there is an insulin production problem, because it will be at it's lowest point in the morning and that's when demand is also at it's lowest point anyway. Plus low carbing creates the least amount of demand for insulin, but if your pancreas isn't making enough because of some kind of damage then what's the point of testing it fasted? IMO - you want to see how well it produces when it's in full swing, post meal.

As also mentioned, get the full antibody panel tests done if you can. I'm pretty sure you'll get an answer. I live with a pancreas that doesn't produce enough, which requires small amounts of insulin to make up for the shortfall. Not a big deal, but it's best to get the right diagnosis decided once and for all so you get the optimal treatment for it.

Just my thoughts from someone who has a part time pancreas. Good luck.
 
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