Type 2 progression to insulin

[bachstrad]

I've been T2 for 18 years and the first 14 years I was ignorant on how to treat IR to the point the NHS wanted me on Insulin as HBA1C was over 10 but I hate needles so found out about Keto and later about fasting and sugar & food addiction and now am doing fine without any medication. The problem is we shouldn't have to educate ourselves, isn't that what doctors are for ?

 

[SOPHIE2006]

A comment was made on another thread that many type 2 progress to insulin within 10 years due to beta cell damage. (In order not to derail that conversation I though it would be interesting to continue this here.)

Is that an assumption based on continued consumption of high carb levels and a medication only approach, and is it often more than 10 yrs?

To my view it is an “assumption” is that beta cells have worn out due to type 2. It’s likely many of these are caused by the wringing out every possible drop of insulin of the already massively overproducing pancreas by medications such gliclazide. It’s also highly likely that many still overproduce, not under, but have become hugely insulin resistant which mimics underproduction.

Few type 2 are actually tested for insulin or c peptide production at diagnosis nor before being moved onto insulin. Even fewer have beta cell checks made (can that even be done?).

So how do we know why so many progress to insulin - if in fact they even do so - and at what point in time after disease onset/diagnosis.

I've been Type 2 since July 2018. I've been on insulin from the day I was diagnosed apart from a brief period between the end of March-June of this year.

 

[lucylocket61]

I've been Type 2 since July 2018. I've been on insulin from the day I was diagnosed apart from a brief period between the end of March-June of this year.

Are you restricting your carb intake?

 

[SOPHIE2006]

Yeah I am. Still have some carbs but try to keep them to a minimum

 

[HSSS]

I've been Type 2 since July 2018. I've been on insulin from the day I was diagnosed apart from a brief period between the end of March-June of this year.

Do you know and understand why this is the option and not some other alternative? Were choices offered and explained? Were tests done to ensure this is the most appropriate option medically? Were your informed preferences taken into account?

Big differences depending on if your answers are yes or no.

 

[HSSS]

Yeah I am. Still have some carbs but try to keep them to a minimum

That’s a bit like saying it’s the length of a piece of string. Means vastly different things to different people

 

[lucylocket61]

Yeah I am. Still have some carbs but try to keep them to a minimum

do you know how many you have in a meal or over a day?

 

[Sax]

How would one go about testing insulin levels in the UK if seeking to do this privately? I don't see many options coming up when searching for an insulin test. It does seem something that would be worthwhile having a data point taken on every few years to understand if a permanent change is happening that normal tests won't detect.

 

[bulkbiker]

How would one go about testing insulin levels in the UK if seeking to do this privately? I don't see many options coming up when searching for an insulin test. It does seem something that would be worthwhile having a data point taken on every few years to understand if a permanent change is happening that normal tests won't detect.

You'll probably have to visit a lab or private hospital to get the blood taken as the old postal system used by medicheck and others didn't seem to get the blood to the lab fast enough for the tests to be accurate (or at least I presume that is why they stopped offering the service).
If you live in London it should be fairly easy if not then maybe harder.. where abouts are you and I'll try to find somewhere local that will do it.

 

[JohnEGreen]

My understanding of this thread is that the OP was asking "what evidence supports the NHS mantra that Type 2 Diabetes has a progression to insulin therapy regardless of medication or lifestyle and if the evidence supports a 10 year timescale for this process." So insulin therapy is an endpoint or outcome

As far as I can see there are no statistics kept on how many T2D had not progressed onto inulin at the time of death - usually, such deaths are recorded as comorbidity events not death by sugar.

I agree to an extent but the question asked was how do we know and there are many paths to Knowing other than statistics and studies there is also the empirical path of experience and anecdotal evidence either supporting the hypothesis or not.

Me I know the orthodox view of this is wrong "cause I feel it in me bones."

 

[Oldvatr]

I agree to an extent but the question asked was how do we know and there are many paths to Knowing other than statistics and studies there is also the empirical path of experience and anecdotal evidence either supporting the hypothesis or not.

Me I know the orthodox view of this is wrong "cause I feel it in me bones."

In my empirical life, I have never known any T2D that had progressed to insulin therapy. None of my friends or work colleagues has been so unfortunate. I know several T1D who use insulin, and my own family history has T1D but I am the first T2D. So my 'knowledge' as you put it does not support the hypothesis, but then I could be wrong. I too feel it in my bones, but I do not smell it in the air. My only contact with T2D who use insulin is on the pages of this forum. And that is the God's honest truth. Nada. Nihil, nix.

But I read science study reports that uphold the hypothesis, so I accept that there is a real world outside my front door where such things seem to be prevalent. Do I believe them? And do I override my personal yardstick?

Or do I just keep taking the pills?

 

[Fenn]

Both myself and sister have progressed onto insulin, I think there are so many different types of type 2, if that makes sense? I see comments where people feel terrible if their bg goes over 10, my bg goes to 26 I have no idea, carbs do different amounts of damage to different folks, IR varies hugely, so many combinations, if you look at 100 people sticking to 20g carbs a day, I guess 10% would progress over 10 years, 100 “normal” or unenlightened about carbs type2’s then it’s prolly 90%

 

[KK123]

[QUOTE="Oldvatr, My only contact with T2D who use insulin is on the pages of this forum[/QUOTE]

It's weird isn't it, I know several type 2s who are using insulin, a couple are friends but most are in the workplace. I wonder if it's an age thing as I'm in my 50s so more likely to have older friends maybe. Of course there could be a few in the mix that are labelled as type 2 on insulin when they could be type 1/lada.

 

[Oldvatr]

[QUOTE="Oldvatr, My only contact with T2D who use insulin is on the pages of this forum

It's weird isn't it, I know several type 2s who are using insulin, a couple are friends but most are in the workplace. I wonder if it's an age thing as I'm in my 50s so more likely to have older friends maybe. Of course there could be a few in the mix that are labelled as type 2 on insulin when they could be type 1/lada.[/QUOTE]
I was making the point that while our personal experience is important it is anecdotal (n=1) and can become a blinkered viewpoint. By the same token, I know some people who have had Covid, but who did not go into hospital and who described it as like a dose of flu. I likewise do not know of anyone in my life and family who has had to be treated in ICU or who passed because of this disease. So I am a prime candidate for the rabbit hole that is conspiracy.

I am of 70+ years experience, so belong to the progression (not prograssive) brigade, So far my condition has remained in control by orals and lifestyle after some 30 years since diagnosis.

 

[lucylocket61]

I know about 7 type 2 diabetics on insulin. I have lost a family member to covid and have a few friends still recovering months after getting it. I had long covid myself.

Anecdata becomes data is someone conducting a study listens.

The people I know on insulin are in their 50's and 60's. I believe there are different forms of type 2.

 

[LittleGreyCat]

My post was more about why type 2 is seen as progressive and insulin use is likely, and if 10 yrs is an accurate assumption of when it becomes likely.

Just wandering back to say that in my case it does seem to be progressive, but 10 years to insulin isn't the time scale.

Given that I am 70, I expect a lot of things in my body to work at reduced efficiency so it doesn't surprise me that my pancreas is one organ that is getting a bit worn.

Noting of course that there are at least two major variants of T2 - insulin over production with ever increasing IR, and insulin under production (generally slim T2) which seems to be where I am at the moment.

If you can cure (or radically improve) the IR for the insulin over producers then the condition should be reversible before the pancreas is thrashed to death.

 

[Fenn]

Noting of course that there are at least two major variants of T2 - insulin over production with ever increasing IR, and insulin under production (generally slim T2) which seems to be where I am at the moment.

If you can cure (or radically improve) the IR for the insulin over producers then the condition should be reversible before the pancreas is thrashed to death.

This is perfect!

 

[Oldvatr]

Just wandering back to say that in my case it does seem to be progressive, but 10 years to insulin isn't the time scale.

Given that I am 70, I expect a lot of things in my body to work at reduced efficiency so it doesn't surprise me that my pancreas is one organ that is getting a bit worn.

Noting of course that there are at least two major variants of T2 - insulin over production with ever increasing IR, and insulin under production (generally slim T2) which seems to be where I am at the moment.

If you can cure (or radically improve) the IR for the insulin over producers then the condition should be reversible before the pancreas is thrashed to death.

I would also offer that reducing the demand for insulin will also help to prevent thrashing. The main cause of
beta-cell demise in T2D appears to be glucotoxicity i.e. excess blood glucose. Glucose control should benefit both T2 variants, which is why we are here, I presume?

 

[Alexandra100]

Noting of course that there are at least two major variants of T2 - insulin over production with ever increasing IR, and insulin under production (generally slim T2) which seems to be where I am at the moment.

Do you have any references/links for slim under-producers of insulin? NOT wanting to lose weight and yet having problems with carbs/bg feels to me like a very lonely position.

 

[HSSS]

Just wandering back to say that in my case it does seem to be progressive, but 10 years to insulin isn't the time scale.

Given that I am 70, I expect a lot of things in my body to work at reduced efficiency so it doesn't surprise me that my pancreas is one organ that is getting a bit worn.

Noting of course that there are at least two major variants of T2 - insulin over production with ever increasing IR, and insulin under production (generally slim T2) which seems to be where I am at the moment.

If you can cure (or radically improve) the IR for the insulin over producers then the condition should be reversible before the pancreas is thrashed to death.

Is there much out there that supports underproduction of insulin in type 2 (before the pancreas is thrashed)