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Dr Sebastian Rushworth

An excellent read! I almost didn't bother to click on the link as I had already answered 'No' to the question you asked, but I'm glad I did.
 
Surely, insulin is needed by everyone.
I think your question is whether t2s need injected insulin.
 
A very interesting read. I have always thought that it's vital for a T2 with excess weight to try to get that weight down by low-carbing plus exercise in order to reduce insulin resistance. This can avoid the need for insulin. For any slim T2 it's always worth doing tests such as C-Peptide to check natural insulin levels when injecting insulin may help and not be adding to excess body insulin.
 
zand said:
An excellent read! I almost didn't bother to click on the link as I had already answered 'No' to the question you asked, but I'm glad I did.
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I like this guy because he just seems to get down to the evidence. No sensationalising, no vested interest.
He's done lots of interesting stuff. He's a big low-carb fan.
 
IF all else has been tried, and low carbing doesnt work or the person, for many reasons, cannot low carb enough to lower their blood sugar levels, then what is wrong with insulin therapy? There are many reasons to use insulin therapy in T2's. I notice the article didnt contain information about those for who low carbing is no longer enough, or possible.

Anecdata: My brother is doing really well now he is on insulin therapy. His Hba1c has come down, his energy levels and problems with his feet have reduced, his eyesight has improved. He simply couldnt benefit enough from other interventions.

My father, a T2 for 40 years, was on insulin for the last 4-5 years of his life. He died aged 86, last year, with all his limbs, eyesight etc. Insulin gave him that extra time, as his pancreas aged and functioned less and less. He died of asbestosis from scientific research work in the 1960's - not anything connected with diabetes.

I also notice the information presented is from 1998 and 2012, nothing more up to date, nor were other interventions mentioned. It seems that those in the studies were eating as many carbs as they wanted, and needing more and more meds. This may not be true for all type 2's on insulin.

The sweeping generalisations in this article seem misplaced and harmful. There is a place for insulin therapy for T2's. I dislike this idea that low carb solves everything and if it doesnt, its not low carb enough. We are all different. Insulin therapy is neither harmful nor dangerous. It is literally a life saver or extender of healthy life for many.
 
But, the point of his interpretation of the research studies in the UK and US is that, despite not having treatment with insulin, so having a higher HbA1C, this was the conclusion: "So, the UKPDS study showed marginal reductions in heart attacks, strokes, and a questionable measure of microvascular disease among those treated with insulin after ten years of treatment, none of which was statistically significant. That is the entire basis on which millions of type 2 diabetics are currently being treated with insulin."

I read it as the 1998 study was the one on which future treatments on insulin was initiated, but on 'relative' oriented results, which is basically a con. He also says the study was part funded by drug companies that make and sell insulin. Much like the ones that recommended the worldwide use of statins.

I'm glad your brother is doing well and that your Dad lived to a good age. And I agree, low carb doesn't work for everyone.
I am suspicious of drugs companies I guess, it takes something that makes me pretty scared to take things.
Also, at the end of the day, there has been so much obfuscation and propaganda surrounding our covid response, it has made me look at health matters that relate to me rather more closely.
 
Jo_the_boat said:
Is insulin life-saving for T 2 Diabetics?

This is an interesting article.

I have purposely not commented, but may do at a later date.
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I hope drs. know this stuff. I don't know how much insulin I should take. I don't think my dr. knows either. I rely on my meter numbers 4-11 as the safe range. I am type 2 as diagnosed.
 
Jo_the_boat said:
"So, the UKPDS study showed marginal reductions in heart attacks, strokes, and a questionable measure of microvascular disease among those treated with insulin after ten years of treatment, none of which was statistically significant.
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with no control group of those type 2 diabetics who were not given insulin. We have no way of knowing what might have happened to them without the insulin. The point is that, at worse, the insulin kept them on an even keel. There must have been reasons for moving them to insulin instead of other drug therapies, otherwise the insulin would not have been tried. Like is not being compared to like.

I notice the article writer is a junior doctor.
 
Jo_the_boat said:
Also, at the end of the day, there has been so much obfuscation and propaganda surrounding our covid response, it has made me look at health matters that relate to me rather more closely.
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please read the other articles by this person closely, he has some wild and unsubstantiated anti covid and conspiracy rhetoric going on based on spurious 'research'. Yes, I read around the blog.
 
Insulin therapy is only suitable if the patient is proven to be underproducing. If they are overproducing then adding more is going to make everything worse. That’s the nuts and bolts of it.
 
Jim Lahey said:
Insulin therapy is only suitable if the patient is proven to be underproducing. If they are overproducing then adding more is going to make everything worse. That’s the nuts and bolts of it.
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not if they cant use the insulin they are producing, due to insulin resistance or similar. Its not as simple as some are making out, or as straightforward. Also, there appear to be many sub types of type 2 diabetes, and different causes and triggers. As we see on this forum, different ways of eating and treatments work for different people. To decry a whole treatment method, which works for some, seems odd to me.
 
@lucylocket61 Adding more insulin to someone who is already overproducing will only increase insulin resistance. It may appear to be working by lowering blood glucose but sooner or later the patient will run out of road. Long term outcomes are not improved. They key point here is that endogenous production must first be measured, but it rarely is. If the patient is underproducing then insulin therapy has a valuable role. Otherwise it’s just kicking the can down the road.
 
When I had a few wobbly moments which were fixed by a warm drink and three grapes, I thought that it showed that I was producing insulin to excess, and that the lack of the 'healthy' carbs was revealing a mismatch between production and actual needs.
Once my poor hysterical pancreas recovered its composure, all was well again.
 
Some type 2 diabetics have insulin therapy as a temporary measure to keep them ok until other measures kick in. It's not black and white.
 

Insulin is primarily a BG lowering drug. That's how it works.. That's why it was developed. Used & dosed correctly. It can be used to manage & why prescribed..

There are to the best of my knowledge no other "miracle" claims it can be beneficial for anything else??
(Unless one happens to be a cheating bodybuilder.)
 
Yes insulin is a BG lowering drug. I feel with IR T2s the issue is with how much damage is caused by hyperinsulimia and how much is caused by high BGs.

If my BGs were regularly in the late teens or the 20s I think I would take my chances with insulin if all else failed. Right now though I am trying keto again (which I hate) along with as much exercise as my body will allow (not alot). If that fails and I am still obese and IR, then I need to accept that I have to choose between high BGs and higher insulin levels.

In an ideal world IR would be spotted at a much earlier stage, but in this world those who fund studies clearly don't want this to happen.
 
I read the paper and the studies it discussed seemed to involve T2s who were often early stage or even prediabetic. I'm not sure how much relevance these studies have to countries where T2s are typically supplied insulin at a late stage of diagnosis (ten years?) , other meds have been tried and failed, and quite possibly the T2's insulin own insulin production has been impaired by long term high bgs. I guess you can't really do a study for these people, because you can't leave a control group untreated.

Try low carb before giving insulin to a new T2? That seems pretty sensible to me. But it says nothing about using insulin to treat a long term T2 who has already run through a large number of other options.

And yes, it would be nice if doctors did more cpeptide tests to determine how much insulin new and old T2s were producing, if only because you could then spot a lot more misdiagnosed T1s and also spot the T2s whose production is failing.

I would argue that insulin is life saving for some T2 diabetics (or at least sight and limb saving).
 
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