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Insulin for Type 2 - is it a slippery slope?

R

RosieMaxwell

Well-Known Member
Messages
81
Location
London
Type of diabetes
Don't have diabetes
Treatment type
Diet only
Hi guys. I have a question that’s not about myself.

Both my parents (who are currently overseas, outside the UK) have contracted COVID and it’s been serious enough that they were admitted to hospital. It’s been an incredibly stressful time but they seem to have got a handle on their oxygen levels and may be discharged.

A side effect of the meds they’ve been given - particularly the steroids - is that their blood sugar has gone through the roof. Both of them are diabetic and on multiple meds normally so this is happening in spite of those meds.

The endo has said they should take insulin injections for the duration of their med course now. 10 days for mum and 5 days for dad.

My question is, will this effect them long term? Once you start insulin is it possible to stop?

I am worried but the docs where they are are very chill and I’d just like some other perspectives...
 
Am delighted that they are both getting over Covid! Well done to both of them. Must be a huge relief for you all.

I have read of insulin being used in conjunction with courses of steroids in order to control the bg spikes the steroids cause.
It seems to be much more preferable than the awful bg swings they would get otherwise. It doesn't mean that they will require insulin for ever, unless there is something else going on.

Steroids are known (in some) to cause steroid induced diabetes, but that is usually after long term use of steroids. Months or years. A few days is a very different matter, and may have no long term effect at all.

There is a question in some of the news/literature that Covid may be triggering diabetes in some patients. But I am not sure whether this same process may be worsening diabetes in T2s who already have a degree of glucose dysregulation. I haven't seen any clear information on how this works, or the degree to which it happens, but it is always going to be a possibility.

Sorry not to be more definite, but it looks like it is boiling down to that old adage 'we are all different' both in our diabetes AND our experiences of Covid.
 
Thank you for taking the time to reply. It’s super helpful because there’s so much I don’t know about diabetes and medication.
 
Brunneria said:
There is a question in some of the news/literature that Covid may be triggering diabetes in some patients.
Click to expand...
I did find this on the subject.

If as some studies are indicating now that covid 19 does directly attack the pancreas it may be that if the damage to the pancreatic cells persists then Insulin therapy may be a long term solution I do hope that this is not the case on this occasion.

It also seems that some patients after recovery are presenting with acute pancreatitis which is normally due to short term inflammation of the pancreas and usually resolves after a short time (about a week) but would involve hospitalization.
 
@RosieMaxwell - I won't add too much to what the others have said, because we don't know anything about your parents' diabetes, their COVID or any of the meds they have been given to aid their recovery.

What I will say is that if your parents need a bit of help with their blood sugars right now, it doesn't necessarily mean they would have to use insulin forever. If their Docs are talking about a few days, it sounds like they want to take insulin for a while. (Then, presumably review.)

Frustratingly, high blood sugars just give the body one more thing to fight, and it ca slow up or inhibit healing, so I would suggest it's very worthwhile keeping an open mind about it all.

I have my fingers crossed for their continuing improvement, and hopefully you'll be able to see them soon, and don't forget to look after yourself too.
 

Thank you. It’s really quite scary to be so far away and not be physically present to discuss issues directly with the doctor. Aged 36 it’s amazing but I am as scared as any child with what’s going on.

That being said, they were discharged today. And they have to start doing the insulin shots themselves - though they’ve never done it before. That in itself is quite stressful.

I was very successful in controlling my high blood sugar (admittedly only ever pre-diabetic) with diet. I want to try and help my mum in particular do this too... but it’s tricky because she just doesn’t accept that she CAN cut down her carb intake.

That is I suppose a battle for a few weeks down the line.
 

That's fabulous news your parents have been discharged. I know they are overseas, but are they at their home overseas, or are they in an hotel, or apartment?

I think we both know from reading around this site that for many people, trimming back on carbs can be really challenging. Some people find carbs very addictive.

My thoughts at the moment would be that they concentrate on managing their blood sugars using whatever tools they have to aid their recovery. I imagine your parents insulin doses are fixed doses, possibly twice a day. Those doses would were calculated roughly based on their usual diet, so changing diet dramatically whilst using insulin can be a bit tricky, because it could lead to hypos.
 
Thanks @DCUKMod for your kind words about my parents' recovery.

I hadn't thought of the fact that the insulin would mean diet changes should be undertaken with more care. But it will have to wait until they have adjusted to being home and having to look after themselves anyway I think because mentally I don't think they can manage it just now.
 

They and you have had a huge amount to cope with in recent times. Hopefully they'll recover their strength soon and maybe reflect on things as time goes on.
 
Low Carb is great, but for those on Insulin it works too well!
So first its important not to provoke Hypos.
Only when the amount of insulin needed for the current diet is well established, should the idea of slowly reducing carbs be examined. But regular testing will be required alongside that.
Reducing carbs slowly is easiest done by substitutions:-
Temperate fruit instead of Tropical fruit
More fibre in grains/starches rather than refined carbs.
Cauli rice (or green Broccoli 'rice') than actual rice .
Celeriac instead of potato.
etc.
 
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