Insulin inevitable?

chaylabling · Oct 27, 2014

I am on Eucreas 50/850 (which is 850mg metformin hydrochloride corresponding to 660 metformin, and 50mg vildagliptin) as in feb 2011 my HA1c was 10.3 and since then was never higher than 6.
I returned from spain to uk in 2013 and my latest reading was 7.8 which I put down to new lifestyle and diet which I plan to amend, however the nurse told me it was inevitable that I would eventually require insulin injections as that is the progression of type 2 diabetes as I am already on eucreas, this would be the next step.
I am in total shock as I had never been told this in the past. is this true? I am 65 and am overweight though not excessively so.
also when I said that I had been told to favour a low carb diet in spain, she disagreed with this advice.

Bluetit1802 · Oct 27, 2014

Hello and welcome.

Short answer - No, it is not inevitable at all. You can control this with the medication you have and a low/reduced carb diet and lose that excess weight. It is even possible to reduce the medication you are already on, as evidenced by lots of people on this forum. It may be your pancreas has suffered too much and may deteriorate, but not inevitable.

Sadly, the NHS hasn't caught up yet with the low carb way of controlling things, so many doctors and nurses here will disagree with it as they are just following their given guidelines.

martinsk8r · Oct 27, 2014

Hi, Sorry to hear of your concerns. I have been diagnosed as Type 2 diabetic for about 10 years and my levels were slowly creeping up despite Metformin,trying harder with diet, and going on to Gliklazide. I hated this one! I was feeling very tired after meals and very hungry all of the time. I begged to go on Insulin and was allowed to have Humulin M3 which is a 30/70 mix of fast/slow acting insulin. It gave me my life back and I am now happily jabbing away morning and evening. My last Hba1c was 7.4. It seems that I have insulin resistance. I hope you don't have to go down this route but insulin was the best thing since sliced bread for me!! My advice is to try hard with the LCHF diet and don't worry about the future medications.

chaylabling · Oct 27, 2014

Bluetit1802 said:
Hello and welcome.

Short answer - No, it is not inevitable at all. You can control this with the medication you have and a low/reduced carb diet and lose that excess weight. It is even possible to reduce the medication you are already on, as evidenced by lots of people on this forum. It may be your pancreas has suffered too much and may deteriorate, but not inevitable.

Sadly, the NHS hasn't caught up yet with the low carb way of controlling things, so many doctors and nurses here will disagree with it as they are just following their given guidelines.

thank you, I will give it my best effort. Is it constantly high readings that show if the pancreas has suffered too much and deteriorates?

sanguine · Oct 27, 2014

This is tragically what happens when the official guidelines don't work because of the carb recommendation, and thousands of T2s fail to manage their blood glucose as a result. The inevitability of decline, more meds and eventually insulin becomes ingrained in the minds of most GPs and DNs. If it wasn't so tragic it would be a joke.

Bluetit1802 · Oct 27, 2014

chaylabling said:
thank you, I will give it my best effort. Is it constantly high readings that show if the pancreas has suffered too much and deteriorates?

I'm not sure on this one as I've never been in that position myself. I would imagine (only my opinion) that if you follow a low carb diet, lose weight, and take your medication correctly, it is then you need to be worried if your levels aren't coming down. That is the time to ask for more tests/medication. Give it a go and see what happens.

Charles Robin · Oct 27, 2014

No one can tell you that you need insulin, but your blood testing meter can. The first thing to do is to start taking the steps that help out your pancreas, which will soon show if it can cope. The main aim here is to reduce your insulin resistance. One of the easiest ways to do this is with exercise. If you do prolonged regular exercise (cycling, yoga, going to the gym, whatever works for you), your body will very quickly increase its insulin sensitivity. This means your pancreas needs to produce less insulin to get the same results, so it is not being so overworked. If you have enough insulin producing cells left, they will stop burning out from too much demand on them, which may well mean you can avoid insulin.
The other thing to try is the low carb diet that is becoming more and more widely accepted (but is still controversial to some). Carbohydrate and sugar put a big demand on your pancreas. You need insulin to counteract it, and you need it quickly. If you are consuming loads of carbs, your pancreas will again get overworked, and the insulin producing cells will continue to burn out. However, if you base your diet on protein and fat, (as well as plenty of vegetables e.g. Green leaf salad, bell peppers), you can put yourself in a much better position. The body can convert protein into glucose through a process called gluconeogenesis. It's a less efficient method, and it is a much slower process. Therefore, your pancreas will need to produce less insulin, and can do it more slowly.
if you take all these steps and your blood sugars are still going high all the time, it is highly likely you will require insulin. However, if your blood sugar readings are normal, I don't think there would be any reason for you to inject.

chaylabling · Oct 27, 2014

martinsk8r said:
Hi, Sorry to hear of your concerns. I have been diagnosed as Type 2 diabetic for about 10 years and my levels were slowly creeping up despite Metformin,trying harder with diet, and going on to Gliklazide. I hated this one! I was feeling very tired after meals and very hungry all of the time. I begged to go on Insulin and was allowed to have Humulin M3 which is a 30/70 mix of fast/slow acting insulin. It gave me my life back and I am now happily jabbing away morning and evening. My last Hba1c was 7.4. It seems that I have insulin resistance. I hope you don't have to go down this route but insulin was the best thing since sliced bread for me!! My advice is to try hard with the LCHF diet and don't worry about the future medications.

thank you, it is reassuring that you are happier on insulin, possibly helped by the fact that you instigated the change. I have no symptoms, and it seems so life changing to me. I will work hard to reduce my levels and see what happens. I did chuckle that you said insulin was the bet thing since sliced bread for you when I am trying to avoid both items

chaylabling · Oct 27, 2014

Charles Robin said:
No one can tell you that you need insulin, but your blood testing meter can. The first thing to do is to start taking the steps that help out your pancreas, which will soon show if it can cope. The main aim here is to reduce your insulin resistance. One of the easiest ways to do this is with exercise. If you do prolonged regular exercise (cycling, yoga, going to the gym, whatever works for you), your body will very quickly increase its insulin sensitivity. This means your pancreas needs to produce less insulin to get the same results, so it is not being so overworked. If you have enough insulin producing cells left, they will stop burning out from too much demand on them, which may well mean you can avoid insulin.
The other thing to try is the low carb diet that is becoming more and more widely accepted (but is still controversial to some). Carbohydrate and sugar put a big demand on your pancreas. You need insulin to counteract it, and you need it quickly. If you are consuming loads of carbs, your pancreas will again get overworked, and the insulin producing cells will continue to burn out. However, if you base your diet on protein and fat, (as well as plenty of vegetables e.g. Green leaf salad, bell peppers), you can put yourself in a much better position. The body can convert protein into glucose through a process called gluconeogenesis. It's a less efficient method, and it is a much slower process. Therefore, your pancreas will need to produce less insulin, and can do it more slowly.
if you take all these steps and your blood sugars are still going high all the time, it is highly likely you will require insulin. However, if your blood sugar readings are normal, I don't think there would be any reason for you to inject.

this gives me encouragement, which is indeed the first step.I do need to take more exercise and I believe I have been eating the wrong food through the tempting availability! I would be happy to rethink diet and lifestyle and hopefully lower my levels. This was my second hba1c in uk. previous was 6 and now well over 7. I said I would cut down my carbs and that is when she said no, you need bread, potatoes, pasta which surprised me. it is confusing that different countries give different advice. in spain I was told eat these were the foods to avoid, and that I should eat plenty of veg that grow above ground, very little of veg that grows below ground. also to eat salad before a meal, when possible, as this slows down the digestion of the main meal.
I appreciate you taking the time to answer my question, I feel a little less panic struck.

Bluetit1802 · Oct 27, 2014

It seems your Spanish doctors were right, your UK were not!

chaylabling · Oct 27, 2014

Bluetit1802 said:
Hello and welcome.

Short answer - No, it is not inevitable at all. You can control this with the medication you have and a low/reduced carb diet and lose that excess weight. It is even possible to reduce the medication you are already on, as evidenced by lots of people on this forum. It may be your pancreas has suffered too much and may deteriorate, but not inevitable.

Sadly, the NHS hasn't caught up yet with the low carb way of controlling things, so many doctors and nurses here will disagree with it as they are just following their given guidelines.

sanguine said:
This is tragically what happens when the official guidelines don't work because of the carb recommendation, and thousands of T2s fail to manage their blood glucose as a result. The inevitability of decline, more meds and eventually insulin becomes ingrained in the minds of most GPs and DNs. If it wasn't so tragic it would be a joke.

Bluetit1802 said:
It seems your Spanish doctors were right, your UK were not!

well I hope so as I intend to follow low carb as it worked for me before I fell off the wagon! however I would of course prefer to be confident following the advice of the health centre I am attending as I live here now. I am interested to know why advice differs, what it is based upon.

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