Metformin vs Insulin

sheepie123 said:

Anyone agree?

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Not me. I have plenty of my own insulin. Injecting more wouldn't stop the pancreas producing its own and would be counter productive, especially where insulin resistance is an issue. It isn't the lack of insulin that is the problem with most T2s. it is the insulin resistance. The cells are blocking the insulin, so you end up with excess insulin floating about, and as this is a fat carrying hormone, you put weight on thus causing more insulin resistance. Vicious circle. The less insulin in your body, the better.

T2D is often caused by a resistance to Insulin.

Injecting Insulin will be unlikely to help with this resistance, and will likely make it worse.

Of course if your T2D is not mainly due to Insulin resistance then the above is incorrect.

My understanding is that Metformin works on the liver not the pancreas.

I thought that Metformin made your soft tissue and muscles more sensitive to the insulin that you produce yourself?
@sheepie123 what do you mean when you say that your type 2 is relatively mild?

@sheepie123 - I have seen many people assume that taking insulin is an easy option, and will/would allow them to have a much more easy going life and attitude to eating. What I have also observed is that insulin use brings a huge amount of work.

If the person takes mixed insulin, it means they have to eat very regularly; both in terms of when they eat but also ensuring they eat similarly (in terms of carb amounts and quantities) at each meal. If, alternatively, the person is using MDI, they must learn how to accurately carb count and match both the dosages required, but when to actually inject. Not all meals require injecting x time ahead of eating. Some find the have to vary the time of their injections to ensure their highs/lows are controlled.

Personally, I like a simple life, taking no meds and just keeping an eye on what I eat. I can't envisage being on meds every day, ordering up repeats. I'm sure I'd feel resentful and tethered to the pharmacy.

Of course, I have no idea what the future will throw at me, and at some stage I may require long term meds, and I guess at that time I'll just have to get used to the idea. For now, however, I'll enjoy my freedom and try to keep it that way.

Hi. As others have said, most T2s will have insulin resistance thru fat deposits in the muscle cells and hence have too much insulin in the body. Injecting more doesn't help. Metformin works by reducing the liver's output of glucose a little and makes the muscle cells more sensitive to insulin a little. In most cases of T2, reducing carbs in the diet will help a lot by reducing insulin resistance. If these actions don't control blood sugar then the diagnosis may be T1 rather than T2, although I'm generalising.

sheepie123 said:

I think of it like a battery

The battery (Pancreas) happly works when needed but its seems when the battery (Pancreas) starts becoming depleted the battery is drained quicker with medications that force it to work harder until it is spent.

I am not against the idea of Insulin even though my T2 is relatively mild as it means I am lessening the strain on my pancreas to make up for it which should stop beta cell death.

Anyone agree?

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You actually have a rather good working model.

And yes more doctors are beginning to realize that sulfonylureas may actually exhaust the remain beta cells. So they are moving towards SGLT2 inhibitors and GLP1 Agonist.

These slides by Dr Stanley Schwarz provide a good summary on getting the right level of circulating insulin level for metabolic health.
http://www.diabetesincontrol.com/insulin-vascular-function-part-1/

The real issue with Obesity related Type 2 diabetes is chronically elevated insulin levels...that is why a combination of low carbs and intermittent fasting are very effective in normalizing both insulin/glucose levels.