Not understanding why some use Insulin with T2D IR

[Seacrow]

Possibly a very stupid question, but does it really make any significant difference if one is LADA or T2 and insulin dependent, as the treatments seem to be very much the same.

I'm type idiosyncratic according to my doc. Just after diagnosis I was GAD+ and extremely low Cpep, so diagnosis was auto immune type one. Insulin resistance went up to 150u to 10g carb, so type two diagnosis. Now I am GAD- and normal, non-diabetic range Cpep.

And here's the fun bit, I usually top out at about 120u per 10g, but if I catch a vomiting bug I can go all the way down to 0u per 10g (or non-diabetic for ~24hrs or so, since my pancreas is still producing).

So type two on insulin can reduce their insulin requirements, but type LADA are always going to need a standard (for the individual) amount.

Or you can throw a spanner in the works and be ex-auto immune with insulin resistance like me.

And the original question, when I'm at the high dose end, one slice of toast will take me from a bg of 5 to a bg of over 30. Unsurprisingly, the docs really want that lower, and insulin is the everyday way. (I could spend 6-8 hrs a day every day throwing up, and that would also work. Not happening.)

 

[Seacrow]

I think some don't change their diet because what they are told to do simply doesn't work. It's soul destroying when you follow what your doctor says to the letter and it doesn't work.

Oh yes, the dietician I saw within a month of diagnosis told me to eat more carbohydrates, try to have meat with every meal and some alcohol would be good for me.

The doctor who told me to restrict myself to 1500cal and exercise for an hour a day, guaranteed I'd lose at least 10kg. I put on 0.5kg, and he cut short our next appointment without explaining anything.

Result : I changed hospitals.

 

[SilverK]

That’s bizarre. They really need to talk to each other and share ideas. Then maybe there won’t be such random information circulating.
My dietician is great. She totally understands that I prefer to eat low carb and is totally on board with that. The whole department seems really clued in. They’re really happy that I can stay in target and take less insulin. She said they have cross border meetings on Teams and the whole of Wales is on the same page. It seems that we’re really lucky with how proactive the hospital care is here for diabetes.