publications about use of insulin not giving full info

[Mep]

I find as a type 2 with insulin deficiency that it's not common to read that type 2's can be on insulin due to insulin deficiency. I find that rather silly considering I know it as reality yet it's not well publicised. Instead I read comments like this about who may need to use insulin: "They are also required for some people with type 2 diabetes when diabetes tablets, together with healthy eating and regular physical activity, are not enough to control blood glucose levels. Comments about what I'm dealing with are "Insulin injections are required when the body produces little or no insulin, as with type 1 diabetes." What about type 2, 1.5, 3c diabetes who have little or no insulin? I wish people who are supposed to be providing public information about the use of insulin would state things correctly. So no wonder why I'm having to always explain myself if I'm questioned about use of insulin because they don't bother telling people it's not just type 1's that have little or no insulin production. Whilst the comment made in the publication applies to some people with type 2, it doesn't apply to all of us and it should be made clearer. I'm left wondering whether they just assume all type 2's still have their own insulin? Ok, rant over. lol.

 

[Positive-ish]

I agree mep. I am also fed up of explaining the differences all the time. Someone said to me only last week. "Oh your type 2, that's not dangerous and you can reverse it" aghhhhh....... It really gets me going!


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[Mep]

I agree mep. I am also fed up of explaining the differences all the time. Someone said to me only last week. "Oh your type 2, that's not dangerous and you can reverse it" aghhhhh....... It really gets me going!


Sent from my iPhone using DCUK Forum mobile app

I provided feedback and hopefully they will update it. It may be they think nothing of leaving this information out... but it matters to me. I'm sure it matters to all of us who aren't type 1 and have insulin deficiency. Perhaps if they worded things correctly then when the public is researching they can see for themselves insulin is used when there is insulin deficiency as well as used by some docs to get people to control their BGLs better. So the way I read things is that people reading that will turn around and ask me which type I am and then say oh what so you can't control it yourself with diet, exercise, and meds? ugh. Also why it matters is it is from the same people that just changed the rules about who can get test strips, how long, etc. So is it that they may decide I'm on insulin because I can't control my sugar in future? I hope not. I know I have a hard time explaining to ER docs when I go there. Although once I explain I'm insulin deficient they keep referring to me as type 1. I have to correct them all the time.

 

[luna50]

I find as a type 2 with insulin deficiency that it's not common to read that type 2's can be on insulin due to insulin deficiency. I find that rather silly considering I know it as reality yet it's not well publicised. Instead I read comments like this about who may need to use insulin: "They are also required for some people with type 2 diabetes when diabetes tablets, together with healthy eating and regular physical activity, are not enough to control blood glucose levels. Comments about what I'm dealing with are "Insulin injections are required when the body produces little or no insulin, as with type 1 diabetes." What about type 2, 1.5, 3c diabetes who have little or no insulin? I wish people who are supposed to be providing public information about the use of insulin would state things correctly. So no wonder why I'm having to always explain myself if I'm questioned about use of insulin because they don't bother telling people it's not just type 1's that have little or no insulin production. Whilst the comment made in the publication applies to some people with type 2, it doesn't apply to all of us and it should be made clearer. I'm left wondering whether they just assume all type 2's still have their own insulin? Ok, rant over. lol.

Hi Mep

The full information about use of insulin shod be given to you by your physician. Unfortunately many of this "doctors" do not give satisfactory explanation to the patients.
Astonishing 99% of the patients look on the "doctors" as they are a members of the society of the Gods. All what they know is from the medical literature. The doctors are not scientist, they are a user of the science. Today every one can acquire the same knowledge as the doctors, if they wish.
Back to the point!
Before the onset of the diabetes, the pancreas has produced more insulin then the organism has needed. It is because T2DM is characterised with the Insulin resistance , i.e. the periphery tissues have difficulties to feel the insulin presence in the blood stream. The people are not aware for this problem. When the pancreas can not compensate more for the missing insulin amount, then the person get diagnosis as T2DM ( if he or she are lucky to have a competent doctor). This is the onset of the T2DM. On the onset of the T2DM, the person can improve the insulin resistance with healthy diet and physical activity or with LOw-Carb diet under medical control or with the recommendations from the competent members of this Forum.
The T2DM is a progressive disease and some day your doctor say you shod use sulfonylurea medications together with metformin and continue with your healthy diet and physical exercises. This sulfonylurea "kick" the pancreas to produce insulin above his limits. One day the pancreas will be breathless and can not more.
As T2DM patient the person have always more insulin in the blood then compared with a healthy persons. It is because the person is insulin resistant and need more insulin with the relation to the healthy person.
After that your doctor say you shod use parenteral insulin (exogenous insulin, i.e. lantus or another).
If you have a normal doctor, then he or she make a blood test for C-peptide and Gad-65 to get all in the system. Your endogen ( your own ) insulin amount can be within the tolerated interval like by the healthy persons, but because you are insulin resistant you must have exogenous insulin to compensate for the missing amount.
All this scenario will continue for the rest of the persons life.

Conclusion:

The persons with T1DM need exogenous insulin because they do not produce own insulin.

The persons with T2DM need exogenous insulin because they are insulin resistant and must have greater amount of insulin in the blood then the healthy people.
Unimportant how much is your own insulin production, if your insulin resistance is huge, then you must compensate for that with exogenous insulin.
It is wrong to compare the T1DM with T2DM. It is like to make compare between the apples and pear.

Have a nice day
luna50

PS I know there are more details, but it is OK for now. Ask if you like for something missing in the text.

 

[Mep]

Hi Mep

The full information about use of insulin shod be given to you by your physician. Unfortunately many of this "doctors" do not give satisfactory explanation to the patients.
Astonishing 99% of the patients look on the "doctors" as they are a members of the society of the Gods. All what they know is from the medical literature. The doctors are not scientist, they are a user of the science. Today every one can acquire the same knowledge as the doctors, if they wish.
Back to the point!
Before the onset of the diabetes, the pancreas has produced more insulin then the organism has needed. It is because T2DM is characterised with the Insulin resistance , i.e. the periphery tissues have difficulties to feel the insulin presence in the blood stream. The people are not aware for this problem. When the pancreas can not compensate more for the missing insulin amount, then the person get diagnosis as T2DM ( if he or she are lucky to have a competent doctor). This is the onset of the T2DM. On the onset of the T2DM, the person can improve the insulin resistance with healthy diet and physical activity or with LOw-Carb diet under medical control or with the recommendations from the competent members of this Forum.
The T2DM is a progressive disease and some day your doctor say you shod use sulfonylurea medications together with metformin and continue with your healthy diet and physical exercises. This sulfonylurea "kick" the pancreas to produce insulin above his limits. One day the pancreas will be breathless and can not more.
As T2DM patient the person have always more insulin in the blood then compared with a healthy persons. It is because the person is insulin resistant and need more insulin with the relation to the healthy person.
After that your doctor say you shod use parenteral insulin (exogenous insulin, i.e. lantus or another).
If you have a normal doctor, then he or she make a blood test for C-peptide and Gad-65 to get all in the system. Your endogen ( your own ) insulin amount can be within the tolerated interval like by the healthy persons, but because you are insulin resistant you must have exogenous insulin to compensate for the missing amount.
All this scenario will continue for the rest of the persons life.

Conclusion:

The persons with T1DM need exogenous insulin because they do not produce own insulin.

The persons with T2DM need exogenous insulin because they are insulin resistant and must have greater amount of insulin in the blood then the healthy people.
Unimportant how mush is your own insulin production, if your insulin resistance is huge, then you must compensate for that with exogenous insulin.
It is wrong to compare the T1DM with T2DM. It is like to make compare between the apples and pear.

Have a nice day
luna50

PS I know there are more details, but it is OK for now. Ask if you like for something missing in the text.

Thanks for that detail, but it has nothing to do with what this post is about. The point is the publication was one available to all diabetics in my country and it isn't giving the full info about who uses insulin and why. I do no fit in their description of T2... nor do many others. And what about other types like 1.5 and 3c? They don't even get a mention... they use insulin too.

As for the conclusion you reach about why a T2 needs insulin you are not correct in regard to why I'm on insulin. You are only referring to one scenario of why a T2 may be on insulin. I have insulin deficiency as well as insulin resistance.... not just insulin resistance as you are describing. I have had both the GAD test and c-peptide test done 3 times since diagnosis so I know what my body is doing. I hardly produce any insulin. I'm not saying I'm type 1 as that is auto immune. I do not have auto immune diabetes. But I do need to be on insulin for life... if I don't take it I'm in trouble. I am not the only diabetic like this, many other T2's in are in the same boat as me.

 

[luna50]

Thanks for that detail, but it has nothing to do with what this post is about. The point is the publication was one available to all diabetics in my country and it isn't giving the full info about who uses insulin and why. I do no fit in their description of T2... nor do many others. And what about other types like 1.5 and 3c? They don't even get a mention... they use insulin too.

As for the conclusion you reach about why a T2 needs insulin you are not correct in regard to why I'm on insulin. You are only referring to one scenario of why a T2 may be on insulin. I have insulin deficiency as well as insulin resistance.... not just insulin resistance as you are describing. I have had both the GAD test and c-peptide test done 3 times since diagnosis so I know what my body is doing. I hardly produce any insulin. I'm not saying I'm type 1 as that is auto immune. I do not have auto immune diabetes. But I do need to be on insulin for life... if I don't take it I'm in trouble. I am not the only diabetic like this, many other T2's in are in the same boat as me.

I have a 100% understood what your post is about.
I steadily claim that the doctor shod inform individually the patient about the use of insulin and not the "publications". The publications write about general insulin use.
Please see on the enclosure letter in your insulin package. There are not information's for all insulin administrations.
IN the sentence : "Unimportant how mush is your own insulin production, if your insulin resistance is huge, then you must compensate for that with exogenous insulin.", there is included your problem.
You have a C-peptide test and Gad-65 and it is a main evidence that you are a T2 diabetic.
T2Diabetic start to use insulin before the endogenous insulin production achieve the minimum border in the interval as a normal insulin production. After the time your own insulin production cross the minimum border ( it is normal) and you are in the situation of insulin deficiency, but you a steadily T2DM.
If you are not insulin resistant and you have insulin deficiency, then you will be a T1.5, until you do not produce more insulin and you will definitely get the diagnose T1DM. ( T1.5 DM is not accepted by the WHO and do not have an ICD-10 code, it is a disease name introduced not legal. Please, contact the WHO and read about this problem.).
I am sorry but I understand your letter on this way.

 

[Mep]

I have a 100% understood what your post is about.
I steadily claim that the doctor shod inform individually the patient about the use of insulin and not the "publications". The publications write about general insulin use.
Please see on the enclosure letter in your insulin package. There are not information's for all insulin administrations.
IN the sentence : "Unimportant how mush is your own insulin production, if your insulin resistance is huge, then you must compensate for that with exogenous insulin.", there is included your problem.
You have a C-peptide test and Gad-65 and it is a main evidence that you are a T2 diabetic.
T2Diabetic start to use insulin before the endogenous insulin production achieve the minimum border in the interval as a normal insulin production. After the time your own insulin production cross the minimum border ( it is normal) and you are in the situation of insulin deficiency, but you a steadily T2DM.
If you are not insulin resistant and you have insulin deficiency, then you will be a T1.5, until you do not produce more insulin and you will definitely get the diagnose T1DM. ( T1.5 DM is not accepted by the WHO and do not have an ICD-10 code, it is a disease name introduced not legal. Please, contact the WHO and read about this problem.).
I am sorry but I understand your letter on this way.

I wrote this post in regard to a publication from an authority that is responsible to allow us to get our diabetic supplies. Of course I get my medication advice from my doctors... that isn't in question here. And why it was worth a mention is because this same authority is now putting restrictions on who can get supplies. I'm concerned they may not be factoring in all scenarios of why type 2's use insulin.

I'm fully aware of what I have and how I got it. You seem a bit confused though because the point is that I am insulin deficient and I do not produce hardly any insulin (not how you described it) and so are other types of diabetes not mentioned in the publication.... this should be included in publications written specifically for public knowledge about who uses insulin and why. Education is key. And quite frankly I'm sick of the public perception and even from some diabetics that I'm on insulin because I can't control my sugar levels. That is untrue. I have had type 2 for over 17 years now... it progresses.... stop telling the public that insulin is only used by type 2 because they can't get control of their sugar.

As mentioned above I have already provided feedback for the publication.... I'm simply venting my frustration here where I'm sure others like me can relate and understand.

 

[luna50]

I wrote this post in regard to a publication from an authority that is responsible to allow us to get our diabetic supplies. Of course I get my medication advice from my doctors... that isn't in question here. And why it was worth a mention is because this same authority is now putting restrictions on who can get supplies. I'm concerned they may not be factoring in all scenarios of why type 2's use insulin.

I'm fully aware of what I have and how I got it. You seem a bit confused though because the point is that I am insulin deficient and I do not produce hardly any insulin (not how you described it) and so are other types of diabetes not mentioned in the publication.... this should be included in publications written specifically for public knowledge about who uses insulin and why. Education is key. And quite frankly I'm sick of the public perception and even from some diabetics that I'm on insulin because I can't control my sugar levels. That is untrue. I have had type 2 for over 17 years now... it progresses.... stop telling the public that insulin is only used by type 2 because they can't get control of their sugar.

As mentioned above I have already provided feedback for the publication.... I'm simply venting my frustration here where I'm sure others like me can relate and understand.

I agree with your argumentation. If this authority are responsible for the laws about who can get medications and make restrictions on who can get medical supplies, then they must inform correct and must know the purpose of the insulin and all about the pharmacological products. There is not excuse. You are right, but it is difficult to do something against the authority. I do not know what country you live. I guess it can be Ecuador???

Every medication has a Summary of Product Characteristics, SPC.
In this SPC there are sometimes a wrong informations.
For example in all insulin products the authoryti write that insulin inhibit liver emission of glucose.
It is not true if you have T2DM, because the insulin has impaired function for this.
The autorities do not like to change this wrong information. It is true the insulin inhibit liver emission of glucose by the healthy persons, but the healthy persons do not need exogenous insulin.
Have a nice day, Mep

PS About your insulin insufience, the C-peptide interval is : 0.37 -- 1.47 nmol/l. If your Gad-65 has been negativ, i.e. your imun system has not anty- bodies against the pancreas beta cels, then you are still T2DM even you do not produce own insulin. You get your exogenous insulin for the missing insulin and for your insulin resistance. My C-peptide is 0.175.