The problem as a type 2 is that the more carbs we eat, the more insulin we need. Now for many type 2 that will be our own and we generally produce huge amounts but it is still not enough as it’s somewhat ineffective due to insulin resistance. Unfortunately the higher our insulin levels are (which causes its own problems in excess independently of blood glucose btw)the more insulin resistant we get and the problem spirals and that is why it’s known as progressive. Adding insulin via injection means there is finally enough to cope with managing blood glucose levels and it all looks hunky dory when only checking those levels. But in many cases it means the circulating insulin is higher than ever and the problem continues to grow. The metabolic problems associated with high insulin (high blood pressure, cvd, large waist measurements, high triglycerides and others) continue to grow despite more normal blood glucose. Albeit slower than being untreated at all.
I will add the caveat that there‘s a minority (mis)diagnosed as type 2 are really some other type like type 1, LADA or 3c who cannot produce any or enough insulin and thus injections are lifesaving. They are often written off as severe or difficult type 2 and never reclassified. It makes a difference even if the treatment (insulin injections) is the same in the nhs as type 1 get different support and different tech options. Other type2 may have spent so much time over producing insulin that their beta cells have “burned out” so to speak and again have little other choice but to take insulin exogenously.
The problem comes in that insulin production is rarely tested in a suspected type 2 so no one really knows why you are struggling. If and when diet and other medications fail to control blood glucose sufficiently it is assumed production is low and insulin added. It obviously isn’t enough to balance the carbs being eaten in the face of whatever degree of resistance that person has - but that’s not the same as actually being less than normal amounts. In fact it might be still extremely high. It’s like adding water to a leaky bucket rather than fixing the hole (insulin resistance and maybe too many carbs). The obvious answer is to test insulin (or c-peptide which is produce in tandem for those on insulin already) - but it just doesn’t happen.
Insulin is largely ignored in type 2 other than to increase it with medication. Surely knowing the starting point makes a difference? Doing so at diagnosis would help find more of those missed type 1’s etc and doing so again when all other approaches seem to be failing might identify why and if the only option is injections or maybe diet could be relooked at.
All of this long winded explanation is to say that adding more carbs than you personally really need or want is only going to add to the problem. Limiting them can only help. It’s all very well to say eat normally as a type 2 and we‘ll control BGL with ever increasing amounts of insulin but the goal should be reducing the core issue and hopefully the problems caused by high insulin as well as high blood glucose - ie fix the bucket. It also depends what “normally” actually means.
