Type 2 Insulin Treatment

[Aphorism]

Hi
I may be going on the Insulin route as my diabetes is not doing well with drugs, as my pancreas may be packing in.
Anyone here who's type 2 injecting insulin?
Love to hear your thoughts in this area if have had the same issues; your experience etc would be much appreciated.
Regards!

 

[Bluetit1802]

Have you had the relevant tests that show whether your natural insulin production has slowed down? Could it be you are insulin resistant rather than insulin deficient? If it is insulin resistance, then injected insulin may not be the best plan. You may already have high circulating insulin, as many of us Type 2 diabetics have, but tests will show this.

I see from your profile that you are on Metformin only, so there are many other stronger drugs still available to you before you get to needing insulin.

 

[rom35]

And as allways - what number of carbs is in your typical meal?

 

[Aphorism]

Have you had the relevant tests that show whether your natural insulin production has slowed down? Could it be you are insulin resistant rather than insulin deficient? If it is insulin resistance, then injected insulin may not be the best plan. You may already have high circulating insulin, as many of us Type 2 diabetics have, but tests will show this.

I see from your profile that you are on Metformin only, so there are many other stronger drugs still available to you before you get to needing insulin.

Hi there
My doc suggested my pancreas was probably packing up but has offered no further test; this was after he advised me 'that if I was a lawyer the bill would be mounting up!' Or words to that effect! Without smiling. I may need to change docs!
Problem is the pressure on doctors is such that they do not have time to do their job properly, sometimes. Subsequently, poor treatment can result. Typical example; due to a boil over my spine not being lanced (nurse was not up for it and failed to call a doctor) the infection became dangerous and took two courses of penicillin and ove three weeks to drain the site, which had turned into a very painful carbuncle with five heads, that caused a raised red rash over my body and extreme malaise. At one point my partner almost called for an ambulance. Seven weeks later successful granulation has finally occurred, although it has left me very rundown.
I was prescribed Pioglitazone, but without being advised the contraindications. Subsequently, after finding out more, and that both Germany and France have banned this drug, I made an informed decision not to take it on the basis of risk, plus having a history of liver damage caused by a gall bladder stone blockage/backflow.

 

[Jaylee]

Hi @Aphorism ,

I'll tag in @Daibell , who may have some input on your query..

 

[Guzzler]

Your recent infection and subsequent stress will have raised your blood glucose levels, perhaps to a great degree causing fatigue among other symptoms. Diet impacts enormously on our broken metabolisms, have you considered the LCHF (Low Carb High Fats) route to better bg management? Many people have seen an improvement in overall health as well as lowered blood glucose and HbA1c with this way of life.

 

[DCUKMod]

@Aphorism , at a presentation I attended recently the consultant presenting told us that there are over 400 different options for treating T2, prior to escalating to Insulin. Of course, some of those options will be more appropriate for any given individual than another, but Metformin straight to insulin is quite unusual from what I have seen, unless there has been a flawed diagnosis.

One thing I would say is if you have recently had disappointing blood test results, but those were either at the time of, or just following a nasty infection, requiring significant antibiotic therapy, the the infection may well have impacted your blood sugars, shorter term.

 

[Bluetit1802]

My doc suggested my pancreas was probably packing up but has offered no further test; this was after he advised me 'that if I was a lawyer the bill would be mounting up!' Or words to that effect! Without smiling. I may need to change docs!

Most GPs think Type 2 is progressive and the pancreas withers and dies. I'm happy to say this is not necessarily the case, but they believe it because most of their patients get worse and worse requiring more and more medication. Gps put a sticking plaster over it in the form of pills without looking for the root cause. Much of this is down to the very bad NHS dietary advice for T2s, which is unsuitable and in some cases dangerous. They don't have the experience of Type 2 diabetes, and don't have the time to learn more. Please have a good read round this forum and look at all the success stories. Many, many members here have brought their glucose levels down to the absolutely normal non-diabetic range and managed to come off medication. Some have even come off insulin. It can be done, but it requires some effort and a dietary change.

That isn't to say everyone can do this. In some cases the pancreas does slow down and give up, but you don't know if yours has. You have just taken on board what your GP said, and he sounds pretty rubbish to me. Surely it is worth a try to get yourself up and running again? If it doesn't work, then medication may be the only answer - but it doesn't have to be Pioglitazone. There are many safer alternatives. Are you willing to give a new diet a go?

 

[Aphorism]

Your recent infection and subsequent stress will have raised your blood glucose levels, perhaps to a great degree causing fatigue among other symptoms. Diet impacts enormously on our broken metabolisms, have you considered the LCHF (Low Carb High Fats) route to better bg management? Many people have seen an improvement in overall health as well as lowered blood glucose and HbA1c with this way of life.

Hi
Yes, lost two stone; low carb diet worked great but stuck on 15.5 stones; although I do rigorous exercise daily and have a rugby player type build, so big bones and muscle account for some weight.

 

[Aphorism]

@Aphorism , at a presentation I attended recently the consultant presenting told us that there are over 400 different options for treating T2, prior to escalating to Insulin. Of course, some of those options will be more appropriate for any given individual than another, but Metformin straight to insulin is quite unusual from what I have seen, unless there has been a flawed diagnosis.

One thing I would say is if you have recently had disappointing blood test results, but those were either at the time of, or just following a nasty infection, requiring significant antibiotic therapy, the the infection may well have impacted your blood sugars, shorter term.

Thanks for that, interesting! 400!
My doc also said I should be able to live another 10 years plus! Really? Now I have never heard anyone tell me that before; like I intend to hit eighty if I can. Being positive; like the guy who said he would have to be killed first before he died.

 

[Aphorism]

Most GPs think Type 2 is progressive and the pancreas withers and dies. I'm happy to say this is not necessarily the case, but they believe it because most of their patients get worse and worse requiring more and more medication. Gps put a sticking plaster over it in the form of pills without looking for the root cause. Much of this is down to the very bad NHS dietary advice for T2s, which is unsuitable and in some cases dangerous. They don't have the experience of Type 2 diabetes, and don't have the time to learn more. Please have a good read round this forum and look at all the success stories. Many, many members here have brought their glucose levels down to the absolutely normal non-diabetic range and managed to come off medication. Some have even come off insulin. It can be done, but it requires some effort and a dietary change.

That isn't to say everyone can do this. In some cases the pancreas does slow down and give up, but you don't know if yours has. You have just taken on board what your GP said, and he sounds pretty rubbish to me. Surely it is worth a try to get yourself up and running again? If it doesn't work, then medication may be the only answer - but it doesn't have to be Pioglitazone. There are many safer alternatives. Are you willing to give a new diet a go?

Interesting! Thanks for replying. Yes, an old friend of mine told me to report him; but that may cause just more issues I cannot be bothered with. What made my last infection worse, I think, was catching a nasty cold virus from my partner; hell! With two issues going, my blood sugar was very high.

 

[Aphorism]

And as allways - what number of carbs is in your typical meal?

Hi
Just low carbs; very little carbs.

 

[Daibell]

Hi. I can only generalise on this. If you consider that you have some excess weight then your T2 may be due to insulin resistance in which case starting insulin may not be that effective as your body may already be producing too much. A low-carb diet can help a lot. Quite a few 'T2s' who are thin may not be T2 but late onset T1 (LADA) where the pancreas is not producing enough insulin; I'm one of those. There are two tests (GAD and c-peptide) to help diagnose the T1. Yes, any illness will increase your blood sugar so wait until you are clear of that to take stock. Personally I would avoid Pioglitazone as it does have a few side effects, some serious. There are some newer drugs now available and Gliclazide is often prescribed for those lacking insulin production and has very few side effects. The treatment for LADA will usually end up with insulin rather than tablets.

 

[Bluetit1802]

Hi
Just low carbs; very little carbs.

Can you tell us what a typical day's food is? maybe we can spot something.

 

[bulkbiker]

Hi
Just low carbs; very little carbs.

Yes but as we have learnt from many posters one persons idea of "low carbs" is another's weekly allowance.. Do you keep a food diary and count your carbs?

 

[rom35]

Yes but as we have learnt from many posters one persons idea of "low carbs" is another's weekly allowance..

This is very important. My body can handle only 5g of carbs without movement. So “low carb” is 15g a day for me. Others can handle more.

@Aphorism - what is “low carb” for you?

 

[Jaylee]

Hi
Just low carbs; very little carbs.

Hi again.

Do you have a home blood test meter? This would help you gauge day to day, meal by meal, what effects your diet is having on your diabetes control.. (In conjunction with any meds.)

 

[SueNSW]

@Aphorism , but Metformin straight to insulin is quite unusual from what I have seen, unless there has been a flawed diagnosis.

Interesting comment - should I be concerned, do you think??

As per my signature, I was diagnosed as Type 2 in Nov 2016 with no symptoms at all - high blood sugar readings were discovered during routine testing prior to double knee replacement surgery. I had 4 weeks on increasing levels of Metformin and then went straight onto insulin.

In combination with a lowish carb diet, my HbA1C reduced significantly (most recent reading down to 6.6%) - but I put on a lot of weight - from a steady 75kg prior to diagnosis up to 89kg.

Diabetic Clinic were not overly concerned - but I was, so saw an Endocrinologist privately who immediately said "well, of course, it's down to the insulin". Since mid-December, following her advice, I have changed to Byetta and have got my weight down to 82kg but obviously still a long way to go. My readings are generally fine, with the exception of morning fasting - that are almost always in the 7s and 8s rather than consistently in the 5 -7 range as they were on insulin.

I guess my point is that I went along with the diagnosis and treatment to ensure the major surgery went ahead last year, but should I now perhaps be asking for more testing and clarification of the diagnosis?

Thanks in advance for any thoughts
Sue

 

[DCUKMod]

Interesting comment - should I be concerned, do you think??

As per my signature, I was diagnosed as Type 2 in Nov 2016 with no symptoms at all - high blood sugar readings were discovered during routine testing prior to double knee replacement surgery. I had 4 weeks on increasing levels of Metformin and then went straight onto insulin.

In combination with a lowish carb diet, my HbA1C reduced significantly (most recent reading down to 6.6%) - but I put on a lot of weight - from a steady 75kg prior to diagnosis up to 89kg.

Diabetic Clinic were not overly concerned - but I was, so saw an Endocrinologist privately who immediately said "well, of course, it's down to the insulin". Since mid-December, following her advice, I have changed to Byetta and have got my weight down to 82kg but obviously still a long way to go. My readings are generally fine, with the exception of morning fasting - that are almost always in the 7s and 8s rather than consistently in the 5 -7 range as they were on insulin.

I guess my point is that I went along with the diagnosis and treatment to ensure the major surgery went ahead last year, but should I now perhaps be asking for more testing and clarification of the diagnosis?

Thanks in advance for any thoughts
Sue

Sue - I think in your circumstances, the use of insulin could have been to influence the speed of getting your bloods into a better range, bearing in mind your significant planned surgery. Certainly in the UK, if blood sugars are over a certain threshold, elective surgery will always be deferred. Indeed, we have several members who find us, having found themselves in that very boat - pre-op blood tests throwing up a T2 diagnosis.

Some people feel insulin is the easy route for diabetes, but I would suggest it takes a lot of very hard work on an every day basis in order to balance everything up with such a strong medication. This, coupled with the fact that many T2s are insulin resistant (their body still creates natural insulin, but it doesn't use it very efficiently, so it needs more and more insulin - natural or otherwise) to bring bloods into range. Where this is the case and some of the food/exercise/illness/stress/sleep/weather/insulin is a little off, then weight gain can occur. That gain can be swift and dramatic in some cases.

I'm very pleased you have seen someone who is working with you to get you off insulin and at the same time you're managing to trim up. Well done for that.

Let's be clear; insulin is a wonderful, life saving drug, but it isn't a silver bullet, and for some T2s, if it isn't managed very carefully indeed, it can become part of the problem as much as a solution.

 

[ickihun]

It's strange but I was losing weight on insulin..... as long as my bgs were in the 5-6mmol/l range with 150g carbs.
I have constant bloating and water retention now so I've added 6lb. Not fat from insulin but water retention.
Lack of exercise due to pain hasn't helped either. Back on tramadol so will see if I can walk more and more.
In a lot of pain, at mo. Even on tramadol, paracetamol and ibuprofen.
I'm sure a few more sunny days will distract my pain. I cannot wait to get back to logging my walking progress. Fingers crossed.

Scan showed fatty liver only but we all know that doesn't cause pain. Scatica pain is my enemy in walking too. Hoping this spring and summer is as positive as last year's on my walking achievements, in pain!