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Starting with insulin instead of oral hypoglycemics

9748 Views 21 Replies 9 Participants Last post by  Jen
That's what I did and at least for me it's really a good way to go. I just found again a couple of articles about studies on the topic.

Insulin the First Treatment Choice for Newly Diagnosed Type 2?s

Research Points to New Way to Treat Type 2 Diabetes: Insulin First

In general, diabetics that did use insulin from the start gained less weight and were more satisfied with their treatment.

I read up on the possible side effects of some of the oral medications and they are a little strange. Insulin is quite natural compared to them.

Anyway, not trying to say everyone should do it that way. It's just that you hear a lot of negative things about insulin that aren't true, like the weight gain I bolded.

best wishes
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Good post, Lia, and I agree, even though I'm one who is still on metformin only. Insulin should not be a "last resort" option. In my opinion, anything that takes the pressure off our pancreas should be made use of - keeping as many beta cells alive & healthy for as long as possible.
I spent 14 months trying to get insulin, and am still on metformin, probably stay on the met for life. And I have antibodies. Suspect it would 've been even harder if I had not.

Boy, these docs are stubborn!

Intersting about less weight gain, though -- had not read that anywhere yet!
I started very early (within a couple months of Type 2 diagnosis) using insulin (basal and bolus - MDI, and then insulin pump) and I'd agree it is a great way to gain BG control with minimal side-effects (when compared to oral medications) BUT I do wish I had known sooner about the low-carb approach to minimising insulin requirement, as I did go through a period of rapid and significant weight (excess fat mass) gain.
I guess that weight gain from taking insulin varies from person to person. I have gained weight from taking insulin. Insulin is a growth hormone. Check out some of the hard core body building websites and there are many people who use insulin as a way to gain weight. You can get some types of insulin without a prescription, so using it to gain weight is not against the law, but I think you should need a prescription to buy it and then maybe it wouldn't be abused by some body builders.
I spent 14 months trying to get insulin
As breezeonby mentions, you don't need a prescription for at least the basic types of insulin, or for syringes. But also, I would be looking at changing doctors. Or take in the links to these 2 reports. A lot of docs aren't going to keep up on the reading like some of us do.

I think you should need a prescription to buy it and then maybe it wouldn't be abused by some body builders.
I have had to buy insulin in a different country while I was traveling, so really happy I didn't need a prescription. At least with insulin it would be hard to over do it like some of the supplements.

I don't really understand the 'growth hormone' part of it. Don't think that would work well for muscle building. Nothing has grown for me since I started it, and I use a lot more than the muscle builders could.
As breezeonby mentions, you don't need a prescription for at least the basic types of insulin, or for syringes. But also, I would be looking at changing doctors. Or take in the links to these 2 reports. A lot of docs aren't going to keep up on the reading like some of us do.
Well, yes, you can ... but I wanted a basal. Those are genetically engineered, and NOT available without prescription.
Good post, Lia, and I agree, even though I'm one who is still on metformin only. Insulin should not be a "last resort" option. In my opinion, anything that takes the pressure off our pancreas should be made use of - keeping as many beta cells alive & healthy for as long as possible.
Shanny, how do you know when your beta cells are healthy and how many you have?
Shanny, how do you know when your beta cells are healthy and how many you have?
Not Shanny but: per research, approx 40% of your beta cells remain viable up to diagnosis ... I suspect (wel lreally, I know!) Shanny has good control and that is why she is hanging tough with just met!
I don't know my science as well as Linda (foxl), but here's a good explanation from our old favorite Blood Sugar 101 . . . I know my beta cells are still kicking out quite a bit of insulin, but just not enough. So using metformin to reduce insulin resistance & keeping to a low-carb diet to reduce the NEED for insulin, allows my pancreas/beta cells to work not-quite-so hard. There are tests to find how much insulin one produces, but I haven't been tested.
Shanny, how do you know when your beta cells are healthy and how many you have?
A c-peptide blood test will tell how much insulin your body is producing naturally.
I think early insulin therapy is the way to go. I wish I had done that. I really think *years* of hammering my poor over-taxed pancreas with oral drugs probably contributed to the fact that my beta cell function is all but gone now.
Well, yes, you can ... but I wanted a basal
What's a basal? Totally new one on me.

Actually when I was traveling I did want Humalog and had to settle for R because of the prescription problem for Humalog.
I think you're on Lantus, aren't you Lia? That's your basal insulin. The Humalog is your bolus insulin.

What's a basal? Totally new one on me.

Actually when I was traveling I did want Humalog and had to settle for R because of the prescription problem for Humalog.
Yep, dawned on me last night. I think of that as my background insulin.

In that case foxl, you're probably thinking like I do. It's just a theory and would be good to check with a doc, but when a person is first diagnosed, why not inject 2 or 3 units of about a 12 hour insulin each morning?

There would be practically 0 risk of hypoglycemia and it would help a little bit. It would take a bit of the load off the pancreas. Over time small bits add up to a lot.
Yep, dawned on me last night. I think of that as my background insulin.

In that case foxl, you're probably thinking like I do. It's just a theory and would be good to check with a doc, but when a person is first diagnosed, why not inject 2 or 3 units of about a 12 hour insulin each morning?

There would be practically 0 risk of hypoglycemia and it would help a little bit. It would take a bit of the load off the pancreas. Over time small bits add up to a lot.
Yep -- resting the beta cells! I have LADA.

What it took to get insulin, though ... :eek:
I can say from my experience that insulin changed the whole game for me. I tried diet and exercise only and a lot of Metformin at first. None of it was enough. My doctor welcomed the idea of me starting a once-daily insulin. I was as high as 35 units of the Lantus and then as I lost more weight and heard the anaerobic exercise targetting the muscles would help most with my blood sugar control I noticed less and less need for the Lantus. The same amount would start making me have these wicked low blood sugar moments before lunch. I'm all the way down to just 5 units now. I'm sure it has really rested my pancreas as others are noting.

If I had known what I know now, then, I would have asked the doctor to start me on insulin immediately. It might have saved me all the issues I experienced with Metformin "down yonder", if you get my drift.

Best of luck with it. The one thing I wish someone would have told me about once a day insulin use (the basal kind) is that you should really follow the instuctions on the label well and sit tight at a number of units that gets you just under 110mg/dL in the am. A lot of diabetics are their most carb sensitive in the am so that AM fasting number will usually be high. But I know I wanted as low as possible. So I kept taking more insulin until I got into the 80's in the am. But then I was hungry all day and tended to go very low before lunch which is my least carb sensitive time of the day. But I loved the low numbers knowing that would keep me the healthiest. The result after one month was no more weight loss and even gaining weight back. Others have explained to me that this was "feeding the insulin". When I got my dose right my fasting numbers, if they were to be plotted on a graph, looked like a "V" yielding about a 105-110mg/dL before breakfast. 85ish before lunch and 100 or so before dinner. At that level of insulin I was no longer hungry all the time (feeding the insulin) and I was able to start losing gradual weight again.

Good luck!
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Hi Pianoman. I see that you're eating a pretty low carb diet. How long have you been restricting carbs? If you just took that up, it's probably contributed significantly to your lower insulin needs. That's why I've been an advocate for lower carb eating since diagnosis. Too many carbs - too much insulin :p.

Jen
Hi Pianoman. I see that you're eating a pretty low carb diet. How long have you been restricting carbs? If you just took that up, it's probably contributed significantly to your lower insulin needs. That's why I've been an advocate for lower carb eating since diagnosis. Too many carbs - too much insulin :p.

Jen
I started this very low carb regimen to get off a long time weight plateau. But truth be told the lowering of the insulin intake was I think because my insulin resistance has been decreasing as a result of the anaerobic exercise I do. I had to start lowering due to hypoglycemic events at lunch time and dinner while still eating 60-80 grams of carbs daily. Though I have heard the wisdom that states that the lower carb you eat the less insulin you'll likely need. It just wasn't the main reason for the lower dosing for me. Like my doc said -- exercise will play a key role in getting off meds/insulin.

Thanks
--Pianoman
Exercise is certainly important. By exercise biking in the a.m. I need fewer correction boluses and reduce my Levemir by about 1 or 2 units. Don't really notice any difference with Pilates. Reducing carbs by 30 grams a day (let's say 80 to 50) would save me 3 units of Novolog.

Jen
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