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Discussion Starter #1
Would like to know why my Dr. tells me that I will gain weight if I switch to Insulin. I would rather be on Insulin + metformin instead of the Janumet XR 50/1000mg x 2 each morning. He tells me that I will gain weight, is that really true? Will I be able to eat LCHF & keep the 60 lbs I lost off? I am scared to re-gain the weight. I worked so hard at loosing it. Plus, will I need a lot of Insulin? I was thinking of a Basal (Levemir or Lantus) + my max dose of metformin 2000mg.
What do you think? Which Type of Insulin should I ask for? Will I be hungry all the time due to Insulin? Will I gain weight because of the effects of Insulin on the body?:confused:
 

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Would like to know why my Dr. tells me that I will gain weight if I switch to Insulin. I would rather be on Insulin + metformin instead of the Janumet XR 50/1000mg x 2 each morning. He tells me that I will gain weight, is that really true? Will I be able to eat LCHF & keep the 60 lbs I lost off? I am scared to re-gain the weight. I worked so hard at loosing it. Plus, will I need a lot of Insulin? I was thinking of a Basal (Levemir or Lantus) + my max dose of metformin 2000mg.
What do you think? Which Type of Insulin should I ask for? Will I be hungry all the time due to Insulin? Will I gain weight because of the effects of Insulin on the body?:confused:
I'm not an expert on insulin, but the reason your doctor says it is because the primary role of insulin is to allow fats and glucose to enter the cells for metabolic use. If you have been urinating all of your glucose and such out of the body, you may gain some weight initially. However, metformin acts as an insulin mimetic independently of insulin, so that is not as likely since you are on metformin (in my non-medical and non-expert opinion). In addition, if you overeat or have BG swings because of overcorrecting for starch intakes, you will gain. I am not familiar with Janumet, but others here are. How much you will need is a person to person thing, and depends a lot on your amount of insulin resistance. It tends to do best to start low and carefully.

I'm in the same position as you. I want the doctor to prescribe insulin for me in addition to my metformin, but he is deathly afraid of hypos, so he refuses.

I would like to see what the "experts" say to your dilemma.
 

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The reason people gain weight on insulin is because their doctor puts them on a fixed amount and then they have to eat enough carbs to keep from going hypo. If you count carbs and take only the amount you need, then you shouldn't gain weight. That is, as long as you continue to eat LCHF.
 

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The reason people gain weight on insulin is because their doctor puts them on a fixed amount and then they have to eat enough carbs to keep from going hypo. If you count carbs and take only the amount you need, then you shouldn't gain weight. That is, as long as you continue to eat LCHF.
This, over and over.
 

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The reason people gain weight on insulin is because their doctor puts them on a fixed amount and then they have to eat enough carbs to keep from going hypo. If you count carbs and take only the amount you need, then you shouldn't gain weight. That is, as long as you continue to eat LCHF.
This is exactly right!

When I started out I was on insulin and following ADA diet. I quickly put on 40 pounds.

Learned how to match my insulin to carbs correctly instead of using sliding scale. Worked down to LCHF. Made sure to reduce insulin as needed. Weight came off as insulin needs reduced.

Just be as you use insulin doesn't mean you'll gain weight as long as you keep on the straight and narrow.

Sent from my iPhone
 

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I'm not an expert on insulin, but the reason your doctor says it is because the primary role of insulin is to allow fats and glucose to enter the cells for metabolic use. If you have been urinating all of your glucose and such out of the body, you may gain some weight initially. However, metformin acts as an insulin mimetic independently of insulin, so that is not as likely since you are on metformin (in my non-medical and non-expert opinion). In addition, if you overeat or have BG swings because of overcorrecting for starch intakes, you will gain. I am not familiar with Janumet, but others here are. How much you will need is a person to person thing, and depends a lot on your amount of insulin resistance. It tends to do best to start low and carefully.

I'm in the same position as you. I want the doctor to prescribe insulin for me in addition to my metformin, but he is deathly afraid of hypos, so he refuses.

I would like to see what the "experts" say to your dilemma.
Some one correct me if I am wrong, but the red highlighted above is wrong. insulin is NOT used in the metabolizing of fat.
 

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This is exactly right!

When I started out I was on insulin and following ADA diet. I quickly put on 40 pounds.

Learned how to match my insulin to carbs correctly instead of using sliding scale. Worked down to LCHF. Made sure to reduce insulin as needed. Weight came off as insulin needs reduced.

Just be as you use insulin doesn't mean you'll gain weight as long as you keep on the straight and narrow.

Sent from my iPhone
Absolutely!

"Insulin made me fat." is absolute baloney.

Bad dietary choices and/or mismanagement of insulin made you fat.
 

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Discussion Starter #9
ok, so say I do take insulin + metformin, how do I know if & how much is too much? Hypo's I guess... So then how do I know how much to reduce it by in qty? what type of Insulin should I push for as Basal? If I am now well controlled on Janumet XR 50/1000mg x 2/day avg bg is 5.5 mmol, will I need a lot of Insulin? I understand everyone is different, I just do not know how much is a big start dose. This way I can tell if Dr. gives me too much @start of treatment. Maybe Dr. is not interested because he would need to walk me through all the steps?
 

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There are several books that walk you through these steps, and one of them is Using Insulin by John Walsh. You'll want to concentrate on the insulin instructions here, because the dietary instructions are not the best, so just focus on how he teaches the management of insulin usage.

Another one is Think Like a Pancreas by Gary Scheiner, who is a type 1 diabetic himself.
 

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Some one correct me if I am wrong, but the red highlighted above is wrong. insulin is NOT used in the metabolizing of fat.
Actually, insulin has multiple components of action.
http://emedicine.medscape.com/article/2089224-overview#aw2aab6b2 said:
Insulin is an anabolic hormone that promotes glucose uptake, glycogenesis, lipogenesis, and protein synthesis of skeletal muscle and fat tissue through the tyrosine kinase receptor pathway. In addition, insulin is the most important factor in the regulation of plasma glucose homeostasis, as it counteracts glucagon and other catabolic hormones—epinephrine, glucocorticoid, and growth hormone.
Or here's a quote with smaller words:
http://science.howstuffworks.com/life/cellular-microscopic/fat-cell2.htm said:
Insulin acts on many cells in your body, especially those in the liver, muscle and fat tissue. Insulin tells the cells to do the following:
Absorb glucose, fatty acids and amino acids
Stop breaking down glucose, fatty acids and amino acids; glycogen into glucose; fats into fatty acids and glycerol; and proteins into amino acids
Start building glycogen from glucose; fats (triglycerides) from glycerol and fatty acids; and proteins from amino acids
The activity of lipoprotein lipases depends upon the levels of insulin in the body. If insulin is high, then the lipases are highly active; if insulin is low, the lipases are inactive.
Just in case anyone is interested. But not crucial to this discussion
 

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From what I have read here of those who are starting insulin, their dose is purposely small so that they can slowly raise the amount to match up their need. One doesn't start out with "a lot of insulin" at first. The goal is to not "go hypo" at all.

"Start slow and learn as you go."

The details of managing insulin are beyond my remit. :)
 

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Insulin is a fat storing hormone and as such, you can indeed gain weight IF you are not careful. In my case the doctor who diagnosed me gave me the typical ADA recommendations and I did gain weight and a lot of it. After I learned how to count carbs and match my insulin dose to my food intake, the weight gain stopped. However losing the weight I initially gained has been an ongoing struggle. My advice would be to watch your carbs, match your insulin dose to the food you eat and don't forget to add exercise into your daily activities if your physical condition permits.
 

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Discussion Starter #14
Insulin & Metformin

Hi All,
I posted a while back, asking what your thoughts of Metformin & Insulin BUT now I would appreciate your feedback from anyone using Insulin & Metformin to control T2 DM. Please share your experiences from the begining of treatment Metformin & Insulin & it's progress, mishaps if any. I have not switched over to this treatment yet, hopefully soon. Please tell me how you felt starting this treatment, eating habits, BGL issues, weight issues, your body's response to this regime. Please share as much info as possible, I really look forward to hearing from you. Thank you!
 
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