Diabetes Self-Management Blog

For the last 10 years or so, medical authorities have been advocating starting people with Type 2 diabetes on insulin earlier rather than later. The idea is to prevent complications by keeping blood glucose down. Lower blood glucose might also help beta cells recover. (I have to admit that I sometimes jumped on this bandwagon too.)

Now a recent report by Roger Unger, MD, of the UT Southwestern Medical Center, says giving insulin is one of the worst things you can do for overweight people with Type 2. Insulin is needed to get glucose into cells for use as fuel, but it also causes the body to create more fat for energy storage. According to Dr. Unger, studies show that high levels of insulin lead to high levels of fat, which then causes insulin resistance.

I am not convinced that it’s the mere presence of fat that creates insulin resistance. Studies disagree on this. I think it may be that not enough exercise, too many calories, and too much stress are the causes. However, does it make sense to give more insulin when the body is trying to resist it? Maybe not. For the same reason, taking sulfonylurea drugs (which raise insulin levels) may do more harm than good.

“Giving more insulin to an insulin-resistant patient is akin to raising the blood pressure of a patient with high blood pressure to overcome resistance to blood flow. Instead, you would try to reduce the resistance,” Dr. Unger said.

The Fate of Beta Cells
As you should know, insulin resistance builds up for many years before blood glucose levels start to rise. For a long time, the beta cells compensate for insulin resistance by pumping out more insulin. When the beta cells can’t keep up, diabetes starts.

But why can’t they keep up? Most experts think the beta cells “wear out,” or “burn out,” from years of overproducing. Others believe the cells are damaged by high blood sugar and stopped working. Either way, giving insulin should help preserve these vital insulin-producing cells.

But the work of researchers such as Dr. Unger brings up a different concept. It seems that fat in the blood also wears out beta cells. The beta cells may “turn off” as a defense against fat. Without insulin, fat cells can’t take in more outside fat, and they will actually release fat to be used as energy. So injecting insulin might go against what the body is trying to do for itself.

Of course, when insulin production “turns off,” blood sugar levels will go way up if food intake and exercise don’t change. So it’s a tough problem of what to do.

Bottom Line: ??
I’m not sure what to think about all this. It is certainly true that insulin often causes weight gain, which can’t be good. But most of the insulin-resistance-lowering drugs have serious side effects too. I think Dr. Unger and I would agree that self-management approaches like exercise, calorie cutting, and stress reduction (which he doesn’t mention, but should) are the best way.

What’s your take on insulin? If you have Type 2 and you’ve tried it, how has it affected you? Please leave us a comment to let us know.

Weight Stories Wanted
Well, I’m going ahead with my weight control book, “From Weight to Wellness.” I would really like to hear from readers who have stories to tell about struggles with weight, successful or less-successful. If you’re willing to tell me about them, e-mail me at nurse@davidsperorn.com, or visit my web site www.art-of-getting-well.com.

New Diabetes Newsletter
I’m getting a lot of information from a newsletter called “Diabetes Alerts,” put out by Marc Onigman, a man who has Type 2 and has two children with Type 1. You can subscribe to “Diabetes Alerts” by mailing here.

POST A COMMENT       
  

Comments
  1. Dear David.

    Possibly another goofy study. It is of key importance to keep your pancreas somewhat alive. If you dont, you end up with unmanageable diabetes i.e. insulin resistance and a dead pancreas. Believe me you dont want to be there it is your worst nightmare.

    Yes of course motherhood and apple pie (not for diabetics), exercise, diet, and stress relief and metformin.

    In my case I lost 85 lb and exercised 2 to 3 hours per day and ate a hypocaloric diet but still I could not get my BG into the normal range. And as a result my pancreas died and then I was allowed insulin. I was of course still insulin resistant.

    The oral miracle drugs did not work. With or without metformin or with or without avandia my BG averages and their standard deviations were the same. The sulphonyl ureas should be banned they are a horror show.

    A bit of insulin at an early stage would have let me keep a reasonable quality of life.

    Posted by CalgaryDiabetic |
  2. Dear David.

    What does Dr. Unger mean by fat in the blood my total cholesterol was in the normal range. HDL a bit low and LDL a bit high. But I am obese and cannot loose weight. I agree with him that insulin is a make fat drug. Not clear was he suggests is it to stop injecting insulin and then try to loose weight?

    Posted by CalgaryDiabetic |
  3. Hi CD,
    Dr. Unger is an obesity crusader. He believes that excess fat is the primary cause of T2D and most heart disease. So his primary treatment approach is to lose weight. He even suggests bariatric surgery as preferable to insulin.
    See this article for more: http://news.sawf.org/Health/56728.aspx

    If you stopped injecting insulin, your sugars would go up of course. To avoid that, you would probably have to crash diet, (you know, like 1000 calories a day or less). You would have to monitor sugars closely and drink lots of fluids. You might want to get advice from a nutritionist or dietitian and your doctor if you went that route.

    Unger does say that insulin should be given to people who are insulin deficient (as you are now, and maybe always were). Your story sounds like perhaps you were / are a type 1.5 (LADA or MODY) and it wasn’t picked up. Doctors should check insulin levels before recommending treatment plans.

    I wouldn’t assume your “pancreas is dead.” It might just be sleeping. I know you exercise a lot already. It would be interesting to see what happens if you lost 80 pounds or so, although you might have to starve yourself and increase exercise to do it. But if your cholesterol, BP, and A1C are OK, you have to ask yourself (and possibly your doc if you trust her) if it’s worth the trouble.

    Posted by David Spero RN |
  4. Dear David.

    Yes it would be worthwhile to loose 80 lb. Don’t have a clue how. Last time I tried with a well thought out plan of balanced food and lot of exercise. I did manage to loose 10 lb then all hell broke loose. The body was under the belief that it was starving. And as with most diets I regained 20 lb.

    Not totally sure I can stop insulin totally even on a 1000 calories per day diet. The BG might go into the hundreds(I would not let it) and there is a danger of DKA but then you dont know if you dont try. I can take say 40 units of levemir only per day that is quite a lot so DKA should not be an issue. Levemir is supposed to be the least harmful insulin for weight gain.

    When I first developped diabetes I did manage a 1000 per day for a long time.

    What do you think, is a radical diet a better bet than just trying to cut 200 a day which failed dismally ?

    The Canadian Diabetes Ass suggests two anti-obesity pills xenical and meridia. My GP said his wife tried xenical with dismal results but that some of his patients had smashing success with meridia. Any thoughts on this?

    Posted by CalgaryDiabetic |
  5. Hey David, When I was first diagnosed I was placed on insulin (Lantus and Novolog). For the past year I’ve been off insulin and using Metformin and Januvia. My A1c has been slowing creeping up with no change in diet from when I was on insulin (around 150g carbs a day) I lost 40lbs pre-diagnosis, and an additional 30 while on insulin. I’ve regained 15 over the past year due to other medical conditions not letting me exercise anymore but then stabilized. I’m still overweight at 4′10″ and 265lbs.

    My point is that you can lose weight while taking insulin.

    On another note… I had to abandon the trial of salsalate. I was at a very low dose to titrate up and it just wasn’t effective keeping my arthritis pain under control at that dosage. I was willing to endure that until we could get the dosage up to effective levels. BUT my insurance (Medicare part D and Texas Medicaid) refuse to pay for Salsalate (a generic) but will pay for Celebrex (a very expensicve Brand). Our Tax Dollars At Work.

    Posted by Ephrenia |
  6. David,
    I have type 2 diabetes and my A1C went to 8.3 in one quarter and my “doctor” prescribed a low dose of “NPR” insulin. I got the drugs, and then had an epiphany. I decided that I am the results of my own experience and will not surrender to yet another form of drug therapy to fix a problem that I created and do have the power to control.
    I crafted an Excel workbook to monitor my sugar readings, carb intake, weight gain/loss back in October. Result I lost 20 pounds, NEVER took one injection, brought my A1C down to 7.1 and knocked my “doctor” out of his socks right when he was patting himself on the back for prescribing the insulin. The key element of the whole exercise is becoming aware of what, how much, and when I was eating. Yes it takes a fair amount of discipline and motivation (mine was total distaste for the injections even just once before bedtime). I would be happy to share the workbook with anyone:
    pongfar@comcast.net
    I am also in the final stages of production of a program that runs on a a Winows Mobile 5.0 PDA/Smartphone to provide parents with an effective Diabetes Management tool for children with Type 1 diabetes who are too young to be on any type of pump.

    Posted by faltopar |
  7. I need to ring in here since I am a person who was given insulin with type 2 diabetes and I was overweight. All I can say is thank you to my doctor. In April, 2008 I was hospitalized with blood sugar of 780 and was told I was diabetic. Prior to the hospital I simply thought I was overweight and depressed. I could hardly walk and was always sleepy. The tests at the hospital showed my sugar was around 375 for the previous three months. I was given four shots of insulin a day. 40 units of Lantus each night and 12 to 15 units of Novolog prior to each meal. I weighted about 240 pounds when I was admitted. I was in intensive care for three of my five day hospital stay.

    It took 6 months or rigorous testing and dieting along with walking 7 to 17 miles per day every day. I stayed on insulin over the six months, never taking oral medication. I reduced my weight by 23 pounds the first three months (yes it was allot of work) and within that time I was completely off my meal time insulin and my Lantus was reduced to 20 units a night. I refused to eat the high carbohydrate diet the diabetic nurse told me I had to eat. I ate about 110 grams of carbohydrates a day (no pasta, bread, potatoes, or rice), and continued my walking religiously. During the six months through diet and exercise I kept my meter reading under 105, averaging 95 to 97 each month. I had plenty of energy every day for my walking and my body reacted with continued weight loss.

    After 6 months, my weight was below 200 (192) pounds and I was taken off all insulin. I have been able to stay off all medication to date and still have average meter reading or 94 to 96 for my 7, 14, and 30 day reading. I walk between 30 and 60 minutes a day.

    I am thankful to my doctor for giving me the right to control my diabetes without the use of oral medications. Insulin gave me the energy to work the weight off and now I have the energy naturally, to keep it off. He has been totally amazed with my results. He thought I would gain weight on the insulin. He didn’t think I would walk off the weight and watch my diet. I know at least two believers in the treatment I received (my doctor and I) and I am sure he will use me as an example of what can be done. My diabetic nurse still thinks I should eat 22 servings of carbohydrates a day because that is what the computer and book says. If I did, I am sure I would be right back on medication.

    I am only one person, but if you ask me, I would rather have taken and stayed on insulin until I was off all medication then to be on oral medications, eating the normal carbohydrate recommended intake, and still feeling out of energy.

    Sincerely,

    A type 2 insulin believer.

    Posted by Robert |
  8. I struggled with type II diabetes since 1995. I lost 80 lbs and then my family doctor sent me to an endo - who is now my former - immediately put me on Actos as well as glucophage. I gained back 40 lbs of my initial weight loss with no improvement to my blood sugar from the Actos. Needless to say, I found a new endo. He took me off Actos and started nightly Lantus last year. I have lost 20 pounds so far and I feel so much better. No matter what I did on Actos I could not lose a pound. I tried continuing my walking and food plan to no avail. I tried Weight Watchers for 6 months. Thanks to my new doctor I feel I am back on the right track. I actually feel like walking now and my depression is much less grinding than it was. I don’t know if it makes a difference but my first doctor was much older than my new one and did not seem too concerned with my concerns. My new doctor actually listens to me and how I am feeling and what issues I have.

    Posted by Cathy |
  9. I have struggeled since 2002 to try to control my Type 2 Diabetes. Most recently I have lost 87 pounds and did not see ANY change in my blood sugars while on 4 seperate oral meds.

    Four months ago my Endocrinologist started me on an insulin pen mix and finally my blood sugars are normal. My A1C went from 9.9 to 7.0 in 3 months.

    Yes, I gained 10 pounds in the first 3 weeks. I have been unable to take that 10 pounds off but have not gained anymore. I have to find a way to take off another 50 pounds and I am determined to do so while taking my insulin and keeping my sugars and A1C low.

    Debi D, Central Florida

    Posted by debiash |
  10. Dear David,
    I tend to agree with you about overweight type 2’s and insulin. I am type 2 and take insulin, but I am not insulin resistant and am quite thin. I take very small amounts of insulin. It is working well for me. However, those who are insulin resistant have to take a lot of it and there is some research that indicates too much insulin can lead to dementia. Also, I know several type 2 diabetics who use insulin as an excuse to eat more. They say “I’ll just take more insulin to cover it.” I think reducing the insulin resistance with exercise and stress reduction should be primary treatments, along with counting carbohydrates very carefully. Then add oral medications if necessary. If all that fails to work, add insulin.

    Posted by Becky |
  11. Congratulations! What did you eat to get 110 grams of carbohydrate per day if you weren’t eating bread, rice, potatoes, or pasta? A lot of beans and fruit?

    Posted by Judester |
  12. I also would recommend reading Dr Bernstein’s Diabetes Solution, and try the low carb route, I was diagnosed two years ago at a a1c over 7% and weighing over 320 pounds, I am now at 260 lbs, a1c in the 5% range, eat very low carb, cholesterol is now normal ( though I really need to get the numbers) and blood pressure is normal.

    Posted by bbeck4x4 |
  13. Dear Robert.

    Great job controlling the disease. Continue, do not fall for the ADA high carb diet some people may survive it but I know I would die quickly following these guidelines. 100 grams of diebetic friendly carbs excluding what you did per day is more than plenty. Leaves room for veggies and fruits.

    In my case meformin and avandia did not help my blood sugar at all and the sulphonyl ureas give you no control whatsoever.

    Posted by Calgarydiabetic |
  14. I was give insulin when I was diagonis with type 2 in 2003. Yes I was overweight but I was am follow the diet and exercise every day and I lost 45 pound in 6 months. I still need to lose some weight but insulin helped me gained my life and I did change to more healthly life style. Two years ago I went to an insulin pump. Have type 2 can be just like any other thing such as heart or whatever. It is up to them and their doctor to do what is best for them. To me insulin was my choice and I chose to change my life so I could live longer

    Posted by Mary |
  15. I am a type 2 diabetic for about 111/2 years. I started on Novolog insulin about 9 months ago. I chose this rather than take Avandia which has side effects I don’t want. I take Metformin and glipizide as well. My mother a type 2 diabetic for over 30 years only took insulin. She had no neuropathy and no heart issues. She was not heavy but not thin. I now have a BMI of 24.44 which I have kept for a couple of years. I lost my weight slowly and have maintained the diet by limiting carbs except for vegetables. I believe if you continue to diet with insulin you will not gain weight. I use my mother as an example. I believe insulin resistance is normal for a type 2 diabetic but that exercise is most important to offset it.

    Posted by Debby |
  16. Thanks for all these great stories - please keep them coming! For those who asked questions, I will reply soon, if others haven’t answered you. At this point, all I can say is that Dr. Unger’s anti-insulin advice seems, from your experience, to be mostly wrong (which is what I used to believe anyway). But diabetes treatment plans obviously need to be individualized, and worked out with the patient in the leading role.

    Posted by David Spero RN |
  17. Hello and so good to read your article. I have a quick comment. My doctor started me on Actos a few years ago and i told her that it made me actually gain weight and she said I just needed to exercise more. Finally I’d had enough and I took myself off of it trying to manage it just by diet and exercise alone, because I was so miserable I really feel like it affected my emotions also, I got agitated easy and I’m such a peaceful person. I no longer have that “bloated” Macy’s balloon feeling and my weight is still not down but staying the same and my peacefulness has returned. I would love to get help and support from people who think taking meds are the only solution. May your path be blessed~~~Cat in Cali

    Posted by catpaws |
  18. I am also a type 2 diabetic that went the route of the medicines and side effects and now am taking insulin. Yes I am also over weight and as we all know and are constantly told weight loss is the key.

    But there are also other factors that must be taken into consideration. Diabeties is not the only issue that I battle. Most of the medications carry the side effect of fatigue. Now that I am on insulin, I am still to tired at the end of my day to do the exercise that I should do. I also battle hypotyroidism and fibromyalgia. So what are the answers for us? I can maintain a diet but still not lose weight, and when all is working against me fall asleep on my husband at the dinner table.

    I think the only thing that we can do is the best that we can do, and our doctors at least a number of the ones I know need to listen to us. We know our bodies better than they do…listen.

    Posted by kim |
  19. Type2 insulin believer struck a chord with me. Any diabetes nurse, RD, any CDE should individualize a meal plan; I rarely encourage more than 3-4 carb choices per meal unless the individual works it off and/or is losing too much weight. A couple pounds weekly is a sufficient weight loss that will help protect from muscle wasting, for the most part. If someone complains of hunger that’s the time for pushing all the nonstarchy veggies sometmes with a bit of lowfat ranch dressing,yumm), hot fluids(fluids in general, hunger can be a sign of dehydration) and a snack here and there. I concentrate on “how’s the clothes fitting? how’s the pedometer steps going?” “how’s the BGs?” “HOW DO YOU FEEL AND WHAT IS BUGGING YOU?” etc. Change will most times bring weight loss, and without making that one aspect of life the entire focus.
    Starving the body slows weight loss, lowers metabolism, and creates ketosis… basically makes one feel like crap and it’s not desirable. Reading all the comments and those of Jan’s (Self-Management) blog remind me how often health care pros need to learn about listening. I was truly blessed in that art plus working with an individual more than once every 3-6 months helps; always be available for questions health pros.
    Sorry for the long wind, but I’m famous for that too. In my long career as a CDE I’ve many success stories and, yes, a few stinkers, but so much more success than loss. Oh, and about insulin; nothing makes me smile more than “Thanks, I feel so much better and my sugar is straightening up; I’ve starting walking again.” We do start insulin too late so many times. Learning how to utilize all the correct medications is an art, plus trial and error. too. Folks work with your doc and educator. Thanks for allowing me to comment.

    Posted by slb |
  20. Dear David.

    This issue sure did get a response. There is one thing that seems clear is that insulin resistant diabetics using insulin and eating the ADA recommended super high carb diet have a very good change of going into an insulin weight gain death spiral. You cannot eat like that without have to inject more and more insulin and gaining weight regardless of the amount of exercise.

    I think with insulin resistance whatever causes it, you need a hell of a lot of exercise per day and you must also minimize the amount of insulin you take by minimizing carbs and maximizing exercise.

    Insulin for type 2 is a great thing with the above provisos. I have nothing good to say about the oral drugs except for metformin that does marvels for some people not me. Suphonyl ureas way worst than insulin, you have no control over BG or over weight gain.

    What do you think?

    Posted by Calgarydiabetic |
  21. Dear Calgary,
    You are in a tough situation. It’s like you have both Type 1 and type 2, and that’s a heavy burden to carry. It’s inspiring that you do as well as you do and keep such a positive attitude.
    As a type 1, you would not want to stop insulin. You might be able to cut way down as Bernstein did. You could go on a long crash diet and lose many pounds, but then what? Unless you’re willing and able and have enough support to just nibble for many years, you would gain the weight back.
    I would support you if you chose that option, but I think if it was me, I’d keep doing what you’re doing, try to increase activity and reduce stress and enjoy life.
    Re: Xenical - it’s just a fat blocker. You could try it, but you could get the same effect by reducing fat calories by 1/3, without risking side effects. Meridia is more of an anti-depressant. It makes you feel satisfied (not exactly full, but happy.) Hopefully it’s safe - it hasn’t been out that long.

    Posted by David Spero RN |
  22. Ephrenia,
    That’s so sick about the salsalate. What a screwed-up system we have! Can you fight them? I hope Obama makes some changes but I’m not counting on it.
    Thanks for telling me about losing weight on insulin and gaining it back on oral meds. I now agree with Jan that Dr. Unger is wrong, wrong.

    Robert,
    Thanks for that inspiring story. If you can use insulin that way - temporarily to get well, then taper off it, you have the best result you can hope for. Of course, for some people it takes longer.

    Cathy and Robert,
    Good testimony on the importance of having a doc who will work with you instead of trying to control everything. Glad it’s going well.

    Posted by David Spero RN |
  23. Debi D and Mary,
    Good examples of insulin working very well without causing too much weight gain. Love both of your positive attitudes.

    Becky,
    I seriously doubt you are Type 2. You sound like a 1.5 (LADA or MODY) and definitely need to be on insulin.

    Cat,
    Is there a diabetes support group near you? You can probably track one down on - line.

    Kim,
    It’s really hard with multiple illnesses as you have. One place you might want to start is with sleep. Check out some web sites - DSM has good pages on sleep - and see if you can’t manage to sleep better. Many people can. Your pain and fatigue will be improved, at least.

    Posted by David Spero RN |
  24. Thank you all for your comments. I am the worst case of diabetes with a dead pancreas and a high insulin resistance need 1 unit of insulin per 2 grams of carbs. So eating the recommendated ADA very high carb diet would lead to massive weight gain and an early death.

    In my case I think it is essential to minimize insulin and still keep the BG in a reasonable range. Low carbs and a lot of exercise is a must.

    Xenical sounds goofy and my GP refused to let me try it. In my case I have to eat a high fat diet. Incidentally on a low carb high fat diet my lipids profile is better than on a low fat and high carbs. Remember nothing messes up lipids more than BG above the normal range. Atkins and Bernstein are right in this.

    Sulphonyl ureas are a disaster and most people should be given insulin. By withholding insulin my doctors ruined my life but followed the Canadian medical ass protocol.

    Byetta and symlin not available in Canada you wonder if there is something wrong with them usually approval is automatic if evidence is good.

    David I know that diets fail and that you regain the weight and more but I do not see any other option. My obesity is causing the insulin to stop working.

    Posted by Calgarydiabetic |
  25. I have been type 2 for 15 years.
    My introduction to diabetes was sudden. Apparently, I was told a virus I had caused my own body to attack my pancreas. After 3 days of vomiting and diarhea, I was put in ICU, in DKA, and was told I would not have survived for more than a few more hours if there was no intervention. I was put on an insulin drip and recovered remarkably. As soon as I was in a regular room a nurse taught me the basics of injecting insulin and the doc put me on a sliding scale of insulin depending on my BGs. He also put me on metformin. Being terrified of what could happen to me again, I put myself on a very strict low carb diet and walked two miles every single morning and evening. I was moderately overweight at the time this all occured and actually lost 40 lbs. just from being in DKA. I was able to lose 30 more with my regimen and while still taking insulin.
    For some reason along the way a doctor added glyburide to this regimine. I have been taking glyburide for over 10 years or so and have been steadily gaining weight. At a recent visit to my endo he suggested I not need to take the glyburide anymore and that I would then be able to lose weight. Well, was he ever right….I should mention that I am on an insulin pump that has made life wonderful for me also! Since stopping the glyburide 3 weeks ago I have lost 15 lbs. I am not able to exercise as I once did due to other health issues, surgeries, and injuries.I’m hoping the results continue to show weight reduction, and, as a result, hopefully my insulin resistance. I am already not bolusing as much insulin on my pump.
    So here’s just another twist on a diabetic experience for you to “digest!”

    Posted by maxart |
  26. faltopar:

    I hope you you still read this post, listen up:

    269 pounds and disgnosed with type 2 diabetes in April 2008. Same story as you. I was admitted to the hospital for 5 days, 3 in ICU and yes, it has been a year and it has gone by pretty fast.

    I too was on lantus with a little novalog in between to maintain my numbers. Now, I was a little heavier than you. However, I too lost 38 pounds and walked rigorously. April was a decent month to get diabetes. Always find the bright spot. I walked, and walked and dieted and dieted. I am fairly convinced you do not need to read a book or search for dieticians. Just walk, and rid yourself of any refreshments containing sugar. That is the first step. No soda, no gatorade, no liquor….Then eat responsibly. Uptake the protein a bit and eat whole wheat bread and stop cakes, cookies and any sweet snacks altogether. Before you know it you will shed the pounds. Next thing you know, the blood sugar readings go from the high 100’s to the low 100’s. Eventually, your Lantus (or whatever) may be able to be reduced. I was on 60 units at first, but 11 months later I was down to 24. I have not taken insulin for 4 days now, and to my awareness, my blood sugar is around 115. I don’t take it right after I eat because it probably spikes, but if it comes down 1-2 hours later to 115 then your Pancreas is producing insulin.

    Even it you cannot get off insulin completely, I understand it is rare to get off insulin, your body will become dependent causing an inability to produce it, you will feel better and the energy you lost so slowly will return.

    I was already chronically ill, so I didn’t find the dieting that difficult. Everyone should give it a try for their family and for their loved ones. It will make you a stronger person regardless of the outcome. I feel quite blessed and hope this is permanent.

    I thought it very peculiar that your story was so similar to mine. When I saw it, I had to post. Best of luck, good fortune and may God continue to Bless You as he has

    Posted by beatdbeates |
  27. Greetings,
    I have been an insulin dependent diabetic for 36 years. I have had a kidney transplant and was on PD 12 years ago. I now need another kidney and am on Hemo dialysis. My question is - how long would it take for the body to shut down completely without the use of any insulin, no hemo, and no nutrition? I am 40 and have lost a son at t he age of 20 from DKA. I am so tired. Any info would be greatly appreciated. I have sought counseling - just in case anyone was wondering.

    Posted by Tausha |
  28. Tausha,

    I’m sorry to hear things are so rough for you. The British Web site RenalInfo says this about stopping treatment:

    “When kidney failure reaches the stage where dialysis or transplantation is required, refusing such treatment means that the patient will die. This could happen within a few days or weeks, depending on how much kidney function they still have. A patient may decide to explore the option of refusing treatment. It is the responsibility of the medical team to counsel such patients and their families, and support them in their decision.”

    I think if you decide to stop treatment, wait until you have arranged everything you can for your passing, said all your goodbyes, and try to deal with unfinished business if possible. You might want to write or tape record some of your life story, so your family will know about you, and to help you make sense of it.

    You may decide to continue treatment, or may not. Either way, I hope you can get support from a loved one or trusted friend or health professional. There are many online support groups that might help. One is at Daily Strength: http://www.dailystrength.org/c/Dialysis/support-group

    But a Google search for “stopping dialysis” will give you many more groups and good information.

    I wish you peace and know that you will be in the prayers of many readers.

    David

    Posted by David Spero RN |
  29. I been able to bring my readings (I am a type 2 for about 2 years)to about 135 from the high 300, with diet and exercise. My question is if you may suffer some irreversible damage through this process and what would be the benefit of doing it without meds. I am just a little bit prejudiced against meds.

    Posted by HECTOR |
  30. I have read some of your input. Iam type 2 diabetes. Iam on the insulin that I inject once a day. I HAVE been diagnois 2 years ago. I exercise everyday, watch what I eat and take my insulin. My concern is, will I ever be able to get off the needle and go to just taking the pills. Or is it possible I will get off completely and not take anything and continue to exercise and watch what I eat. My readings everyday is 100 to 90. Looks very well to me. But now I have a continus headaches and stomach aches. Have told this to my doctor, and she says it is o.k.

    Posted by JOYCE |
  31. Everyone should read “Dr. Barnard’s reversing type 2 diabetes”…. Its a life saver!

    Its a life changer and you can get better. But it will take a diet change and determination. Always consult your doctor before making any changes to your diet and program.

    Posted by Jan |
  32. 30 years experience, a stroke and now under control suggests the following:

    One needs to fix any glucose leak over generation due to medical hormone screwups - these can and do override diet and any other improvements.

    Next, one needs exercise - insulin does not get rid off glucose, only exercise and process burn, shivering in the cold and some fat storage do that.

    On old gene hunter gatherer digestion systems too eficient on modern diet fare,
    one needs to control carbs carefully.

    28 years I was hammered with adding extra insulin or oral pill generation. Metformin not available.

    In last 4 years finally caught culprit of liver trying to make marachino cherry of my body.

    Proper timed doses of metformin can shutdown liver crap( one large daily dose useless); during that time when liver crowding picnic; I could not lose an ounce.

    Once liver leak plugged and on diet of 1200 calories; in 6 months my body went back to using its own insulin. Man I was yanking the external starlix and 26 units of 75/35 fast.

    Cars get a better service check when they plug in the testor and read out all the parameters.

    type 2 Insulin resistance diabetes needs a simialr low cost test of the endocrine systems - awake and sleeping to catch the grief.

    Adding insulin is a type 1 answer for valid reasons in that arena. For type 2 is a holding pattern condemming patient to ever more insulin
    and corroded out system.

    Insulin resistance comes about in my opinion as a cellular/body response to a chronic higher levels of glucose from diet and/or medical organ failure-degeneration on a long term basis.

    Sufficient exercise is required to flush out glucose in cells on regular basis or cells top off and turn off the body insulin as a defensive measure.

    Fat does not cause type 2 diabetes insulin resitant cases, chronic too much glucose causes that. This is not a meal by meal - its your knife and fork war dance but over time cells are chronically topped off.

    Ergo, heraty exercise and carbs control are required to prevent body cells getting topped off chronically.

    Yes, I needed some insulin to make up aging and a boost on basil from Lantus - but the prior 26 years throwing insulin against the problem - shere stupid.

    I had a test platform of my body that my liver blaste the glucose through the roof every day on every morning.

    Prior to metformin; I found that walking every day 2 miles would burn out the excess glucose and get numbers back to 100. First thing in am 26 units of 75/25 insulin dose did nothing till I walked 1.6 miles I would finally see BG start to drop and by lunch back to normal numbers and body was responsive again to small amounts of insulin or food.

    Is this a cure - no; but it gets the system back to a point were it halts the damage, those things that can regrow/improve do and one retains the working balance.

    I have nothing to prove and the numbers out there say something else.

    I have multiple lab reports and data that confirm that kidney degredation halted, eyes and bleeding halted, lungs better.

    The current hammer of stuffing insulin on type 2 insulin resistance folks is incorrect and worn out. Put me down as fet up.

    Posted by jim snell |
  33. HI THERE

    I HAVE BEEN A TYPE2 DIBETIC FOR 2 YEARS STARTING AT THE AGE OF 60 I HAVE PUT ON 4 STONE AND NEVER FEEL WELL AND THIS IS ALL DUE TO THE INSULIN.

    Posted by annette lang |
  34. Doctor put me on novolog 3 times day and levemir one time day. Sugar is still in 200’s. I am 6′ 190lbs. I walk 2-3 miles everyday. Should I get off teh insulin and if not will it make my pancreas stop making it? I took glipizide for about 10 years and A1C averaged 8.3 over the last 10 years sometimes 10 and sonmetimes as low as 6.

    Posted by Merv |
  35. Merv, I can’t really give medical advice, but if your blood glucose stays over 200 with all that insulin, there is something wrong. You say you are walking, but I wonder what you are eating. It’s hard for me to believe you aren’t having too many carbs.

    You might want to look at some of the diet ideas I blogged about here.

    Posted by David Spero RN |
  36. Hi, I was Dx with type 2 two years ago. I’ve been up and down in levels. I am now on Victoza and don’t want to stay on it due to the possibility of pancreatic CA. they want to put me on insulin due to an upcoming surgery. I do not want to go on this, it’s to early for that I feel. My surgers are down to about 122 to 160 now since I’ve been eating better and walking. I have trouble with metformin, and I would love to find something that does not cause CA or some other horrible side effect. I need help convincing my DR not to put me on insulin. Debora

    Posted by Debora |
  37. Actually as a 30+ year type 2, what gets missed is that the oral glyburides, starlix simply push the pancreas to whack out as much insulin as it can.

    As a result one is eating to the pill to prevent lows.

    While I realize the specter of needles is daunting, one is adding only the calibrated amounts of insulin for the carbs eaten.

    Properly done and with exercise one should not gain weight.

    Trying to diet on the oral pills like glyburide/starlex is next to impossible and trying to eliminate lows.

    Posted by jim snell |
  38. Debora, you could go on insulin to prepare for the surgery and then come off it afterward. The rate of cancer with Victoza is less than 1%, so you might consider living with that risk. But you also might try other treatments we have been written about, including cinnamon, vinegar, exercise, or bitter melon. Perhaps one or more of those will enable you to get off Victoza and stay off insulin.

    Posted by David Spero RN |
  39. I am a type 2 diabetic. I had gestational diabetes 15 years ago, and it got gradually worse as I aged. Here’s the fun part — I started taking insulin, eating 1200 calories a day, following my diabetic recipes and diet, watching my carb intake and increasing my exercise. With all this I gained weight. Actually, I find it unprecedented, because I have gained over 25 pounds in one year — something I’ve NEVER done before. In fact, I had a few extra pounds on me when I started taking insulin, but I was not obese — which I am now.

    I think it ironic that weight, something which is such a no-no to diabetics actually became a problem to me after I started taking insulin. I feel worse now than before I started taking insulin.

    I’m not sure what to do at this point, but the argument that insulin may actually hurt some diabetics may carry some weight (no pun intended). Perhaps each individual is different, so prescribing insulin shots to help me may not be a good regiment, although I’m sure it helps other people.

    Posted by KayKay |
  40. Hi KayKay

    It sounds like you might talk with your doctor about getting off the insulin if it’s making you feel bad and gain weight. However, some insulin products, like detemir, do not seem to cause weight gain.

    I would definitely consider eating less carbs and using less insulin as a way to control weight. But perhaps you can do without the insulin entirely. There are other medicines. Ask what it would take to get off it.

    Posted by David Spero RN |
  41. Dear David,

    I was diagnosed with type two diabetes after a course of steroids for my asthma brought the diabetes to light, although my blood sugar is high often off the scale I don’t get ketones, and My vision is not disturbed neither are my feet or nerves it doesn’t make me drowsy either having such high blood sugar. I refuse to take Insulin or metformin and have gone from 19 Stone to 12 Stone in a little over a year insulin made me fatter I’am not ill with high blood sugar I’am leading a normal life without the medication so I would like to carry on unless I become I’ll I will not take Insulin.

    my doctor is confused how I’am not unwell nor have ketones and am not in a coma.

    Posted by Jo |
  42. I have been on insulin for over a year. I was on metformin only for years and did not watch my diet. The insulin is still not helping me due to my poor diet. I am going off of insulin and drastically changing my diet for one week to see the results. I may take some old metformin as well to help me along. I have woken up with rectal bleeding more than once, and I have no colon due to Ulcerative colitis and surgery from before I had the diabetes.
    The bleeding happens in the morning after I have slept after taking my Lantus. I believe that Insulin can definitely save lives, that some diabetics really need it, but, I think my problems are diet related, and I may be able to control it better that way. At least with minimal insulin usuage. I believe there is a direct correlation to Lantus at bedtime and the rectal bleeding.

    Posted by CINDY |
  43. I guess I feel that insulin usage makes us think we can eat things we shouldn’t.

    Posted by CINDY |

Post a Comment

Note: All comments are moderated and there may be a delay in the publication of your comment. Please be on-topic and appropriate. Do not disclose personal information. Be respectful of other posters. Only post information that is correct and true to your knowledge. When referencing information that is not based on personal experience, please provide links to your sources. All commenters are considered to be nonmedical professionals unless explicitly stated otherwise. Promotion of your own or someone else's business or competing site is not allowed: Sharing links to sites that are relevant to the topic at hand is permitted, but advertising is not. Once submitted, comments cannot be modified or deleted by their authors. Comments that don't follow the guidelines above may be deleted without warning. Such actions are at the sole discretion of DiabetesSelfManagement.com. Comments are moderated Monday through Friday by the editors of DiabetesSelfManagement.com. The moderators are employees of Madavor Media, LLC., and do not report any conflicts of interest. A privacy policy setting forth our policies regarding the collection, use, and disclosure of certain information relating to you and your use of this Web site can be found here. For more information, please read our Terms and Conditions.


Type 2 Diabetes
High-Salt Diet Doubles Heart Risk in Type 2 Diabetes (07/25/14)
Insulin for Type 2 (07/14/14)
Rutgers Recruiting for Type 2 Diabetes Study (07/03/14)
One in Ten Heart Attack Patients Has Undiagnosed Diabetes (06/19/14)

Insulin & Other Injected Drugs
Insulin for Type 2 (07/14/14)
FDA Approves Inhalable Insulin (07/03/14)
FDA Approves Weekly Type 2 Diabetes Medicine (04/18/14)
Do You Know Your Insulin Level? (10/25/13)

 

 

Disclaimer of Medical Advice: You understand that the blog posts and comments to such blog posts (whether posted by us, our agents or bloggers, or by users) do not constitute medical advice or recommendation of any kind, and you should not rely on any information contained in such posts or comments to replace consultations with your qualified health care professionals to meet your individual needs. The opinions and other information contained in the blog posts and comments do not reflect the opinions or positions of the Site Proprietor.