spiritfree
Well-Known Member
- Relationship to Diabetes
- Type 1
This is probably a dumb thing to ask but why don't type 2 get to use insulin to help their control diabetes? I should understand this but I don't, I'm nice but dim hahhaha.
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Probably a dumb question
- Thread starter spiritfree
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Not a dumb thing to ask at all🙂 I went onto insulin at the beginning of May when the highest dose of Gliclazide I could take was still failing to control things. Was really apprehensive about injecting, but am now jabbing away with no problems whatsoever. Insulin has had an amazing effect on my BG levels - invariably now at normal levels. My diabetic nurse said that in other countries they don't fanny around with tablets first, you're put on insulin straight away.
This is probably a dumb thing to ask but why don't type 2 get to use insulin to help their control diabetes? I should understand this but I don't, I'm nice but dim hahhaha.
To me, the simple answer is I think/believe, that type 1's produce NO insulin, whereas type 2's do produce their own insulin, but their body doesn't process it properly.
Therefore immediately introducing insulin to type 2's could potentially send you hypo all the time when your body does decide to process the natural insulin correctly as well as the injected insulin. Therefore the idea of things such as metformin is to help the body process it's own naturally produced insulin. As type 1's produce none of their own, they HAVE to have it injected. Over time, the body gets more and more sluggish at processing the naturally produced stuff, so then it's time to start injecting.
Feel free to correct me if I am wrong!
Tina
Tina has hit the nail on the head. For some of us T2s, weight and diet are the major factors in making us insulin resistant. Taking action to improve those, with or without metformin, can be enough to help the body use its own insulin effectively. That's what has happened to me. Injecting insulin would probably kill me!
There is no such thing as a dumb question because they are asked by intellegent people!
Insulin is given to type 2s when everything else has been tried. We do produce a little of our own insulin, but many of us have insulin resistance, so we get given things like metformin. As diabetes is progressive when the pancreas starts to get lazy things like gliclizide are added. In the end when we have the maximum medication we can insulin is added.
Hope that helps.
Insulin is given to type 2s when everything else has been tried. We do produce a little of our own insulin, but many of us have insulin resistance, so we get given things like metformin. As diabetes is progressive when the pancreas starts to get lazy things like gliclizide are added. In the end when we have the maximum medication we can insulin is added.
Hope that helps.
Copepod
Much missed Moderator
- Relationship to Diabetes
- Type 1
Basically, ALL people with type 1 diabetes need insulin from the beginning, while people with type 2 diabetes MAY need insulin at some stage of their progress with the condition - they may need it early, late or never, depending on how their bodies respond to other methods of control, typically diet and exercise alone initially, perhap adding oral medication / tablets later (perhaps swapping and / or adding tablets), perhaps adding injectable medication later, perhaps adding insulin after that.
DeusXM
Well-Known Member
- Relationship to Diabetes
- Type 1
My understanding is that the issue with most (but not all) T2s is in fact, insulin resistance.
People with insulin resistance usually OVER-produce insulin. And this is a problem because insulin can actually be a pretty harmful hormone. Many of the complications of diabetes are actually caused by too much circulating insulin rather than too much circulating blood sugar.
In the first instance, insulin blocks fat metabolism and promotes fat storage. If we accept that those with insulin resistance overproduce insulin, then clearly, the weight gain associated with T2 is likely to in fact be a symptom, rather than a cause of the condition.
Second, insulin plays a role in cholesterol synthesis in your liver. The more insulin you have, the more LDL cholesterol your liver produces.
I think insulin also causes inflammation of the cardiovascular system as well, which leads to hypertension and other fun problems.
Therefore if you have a T2 who is insulin resistant and producing a lot of insulin, clearly it would be insane to add more insulin to the mix. It's like pouring petrol on a fire and is also unlikely to actually really tackle the issue of high blood sugar as you still have the underlying issue that the insulin is not being used efficiently enough to regulate blood sugar.
It makes much more sense in the first instance to tackle the issue of insulin resistance and see if it's possible to achieve both normal insulin levels AND normal blood sugars in a T2.
There do, however, also seem to be T2s who aren't insulin resistant but simply for some reason or another don't produce enough insulin. These people probably should be put on insulin rather than medication that forces their pancreas to burn itself out by producing more.
It's also worth noting that the points made about the impact of insulin on your body also apply rather strongly to T1s as well. Because the insulins we use to inject are imperfect, you are likely to inject more insulin cumulatively than your body would produce under normal circumstances - thus leading to the usual suspect complications. That's why everyone should be very cautious about the prevailing wisdom that MDI or the pump allow you to eat whatever you like. While this is true from a blood sugar perspective, it is probably worth thinking about whether there is a benefit in finding ways to safely reduce your insulin intake so you still have normal blood sugars but don't have the excess 'waste' that causes problems.
People with insulin resistance usually OVER-produce insulin. And this is a problem because insulin can actually be a pretty harmful hormone. Many of the complications of diabetes are actually caused by too much circulating insulin rather than too much circulating blood sugar.
In the first instance, insulin blocks fat metabolism and promotes fat storage. If we accept that those with insulin resistance overproduce insulin, then clearly, the weight gain associated with T2 is likely to in fact be a symptom, rather than a cause of the condition.
Second, insulin plays a role in cholesterol synthesis in your liver. The more insulin you have, the more LDL cholesterol your liver produces.
I think insulin also causes inflammation of the cardiovascular system as well, which leads to hypertension and other fun problems.
Therefore if you have a T2 who is insulin resistant and producing a lot of insulin, clearly it would be insane to add more insulin to the mix. It's like pouring petrol on a fire and is also unlikely to actually really tackle the issue of high blood sugar as you still have the underlying issue that the insulin is not being used efficiently enough to regulate blood sugar.
It makes much more sense in the first instance to tackle the issue of insulin resistance and see if it's possible to achieve both normal insulin levels AND normal blood sugars in a T2.
There do, however, also seem to be T2s who aren't insulin resistant but simply for some reason or another don't produce enough insulin. These people probably should be put on insulin rather than medication that forces their pancreas to burn itself out by producing more.
It's also worth noting that the points made about the impact of insulin on your body also apply rather strongly to T1s as well. Because the insulins we use to inject are imperfect, you are likely to inject more insulin cumulatively than your body would produce under normal circumstances - thus leading to the usual suspect complications. That's why everyone should be very cautious about the prevailing wisdom that MDI or the pump allow you to eat whatever you like. While this is true from a blood sugar perspective, it is probably worth thinking about whether there is a benefit in finding ways to safely reduce your insulin intake so you still have normal blood sugars but don't have the excess 'waste' that causes problems.
ukjohn
Much Missed Member
- Relationship to Diabetes
- Type 2
Just to throw a spanner in the works on some of the theories. I was rushed into hospital in a coma, I was diagnosed type 2 and put on a sliding scale of insulin. When stabilised, I was put on Novomix, then 3 days before discharged the consultant put me on MDI of Novorapid and Levemir, so I have been on insulin since first day of diagnoses.
Redkite
Well-Known Member
- Relationship to Diabetes
- Parent of person with diabetes
To add to what DeusXM said, the increased risk of cardiovascular disease from having high levels of circulating insulin applies to EVERYONE, not just people with diabetes. The unhealthy western diet based on vast amounts of refined carbs, together with sedentary lifestyles, means most people in society have higher levels of circulating insulin than is optimal!
mum2westiesGill
Well-Known Member
- Relationship to Diabetes
- Type 1
I know a type 2 person who takes metformin 500mg 2 tabs twice daily then humulin kwik pen 50 units at night time
Copepod
Much missed Moderator
- Relationship to Diabetes
- Type 1
I think I covered that scenario in #8? Anyway, important thing is that each person gets the treatment that's right for them.
Casper
Well-Known Member
- Relationship to Diabetes
- Type 1
As an aside, lovely to hear from you John!
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