Type 2 diabetic here. My doctor admits I am “well-controlled” with oral medication, diet, etc.
Nevertheless, he keeps pushing for me to start on insulin. Why? Do doctors get kick-backs for getting someone onto insulin?
1 Like
Possibly. There are many different guidelines out there that define “well-controlled” differently. Having a lower A1c will lower the probability of developing complications. He may simply be trying to help prevent you from developing those. It’s hard to say without knowing your A1c.
I personally believe that many doctors are content with their patients obtaining A1cs that are still way too high and do put them at risk for complications.
3 Likes
He’s not one of those. He wants A1C to be very low. I’m making that target. He is just pushing insulin. He keeps telling me that all type-2 diabetics end up on insulin, eventually.
I know that’s ■■■■■■■■, but I haven’t yet had the heart to pull out the primary research literature to contradict him. I’m a medical researcher in neuroscience, so I have had to become familiar with diabetes and metabolic syndrome, since they contribute to neurodegenerative disorders.
3 Likes
For some folks, going on insulin early to ‘get numbers in order’ helps establish a better baseline and has been shown to produce better long-term results. Unfortunately, for others, adding injected insulin only helps to speed up the cascade to greater insulin resistance.
I think you should ask for additional testing – to identify how much of your problem is due to insulin resistance, vs. reduced insulin production/availability. Do a fasting and post-prandial c-peptide and insulin assay, for example. If your insulin production is high, as it is for many Type 2’s, you’ll want to consider ways to reduce the amount of insulin in your system (like a low-carb or very low-carb diet) rather than just supplying more. If, however, you have very low insulin levels, you might consider other options.
4 Likes
I doubt that your doctor is promoting insulin use for his economic benefit. In general, doctors resist placing a patient on insulin since it increases their workload. It requires some basic insulin education at least to the extent that the patient needs to understand that insulin is a powerful tool and it requires respect.
I agree with @Thas’s suggestion to get more testing so that you and your doctor are better informed about what’s going on with your metabolism. I also agree that if your metabolism is already producing plenty of insulin but your blood glucose runs high due to insulin resistance, then experimenting with a low carb way of eating might help.
4 Likes
Diabetes is a progressive disease. There is no guarantee that you will be able to stay off of insulin. If you were exercising like a madman to help control your D, all it would take to change the equation is an injury that kept you from exercising for a while.
Prepare your mind for the eventuality. As Yogi Berra has said:
Baseball is 90% mental and the other half is physical.
1 Like
Ya Gotta love Yogi
2 Likes