Metformin or Insulin?

So, I am a 38 year old, 9 month old diabetic with T2. I am still learning the ropes… Today I received my Diabetes Forecast and there is a letter in “Mail Call” from a person who says he too is a T2 and was immediately put on insulin versus a pill when he was diagnosed. He refers to an article from the previous month’s issue about “Embracing Insulin”.

This is the n’th number of times I have come across an article like this which suggests that diabetics who are put on insulin shortly after their diagnosis do much better managing their diabetes in the long run.

I had suggested to my wife that I should ask my doctor about perhaps switching to insulin, and my wife actually suggested that I just want to be “shooting up”! I was galled by her response. She also thinks that I have become a hypochondriac since my diagnosis. Then she suggested that there are plenty of diabetics out there who only manage their sugar levels through diet. I wanted to ask her to produce one.

I got mad! I asked her if she honestly thinks that I want this disease, or if she thinks that I like sticking sharp pointy things in my skin three times a day, every day. Then I told her that I hate freaking out when I forget to take my pill or leave my meter behind. I just want to live, and I feel like she thinks this is no big deal.

It is your doctor who has to decide what is best to control your diabetes.Metformin,exercise & diet if do not normalise your Hb A1c,then your doctor has other options.Some prescribe insulin with metformin but you are not in the status to need only insulin to control your diabetes.The good thing is you do not resist the idea of shots as many of type2 diabetics do here( by the way type2 children have to be treated with insulin in addition to metformin…)

I am currently on two forms of insulin treatment Levemir (basal) which is a long acting, and Novolog with my meals (bolus).
I also am taking Glucophage XR (1500 mg) at my evening meal. Working with my Dr every three months we look at the results and he indicates I may trying eliminating the Glucophage at the next appointment.
I orginally was strictly on oral meds, Amaryl then Actos with the Glucophage XR but they really never brought the numbers down and I felt like I couldn’t eat anything I liked, then came the insulin. First it was a Novolog 70/30 mix that worked better but had way to many lows, we took away the Actos things got better and my A1C came down below 6. After doing some research and reading posts from this site I talked with him about a long term (Basal) insulin and that’s how we tried the Levemir and I have to say it has been great one dose in the evening and then the Novolog at meals. I adjust the Novolog dose to match what I’m eating.
Everyones body is different and reacts differently but going on insulin for me has turned out great.
I always test before meals, and while I was getting used to new doses it would be after eating as well to see how different doses react. it’s always a work in progress I now even look forward to my appointments.

Obviously, your wife was not the one to talk to. I am t2 on insulin and metformin and it is working great for me . a little bit of obsession with the disorder is normal. I like a book called “Type 2 The first Year” by Gretchen Becker. It covers everything from emotion to medication and diet. It is a good reference for meds.
good luck

Craig, you are absolutely justified in asking these questions, and like everyone here, I agree that (a) it’s great that you don’t treat insulin like a “obviously I failed and my doctor is punishing me” treatment and (b) that you are asking questions! I agree with Danny that you should get that book. I think I found it for $6 on amazon for my mother-in-law (I’m a type 1).

There are two other things to remember here. First of all, you are going to re-evaluate everything in your health under this new microscope of diabetes. That’s normal and reasonable. If it causes you to be a bit of a hypochondriac, either it’s understandable or you’ve taken it to the point where counseling would be helpful. Either way, it would be great if she were more patient with you.

But secondly, this may be harder for her than she’s letting on. Maybe she isn’t dealing well with how it has changed you. Does your hard look at your lifestyle implicitly point a finger at how the two of you together have been feeding your family, approaching exercise, monitoring your health? Is she feeling guilt? Fear of losing you? Puzzled at the changes it’s brought about in your personality? She may really be resenting the entrance of diabetes into your life together. I hate that with everything we deal with we have to also consider how our health and attitude affect others, but doing so has helped my relationship with my husband and family.

Best of luck, Craig. Talk to your doctor about your insulin options if you’re really interested.


I was diagnosed in July of 2007 and my doctor immediately put me on insulin. My A1c at that time was 12.7. He put me on Humalog Mix 75/25 12 units per day. Really the shot did not hurt a bit, so don’t let that scare you off. I HATE needles, but had no problem giving myself that shot. I asked him at the time if I would ever be able to get off of the insulin and he said something like, “we’ll see.”

Approx. 10 months later, in May of this year my A1c had dropped to 5.69 and I again asked him if I could get off the insulin. (My biggest issue was having to eat within 15 minutes of having the shot, I have a breakfast meeting in town every week (15 minute drive plus the time to get my breakfast cooked) that was a pain to plan around). He told me to TRY metformin and see what it did. Since May I have been taking 2 metformin ER 500 mg tablets a day, one morning one evening, and my blood sugars have been staying right in the range we want them to be (unless I do something stupid like eat too many chips and salsa).

I really believe that my doctors aggressiveness in giving me insulin immediately was the best thing that could have been done in my case. Every case is different. I would definitely discuss this with your doctor.


Yes. There is a lot of evidence that using insulin early in Type 2 for even a sort period of time can give your beta cells a major boost and give you much better health long term.

Unfortunately, family doctors who treat most Type 2 diabetes don’t know this because they don’t have the time (or interest) to follow diabetes research.

Your wife really needs to do some research about diabetes and what happens to people who don’t “shoot up” when it is time to . Her attitude is really warped.

Melissa, that was profound. You’ve opened my eyes to another aspect I hadn’t really considered before now.

Yeah, this was why I thought it would be a good idea to at least discuss it with my doctor.

I have seen this book mentioned before, I definitely need to check it out.

You message was very insightful and I think that you hit some points head on. I had not really considered that she might not be dealing with things well, she puts on such a rock steady front.

I also had not considered that this has brought about changes in myself. Upon some introspection, I can see that I am certainly a little more quick to get angry, and I have maybe become a little more selfish, among other things.

I agree with your comment about dealing with everything, and am only now beginning to appreciate how my health and attitude is affecting the other members of my family.

Thank you Melissa