To go on insulin or not to go on insulin, that is the question

My DX is fairly recent, only about half a year. I have been trying to get it under control, but that has proven problematic. I started one med and changed my diet. that helped some and got my sugars down to the 150’s. My DR wants me to get my number lower, so he added a second med. that med made me very ill. I was sick the entire time I was taking it. Now, I’m off that med, but my numbers are back up ti the 140’s and 150’s. I don’t have health ins. so the other meds are two expensive. So, my doctor is recomending either going on insulin, or going on a vegan diet. I do not think that I can cut it on a vegan diet, but I don’t want to go on insulin either.

I would like to know what your experiances have been. What would you do? I feel stuck. I don't know what direction to go in. Everyone around me "knows what I should do", but none of them have diabetes. So what do you think?

What your doctor should be recommending, in my opinion, is a test to determine if you really are a Type 2, and not a LADA (or Type 1.5). For these folks, orals may work to an extent, in the beginning, but quickly lose their luster because they are enduring a slow onset of an autoimmune attack on their pancreases. Man, I am glad your doctor is open to other forms of dieting… But he should keep the entire picture in perspective, too. lol For dieting, I would recommend a low carbohydrate diet, personally… It doesn’t have to be as low as Dr. Bernstein or Atkins, but low enough to get you good numbers, and good control. Use your meter to gauge how carbs spike you.

Also, insulin is not a failure. Insulin can be more or less successfully managed every day, and even more so, on a low carbohydrate diet. This allows you to dose for small doses of carbohydrates, and small numbers equals small errors. It’s NOT that bad. Your lancet pricking your fingers hurts more than some of the needles they have these days! :slight_smile: They even have pens that don’t look like needles, at all, so you don’t have to freak out as much about it. :slight_smile: Also, it is better to have good control, and be healthy… than to suffer under the wrong treatment.

Wow! Thanks that really helps! It has felt like a failure. I thought that, if I work really hard at this it will be ok. It has been very discouraging to keep makeing changes but not seeing the results I want;)

About insulin. (All my opinion)

First look at what you can be doing better. Do you have high triglycerides? Can you make dietary changes (lower carbs to lower weight, BP and triglycerides?) Do you have high insulin levels in the first place?
Be really honest in what you do - do you eat things that should be off limits for any diabetic - T2 or T1? Cut them out if you do. Do you walk or have other activities?

I do not have the antibodies for T1 but the genetics for it + other autoimmune diseases associated with it. Thus I’m considered T2 with normal BP, weight and triglycerides. I tried metformin - mixed reviews on that but in small doses it did work somewhat. Going gluten free helped my glucose control (was later diagnosed with Celiac)

Switched to Levemir (a long acting insulin) in April of this year and it’s the only thing I take. I have a normal fasting but tend to spike when I eat. I take 2 units of Levemir in the am and two in the afternoon before dinner (not at night since my fasting is fine). This system works for me, it allows me to eat better but it doesn’t allow me to eat a big meal or a lot of carbs. My body took to it very quickly (meaning I felt so much better on it right away).

So there are many factors to consider when you think of going on insulin.

For my situation it was the best choice. For someone else it may not be the first option to consider.

I use a pen and it’s no big deal on sticking myself - BEYOND easy and I HATE finger sticks… Negative on the pens - expensive.

Hi. I’m very passionate about this topic because I too was really struggling before I got put on insulin. Not I’m on two diffrent insulins ones a twenty four hour and the other covers food. My blood sugar is completly under control now I mean my numbers are honestly perfect! I was in the 200 300 range! I thought nothing would help until insulin. Also I feel sooooo much better on insulin! I have my energey back! Its been a God send. Truthfully its painless! Its just like brushing my teeth now its that easy. I use a insulin pen and a syringe. I understand its scarey at first but don’t be afraid! The benifits well outweigh the alternative.I’m so greatful I’m on insulin now I think once you get your dose right you also won’t regret the choice of insulin. It will take some time to find your correct dose but don’t give up! Now that I have my dose my numbers are that of a person without diabetes! Ill mention again how much better you will feel! I’m glad my doctor choose insulin for me. Id give it a try if I were you! I think you will be plesantly suprised at your results on insulin!

Try a low carb diet: fish, meats, fat, olive oil, broccoli, cauliflower, spinach, cabbage, peppers, egg plant. See if enough of your pancreas is still alive to get your BG into th 75 to 110 range. If not then you need insulin.

Interesting that your doctor suggested a vegan diet as an alternative because vegan diets are typically high carb.

Using insulin, if you need it, is fine. The goal is to get your BG under control by whatever means available.

Lowering carbs is another option worth trying. Check out Basically, you want to avoid grains (bread, pasta, crackers, cereal, rice, corn), beans, starchy vegetables (potatoes, peas), fruit & juice. Milk, because of the lactose, sends many people high, Most vegetables are low carb.

I am actually a vegan and I was already one when I was Dx this year. But I do agree with the others - going on a vegan diet isnt’ going to change your numbers. It is WHAT you eat and how MUCH that matters. Unless your dr. is wanting you to eat all greens and veggies, it won’t really matter unless what you are eating is no sugar and low carbs. Meat has no carbs and neither does cheese. Just wondering what your doctors reasoning is for wanting you to go that way? I could understand if maybe he thought you were eating too much saturated fat - than a more vegan diet would help for losing weight because it is low in fat. But make a difference in your numbers. No not really that I can see. A vegan diabetic diet means really almost no bread, rice, potatoes, pasta - these are vegan diet staples and high carb foods.

What are the meds you are taking? If he keeps increasing the dosage and it is not working and you are keeping a low carb diet (that is key too - you have to do the diet also) than your body might need insulin. I have learned on here that just because you need to move on to insulin that doesn’t mean you failed. I am sure I will be nervous if it ever comes to that for me one day too but I would rather do that than risk any of the other side effects or complications.

I would demand more tests. You need the c-peptide and some other tests that might test you for Type 1. But you can still end up being a Type 2 and need insulin.

Is there anything you are eating now that might be causing your high number? What is your diet like now?


Treat yourself to a treat! Insulin saves your pancreas’ too hard work. It’s not doing the job. Vegan means more carbs.

Learn about how to use insulin: Walsh, Using Insulin, and or Scheiner’s think Like a Pancreas. Learn about basal doses - round the clock. Learn about insulin to carb ratios for eating. You’ll be in control. Your numbers will thank you.
Oh, and all those other tests? They don’t change your major treatment, which is insulin.

Let me start by saying that I am type 2 DX in 2007 and was put on Byetta for 18 months I did well at times but the effectiveness wore off so I was jput on MDI Lantus and Novolog and a glimipride and I did well for one year. My ENDO thought at that time that Victoza, Novolog and glimipride would be a better fit I have been doing this since July 21, 2010. Over the 3 years I have lost and gained weight but I have been able to keep my A1C in the 5’s - most recent 5.5, 5.7, 5.9 and 5.5. Thru all of this the most consistant thing is that I do NO CARB/very Low carb dieting.
I recently had gastritius and changed my diet a little add some complex carbs back in and I think I am gong to stay this way for a while. I feel better have more energy.
This disease is all about finding what works for you. You need to keep track of what affects you blood sugars the most and stay away from those. Add something new once a week or twice a week that helps with varity so that you don’t get boored eating the same thing all the time.
Give yourself a free meal 2 or 3 times a month you need that so that you don’t think you are depriving yourself.

I am still not sure why you wouldn’t want to try some insulin? There was a study referenced in DF a year or two ago that explained that T2 had better results w/ insulin than without. I have read posts (on the other message board I hung out at until recently…:-)) from people struggling to control stuff on various pills that seemed like a little bit (or maybe a lot?) of insulin might have fixed things very easily? It is definitely a ‘hard’ drug in that it can kill you or at least completely mess you up but for processing carbohydrates, it’s pretty hard to beat?

I believe the trend in Canada is to start one on insulin as soon as possible …my experience from listening to folks with type 2 diabetes and getting this from CDE’s as well .

Keep repeating - Insulin is not a failure. Insulin is not a failure. Insulin is not a failure.

plus, if you listen to “Gimme Shelter” REALLY loud, syringes = fun! :slight_smile: