Type 2 Diabetes TOO is Serious

LOL, thanks Brian! You didn't "accept" insulin, you siezed it by the vials! Literally! There are many T2 heroes here at Tu and other websites. I made ill-informed comments about low-carb and maybe, in that context, T2 back when I joined up and still recall you, the dearly departed DWQ, BadMoon, etc. schooling me, I tried low-carb (not T2, *thankfully!*) and, much to my surprise, it worked very well, even running so I added eating less to my arsenal and it's been useful in continuously working to improve. I know jack $#!+ about T2 but try to be very respectful of the people dealing with its challenges because the consequences are pretty similar and we need all the boots we can put on the ground to fight insurance companies, the government and the medical industry conspiracy against us.

Sarah, as a T2 who has had extremely tight control for several years, I want to tell you it has been a nightmare despite that. I have had much worse issues in that time than a lot of long-time T1s, including autonomic neuropathy, regular neuropathy (can't feel anything up to my knees), amyotrophic neuropathy (couldn't walk for most of a year, have only been able to shuffle since then), lost 1-1/3 toes and had Charcot. All this even though my A1C has not been over 5.5, I eat practically no carb whatsoever, and have to exist on fewer than 1200 calories a day or I gain weight. In the past 6 months I've gained 20 lbs on 900 calories a day. Some of that is because it's very hard to exercise when you don't walk well, but some is just that my body seems to make fat out of air. There is nothing further about my lifestyle I can change. There is no medication I can take (metformin did not work for me). Every day is like a total crapshoot. No, I don't have lows and I've never been really high, but the effects have been so bad already, I might as well have been. I don't get to see an endo because my A1Cs are too low, I just get to fumble through every day with no tools whatsoever except my test strips and a stubborn determination, and people looking down their noses with comments about "lifestyle changes." Like some other T2s have said, I NEVER eat anything that will raise my blood sugar. I think all of us see other people and think we're worse off than they are. The unfortunate situation with diabetes is that we're all screwed to some degree. Just wanted to let you know it's not that easy as a T2, either.

I truly appreciate what Manny has said. As a long term T2 I have ridden that downward slide. I once beat myself up over my disease because I was not doing all I could to help myself but I no longer do. I no longer feel that I am failing now I have a winning strategy and it includes insulin. Actually these days it includes an insulin pump.

What Sarah has said about insulin resistance and beta cell function is just plain wrong. Insulin resistance is very prevalent in most T2s. To say that IR is aggravated by the extra weight that some T2s carry is a true statement but to say that all a T2 has to do is loose weight is simplistic and narrow-minded, I and every other T2 out there wish it was just that easy. On the subject of Beta cell destruction all I have to say is that if mine are only asleep could someone please tell me how to wake them up.

Thank you Pancreaswanted for your understanding. Yours is the spirit of understanding that makes this a great place.

By an error in circumstances (being misdiagnosed as type 2 due to my age) I got to walk for 15 months in type 2 shoes. I was told to test 2-4 times a day I believe. In my ignorance I told the dietician they sent me to that "I haven't eaten sugar for 13 years, and I am a vegetarian; I eat very healthy". She never asked me if I ate a lot of carbs, which of course as a vegetarian I did, lots of rice and pasta, bread and cereal. I'd have to look up when I tested to know if I saw the highs after those dinners. I was put on oral meds and sent on my way. I figured, "no biggie, I'll just pop some pills and be good to go". I got, that is, typical type 2 deficient care.

I gained some weight on insulin and at my age it has been very hard to lose. I'm doing so by lowering carbs and thus insulin. I don't use insulin as a tool to eat treats, but as a non-exerciser it gets me by. The very thought of insulin resistance terrifies me. What a catch 22 - it's easier to manage if you lose weight but IR makes it maddeningly hard to do so. I jump in with strong cautions for Type 1's who have been told they can "eat whatever they want and bolus for it". But it's really myself I'm afraid for. I don't want to gain weight and I don't want Insulin Resistance. To me, IR is the boogeyman and it's the chief characteristic of Type 2! "Not serious?" Then when you add in the stigma that is second only to mental illness in this country and the poor doctoring which includes both negligent care and holding out insulin as "punishment" if you are "bad boys and girls" you have a recipe for disaster.

Thanks Zoe. I am struggling with insulin resistance, non-weight loss despite being asked by a dietitian if I was hungry on reading my meals chart, and added metformin which does not seem to be having quite the effect I wanted. I could sit down and cry when people say all T2s have to do is to lose weight!

"Most Type 2's have metabolic syndrome, which includes high blood pressure, cholesterol, etc...all which can be managed and controlled if their lifesytle changes, i.e., lose weight, exercise, eat better, etc...these are just facts, not judgments."

Please show some scientific/experimental research backing up all of these alleged facts of yours.

"In time, the patient who could maintain normal blood glucose with diet and exercise alone may discover that he or she needs to add oral diabetes medications — or perhaps even insulin injections — to keep blood glucose in a healthy range."

Most T2s have an underlying metabolic condition, and it is possible that the weight gain is a symptom of the disorder and not the cause. Exercise and eating will improve their condition, and in many cases get their BG under control for some duration of time. However, that doesn't mean that the underlying metabolic condition goes away. There are many T2 diabetics who will still need medicine and eventually insulin even if they change their diet and exercise regularly.

Additionally, the midsection weight gain in many T2s could very well have been the result of the metabolic issues and not the cause. Yes, that midsection weight gain leads to some insulin resistance, but there is insulin resistance that is independent of it. There are many many obese people who aren't diabetic and never become diabetic because they don't have the underlying metabolic problem.

Tom Hanks is 57, and as far as I can tell there are a handful of photos showing him maybe 20 lbs overweight in the past few years. He apparently has never been obese.

Finally, I have to ask why you feel that all of the symptoms of T2 are completely avoidable and the fault of the diabetic while the symptoms of T1 are beyond your control? T1 can be very well controlled with a very regimented/controlled low carb diet, exercise, regular testing, and insulin at the correct levels? Easier said than done of course. So how would you feel if someone blamed you for any symptoms of T1 diabetes that you contract?

Nobody is getting defensive about your claim that T2s have weight issues. They're defensive because you are blaming them for their disease while claiming that their problems would all be solved if they ate less and exercised. Additionally, DG's lifestyle (and that of others) counters your claims that they could cure themselves.

As a 30 year plus type 2 I have my comments as follows;

1. This is not a diatribe about T1 versus T2. Each have their own nasty issues.

2. T2 is a tough version due to a lot of other factors besides pancreas islet issues. Flow control of glucose in the blood system and transfer to skeletal muscles is not properly understood and skipped over. This is a matter of multi-organ interaction - liver, pancreas, intestines, kidneys and thyroid - an orchestra of players - not just your insulin is now down and this is your fault.

3. Not withstanding extensive research work on skeletal muscles and insulin receptors, some folks have done work on how insulin receptors downgrade their shape on muscle cell wall to reduce glucose transfer when skeletal muscles load up fully with glucose. Insulin resistance is understood but its actual operation in my mind is not properly understood. My impression and read is that glucose regulation of the blood system is done by storage of glucose in the skeletal muscles upon order of the hormone insulin - a storage hormone used in a distributed glucose storage system of the skeletal muscles of the human body. As long as room to store more glucose, regulation should continue with help of insulin. My impression is that as muscles fill up with glucose, insulin resistance soars and the excess glucose stays and backs up in the blood system.

Glucose sent to skeletal muscles stays there till burned off by exercise - hence sufficient exercise is critical.

4. Yes, a lot of good work has been done on T1 , pancreas and auto immune diseases knocking off pancreas islets.

5. There is work out there suggesting that T2 islets are not dead but after a long time bathed in excess glucose and glucose products, pancreas islets go into some non producing state. Studies done in Italy on Cadavers of non diabetics and T2 diabetics have had curious findings that under examination - no major differences could be seen between the two types. So they put the T2 islets in a normal ( non diabetic) glucose levels and those islets started making insulin.

6. Similar results have been seen in bariatric surgery and extreme diets whereby after surgery and short delays after starting the diet, liver and pancreas return back to work. Interestingly both groups rely on starting diets of 600 calories. Results checked on MRI spectography noninvasively suggest that fat inside liver and pancreas islets is getting re-absorbed. This was early and well before any other body fat gone. Suggestion seems that getting excess glucose and oxidation products out of blood system by aggressive drop in glucose generation facilitates this improvement.

7. Others have reported getting there islets back working and the suggestion I saw was that aggressive removal of excess glucose presence facilitates islet recovery if that is possible.

8. The statement that T2 is ones own fault is ignorant, nasty and useless comment. As if any T2 was responsible for the massive changes in food stuffs, refined foods and steps take to save worlds people from starvation by genetic improvement in yields and stopping pests and massive automation to grow more grains, corn, rice et all. On top of that as food qualities and availability were ramping through the roof, energy needs and burn by current generation has dropped dramatically due to all the couch potato tools, cars, computers, video games, lap tops et all. That's a personnel fault is ludicrous clap trap.

The human body and its ancient form never needed to regulate against excess energy intake consumption as that was hard to cause that excess except for a few special cases. That said, today this ancient body frame needs careful external monitoring and control to prevent overloading the system. We do not do what the ancient north american Indians would do at a pot latch and that was to throw up the excess. Prior to 1970's we probably did not have to monitor our intake or add much exercise that much.

On another note sugars from sugar cane and sugarbeets was not as widely available everywhere prior to the 1970s. After that thanks to modern science
we now convert corn starch to high fructose sugar on pennies on the ton providing all sorts of cheap sugars everywhere.

That all said, now today carefully controlling one's diet and getting proper sufficient exercise is crucial to controlling/preventing T2 and along with meds for medical body organ degeneration of a T2

DG-thank you sooo much! I just started insulin today and feel like such a failure! It doesn't help either that my 95 year old mother is still alive and reminds me that if I was not "such a pig" I would not have diabetes to begin with and it is all my fault that I do have it. Never mind that both her brothers were diabetic, my brother and sister are also diabetic as is my niece and just found out one of my sons is insulin resistant and the dr told him he will probably develop diabetes...unless he exercises and eats right and loses weight. He too is a bit discouraged as he is a Paramedic and in great shape and eats correctly and is not overweight! My endo said it is a genetic type and not to worry....but I still feel like a terrible failure.

Oh my, Mikki, I'm so sorry about the judgments you have been subjected to. Our family have so much emotional power over us, cancelling out logic, knowledge and expertise. You are NOT a failure. You didn't deserve getting Type 2 diabetes, nobody does. Genetics are so powerful, but so is stigma. Insulin is a good treatment for Diabetes, whichever type. Good luck with your treatment and be gentle with yourself!

"Many of us T2s were far from obese at dx. I sometimes wish I was insulin-dependent so I could bolus for the occasional piece of cake or baked potato or brown rice or banana or pasta salad. But I can't cover the spikes those items and many others would give me. So I don't eat them. Ever."

According to my view of diabetes and health, that makes you insulin dependent, period. Not to stay alive, but to live. Healthy.

If you can not maintain normal BG with your treatment modality, you are not being successful in treating the disease. If it puts major restrictions on your lifestyle (within reason, of course), you are not being treated properly.

I'm T2, now 15 years. Never had an A1c under 8% until recently. I'd test before meals, and 3 hours after -- usually 7 times a day (meals, and 1x before bed). If things were bad, all I could do was get on the Lifecycle, go for a vigorous walk, etc. Like you, I pretty much had to avoid any high glycemic food, or resign myself to feeling like crap for hours, and high BG that would come slowly down.

Went off the wagon for a year and a half, ignoring my diabetes completely. I was depressed. To make matters worse, I overate of course. Landed in the ER crashing 6/2 a few months ago BG >400. That was my come to Jesus moment.

My GP wanted to get me back in the saddle with pills, diet, exercise. I told him no -- I'm going on insulin. Full bore. Basal and bolus. I'm going to achieve tighter than tight control. A1c goal <5.5. So I started MDI with Lantus and Humalog. After a month, I learned all about pumps and CGMs. I saw my new endo, after extensive research, and asked to be prescribed Omnipod and Dexcom G4. She was my biggest supporter, and turned the whole thing around in record time. In one week I was monitoring my BG continuously. Two weeks after that I was pumping insulin. These technologies have, literally, changed my life!! I am achieving tight control -- latest A1c 6.3, down from 11% that awful day in the ER, still not as tight as my goal, but I know now it's totally achievable.

Best of all, I can have caked on occasion, like at a birthday party. The Omnipod is so discreet, no one has any idea I'm giving myself some juice. The other day I splurged from my usual low carb, healthy lunch, and went all out at Panda Express.

Through this, and anything I eat, I keep myself under 140 at all times, including postprandial, stay 80-100 the rest of the time. I've had a few hypos, but nothing bad.

In other words, my T2 diabetes, with these technologies/treatment, is mostly just annoying inconvenience, and not very much these days. I'm liberated from all those restrictions and demands treating T2 with diet/exercise/meds incurs.

So, I am a vociferous advocate of treating T2 with insulin from the moment of DX. Any treatment, devices, etc. should be available to any T2 that wants to put the effort in to using them. Pumps aren't for everyone -- they're technically complex. However, as TuD demonstrates, a wide range of people can handle these tools, and it makes diabetes so much easier to live with.

If you lost a leg, would you accept a prosthesis that stopped at the ankle and didn't include a foot? Hey, you can get around! So it's hard, big deal!

Of course not. No one would accept being partially healed/treated/restored, when you can be made whole. Why is diabetes different? Why do we accept, "A1c 7% is OK"? The risk of winding up with vision issues, amputations, dialysis later in life at that level is still pretty significant.

Why aren't T2's given the same opportunity to treat their condition so they can achieve as normal a life, and health, as anyone else?

Only diabetes seems to be a condition where we say, "well we'll keep you alive and sick", and crap on quality of life.

Elizabeth, consider getting on an insulin pump and CGM. It will change your life.

f T1 had nothing in common with T2, then late onset T1 diabetics (LADA) wouldn't have been diagnosed as T2s for decades prior to the development and implementation of the antibody testing in adults. Even today many T1s are misdiagnosed as T2s. Both diseases involve the body's inability to regulate blood glucose, and many of the medications as well as tools (meters, pumps) are used with both.

Hi Mikki,

Zoe's post above really hits the mark. I wish you great success with the insulin. It and greatly reducing carbs has completely turned things around for me. Isn't this place great for info and motivation?

Best of luck to you!!!

Dave, your post makes a lot of sense. I wonder if it will soon be time for me to do the same for all the same reasons.

Like most people with LADA, I was initially misdiagnosed as T2. Accordingly, although T1, there was a period of time when I thought I was T2. I never have forgotten what I felt during that time – paralyzing shame, anger with myself, failure, and embarrassment – all because of the bias that had been imposed on the former non-diabetic ignorant me that somehow I was wholly responsible for causing my diabetes. This baseless self inflicted stigma also led to what I am ashamed to admit was a modicum of relief when I found out I was T1. Huh?! I still had diabetes, but in my grossly misinformed mind I was no longer guilty of what I had been convinced was my fault. Fortunately, a lot of good information from resources like the TuD community, everything I could find from Kelly Close, a brilliant CDE, and countless journals and white papers, has successfully eradicated the stupid that was crowding my brain. I also know from those months as a “Pseudo T2”,that managing BG with diet alone is one of the most torturous feats known to (wo)man. I think about it anytime I to do a correction bolus. How fortunate I am to have this pump stuck to me and I can just adjust the problem. When I was a Pseudo T2 I would flip out over the slightest BG spike because I didn’t have the insulin extinguisher to put out those fires. So what is my point to my rambling post? 1. We need to be vocal in tearing down the stigma associated with T2 - in addition to making people feel unjustly responsible for the onset of their Diabetes, it may very well keep people from seeking diagnosis and treatment because of unwarranted shame, 2. Insulin for treatment of T2 is not failure - in fact it is smart - helps those remaining beta cells do their work and gives the T2 patient a valuable addition to his or her diabetes management arsenal.

Thank you, Dave. I have found many substitute pleasures and after 7 years of lo-carbing, I don't really feel the need for potatoes and pasta and bananas. What's normal, after all? Sara's tone was too judgmental and narrow-minded. T2 is very complex......

PS. I came back to my dance career after 3 knee surgeries between the ages of 16 and 46. Then I had a total knee replacement which only made my life worse...LIFE is complex.....

I think that weight is a symptom.

Linda,i am of the opinion that hanks gaining and losing weight for movie roles played a role in his case of diabetes.

Zoe,i am coming up on my 1st diaversarry in December and I don't use insulin yet but I have been reading the book called think like a pancreas and it has eased my mind about taking insulin if I ever get to that point.

Thanks DG! I am very lucky to have a son who is a trained chef and he has really stepped up to work with the diabetes...I have already dropped about 50 pounds which helps a lot and I would so love to be able to get out there and try walking again..... Problem is there are a lot of other health issues and a couple make that very difficult if not impossible. I am still working at being able to walk through one store without trouble. People are so judgmental about T2 diabetes. I am lucky to have finely gotten a good endo to help me with this...