The big one I hear from T-2s is weight gain.
Weight gain is common in T1s too and it gets worse if doses go up. It takes a lot of discipline to keep to a diet and not to ābolusā foe extra carbs.
I think itās misleading to some people.they think things will be easier and thereās a sting int the tail.
Hana
PS the medics here in the Uk are trying to get everyone on to insulin, because it would be easier for them. Things like weight gain can be blamed on the patient.
PPs I have met a grossly obese T2 using U500on a pump! a low carb diet would be just about the only way of improving things for him.
I have lost about 42 pounds on ontrolled carb
Hana, when it comes to sharing oneās opinion with a credible source for diabetes management in humans, the opinion of a veterinarian does not make the grade. Why not the butcher, the baker, the candlestick maker? All have opinions. An internist or a physician would carry more weight, especially an endocrinologist who specialized in treating diabetes.
I had been a T2 for more than 10 years before I chose to switch to insulin. My choice was centered around the side effects I have experienced over the years using oral meds to help manage my diabetes.
BTW, you are fortunate that you can tolerate Metformin. Many diabetics cannot, including myself. I was Rxād Glipizide for many years and had wonderful success with that medication. Six years ago my internist took me off Glipizide, and he steered away from all other sulfonylureas. Increased mortality, pancreatic burnout, and arterial complications are all associated with this class of drugs. Again, I had been taking Glipizide for years. Just lovely!
The bottom line is that one has to weigh the benefit of the oral meds for treating T2 (or T1) against the side effects. Furthermore, there is no way to weigh the immediate benefit against whatever unknown specter looms in the future with regard to the use of oral medications. The Avandia issue should teach us all that there may very well be other serious unpleasant surprises when it comes to long-term use of diabetes-related oral medications.
Itās great that the medical community in the UK are out from under the influence of big pharma enough to be recommending insulin for T2s early in the game. I only wish that were the case here in the U.S. However, instead of assuming that doctors in the UK Rx insulin to T2s early on so as to pass blame for future failed care onto the patient, perhaps you should be more open-minded to other possible motives, such as fewer side-effect-related patient visits with regard to oral medications. Perhaps the motivation is to reduce the long queues one has to endure when needing to see a physician in the UK. That being said, whether a D patient is Rxād oral medications or insulin, no matter what oneās course of treatment, adherence and discipline are required to stay the course.
As I stated in an earlier post, I am pleased to be off all oral medications for diabetes and only wish I had started on insulin years ago. Many T2s would do well to let go the stigma and over-blown fear of injecting insulin.
You of course realize that both a medical doctor and a veterinarian go through the same basic education and it is only the practicum that differs. While I agree that most doctors donāt have much diabetes education, I think both a medical doctor and a veterinarian probably know more about diabetes than the local butcher.
1 Like
Most Type 2ās in the US are cared for by PCPās, who have had, maybe, an hour of diabetes education in their whole medical training. If the docs themselves are afraid of insulin (because they donāt know how to prescribe it or adjust it), what do you expect from the patient?
I once went to a diabetes support group which turned out to be all Type 2, and the misinformation they were passing around was horrifying. The LEADER of the group said āNEVER go on insulin; it will make you gain weight!ā I tried to tell her of my experience, which was that going on insulin took away the terrible hunger, and I lost weight. But she wasnāt having any of it, and I never went back.
Iām glad that I went on insulin after 5 months of absolutely ineffective sufonylureas ā it has allowed me to celebrate my 20th anniversary with diabetes this year, and no complications. And no side-effects from insulin, except the occasional low ā but you can get those with sulfonylureas, too, and the other drugs are too new to know whether they will cause side-effects. And then there are the GI effect with Metformin ā I already have enough bowel problems, and donāt wish to even try Metformin.
But in the final analysis, everyone needs to research and get educated about diabetes for themselves, because weāre all different, and what works for one may not work for another.
Metformin has been around for many years and the only side effect seems to be the digestive issues. If you can tolerate metformin and achieve good control, that would seem to be the best first option. But the other T2 drugs all have undesirable side effects, so insulin would seem to be the best second option IMHO.
I am a T-1, been on insulin for 12years (of course, I have no choice) and I havenāt gained a pound. I do watch what I eat, but I am not on low-carb. I think T-2ās are either afraid of needles ( they really DO NOT hurt) or they think going on insulin is a failure on their part to successfully take care of their D. Actually neither is true. Since T-2 is a progressive disease, it is normal to need insulin after a period of time of using oral meds. I would think that T-2ās would be glad to do anything to keep their BS in normal range and their A1c under 6.5. This can be achieved more easily with the use of insulin.
I have heard of this before. I definitely want to check to see if this is a myth or not. With most of us knowing how individualized diabetes care is I donāt understand why people just believe one thing and hold it as gospel. it may make one person dependent but not another.
Besides, as a Type 2 most of us are dependent on oral meds. People are addicted to cigarettes and alcohol. I am addicted to the internet.
This is so true. I had a discussion with a woman about this and I told her the idea is to be healthy. Insulin will only help your body not struggle so much to do something that doesnāt function properly anymore.
Do you still use byetta? I had to get off of it because it didnāt curb my appetite any more. I use the remaining dosage to drop my sugars if needed but otherwise it is uselessā¦
Hana, itās clear you work very hard at your diabetes, and all power to you for that.
But diabetes does affect each person differently, so the positive outcomes you have experienced may not hold true for another person who follows the same strict regime as you.
The fact that Met+low carb+exercise works for you does not mean that it would work for the next person - and does not mean that the next person has failed or is working less hard. It could just be that for whatever reasons, your pancreas is holding up because you are kind to it. But someone else with a more dodgy pancreas could do exactly the same as you, yet have worse numbers, simply because of their structural disadvantages.
My remark was not intended to disparage veterinarians. I respect them and their profession. However, I donāt consider a veterinarian a credible source when it comes to the treatment of diabetes in humans and what prevents the progression of the disease. Maybe you do, but I donāt. I would consider a butcher with good blood-sugar control and who has been a diabetic for many years a much more credible source than my neighborhood vet.
Iām not suggesting that you are out to get the vets. But many pet owners out there will tell you dogs and cats get diabetes just like us humans (but at higher rates). And most vets are pretty savvy about diabetes and will also tell you that for dogs and cats a low carb diet is the way to go. Probably better advice than you would get from many doctors. Just some food for thought.
BMT2, I feel pretty much the same way as you do. I havenāt done much research into Metformin because I simply couldnāt tolerate it, so I donāt have an opinion regarding its use one way or the other. That being said, ten years ago I would have been praising the benefits of Glipizide. Now I know better and wish I had never taken the drug.
BMD - hear here! There are too many experts out there who have no experience of diabetes except that someone in their family had diabetes - three generations ago!
Yes, bsc, Iām aware that veterinarians have to deal with treating animals with diabetes, so those professionals are more adept with the nature of the disease and its associated complications than the average Joe. However, I disagree with the general concept with which Hana and her vet were in agreement, that is that T2 is not "inevitably progressive."
It is a well-established fact that for some T2s diabetes is progressive, no matter how tight their control of blood sugar. For some diabetes patients, progression comes quickly, and for some it takes many years before complications snowball. Other patients are able to live full, relatively normal lives with little progression of the disease. There of course is no one-size-fits-all prognosis, so clinging to such a bias point of view that Hana is putting forth is neither accurate nor helpful to T2s who are doing a good job of controlling their blood sugar yet are still experiencing progression of the disease.
I do agree with Hana though that a low-carbohydrate diet coupled with exercise are important measures for T2s (and all diabetics for that matter) to follow along with some other course of rxād treatment. For Hana, Metformin has worked well over the years. Goody, goody, gumdrop for her! However, I do not believe that she should knock T2s or the medical professionals who rx insulin for T2 patients eary in the game and claim that they are looking for an easy way to deal with the disease. All of us with diabetes know that there is no easy way.
Exactly, Lila. You get it!
Love your post, Natalie. I respect my PCP for recommending that I see an endo when I developed hypothyroidism in addition to the T2 that I have had for years. My PCP didnāt let ego get in the way of him helping me make a decision that was best for my overall health care. He also wanted my endo to work with me on getting a solid insulin regimen established once I had decided for myself that I wanted to go the insulin route. Iām so glad I followed my PCPās advice, and yes, he is still my PCP. I trust his judgment, and that means a lot to me.
Hi Natalie,
I soooooooooooo agree with you on not only the meds, but the misinformation. In addition to diabetes, I have IBS, and some gluten intolerance. I just canāt take those drugs anymore; and none of my doctors wanted to prescribe insulin to me. I was on metformin for about 1-2 years, before I could not take it anymore, and I started having explosive diarrhea. Then the same dumb *ss doctor wanted to give me metformin again, but with ātime releaseāā¦ Oh, so you want to kill me slowly now? Thatās when I decided to see another of many doctors.
Guys, insulin is NOT all the bad things you may think it is. Yes it is a lot of responsibility, and a lot to learn, but it is totally worth it. The benefits to taking insulin, outweighs the horrible side effects of meds. Plus, I donāt have to worry if I decide to eat a grapefruit, will it interact with my meds, or none of that crap. Yes, insulin is considered meds on paper, however, itās still a hormone, regardlessā¦
As far as weight gainā¦ Insulin is doing exactly what it is supposed to do, whether you inject it, or make it on your own. If you eat more, and need more insulin, you will gain weight. I havenāt lost a sugnificant amount of weight, but I havenāt gained any either; and iāve been on insulin for about two years. We still have to watch what we eat regardlessā¦ And of courseā¦ Exerciseā¦!!!
-Yogi
*
It is sad to see diabetics think of themselves as failure because of taking insulin. I proudly wear my insulin pump!! Insulin is just another tool to control your blood sugars, thatās it!! No one should be ashamed of anything. What you should be ashamed about is, knowing you have diabetes, and doing nothing to take care of yourselfā¦
-Yogi