Would you ever ask to be put on insulin, why?

Type 2
1

I am a type two diabetic.I am a type two diabeticI have been diabetic for 10+ years. I have been on the worst meds and some of the best ones to control sugars. I have lost over 80 lbs now, and although I still carry that carb mid section, I am feeling well. My last A1C was 6.7 — not bad, not good for me. I swim four days a week for 45 minutes and walk for 15 despite the arthritis in my knees. I am down to 80 carbs a day…I take janumet, amaryl for the diabetes and several anti inflammatories for the arthritis. I’m doing as I was told, my my daily numbers don’t prove that. FBS is about 130; dailies can run from 90 - 180…so I am considering asking to be put on insulin to get back in control again.

I have questions, let’s say my doc goes for it, and I gain weight…I will bawl very loudly, because this is the thinnest I’ve been in 30 years. So what do I have to do not to get the “insulin weight”.

Is it true that once you go on insulin, you’re committed, you don’t come off of it?

I am thinking this is the best treatment change for me, if we can get the numbers down, and I get this under control again.

Ideas, thoughts please.

2

In my opinion three EXTREMELY important numbers are blood sugar, blood pressure and cholesterol. Your weight although important, is not yet an issue. I never cared how I got reasonable sugars as long as I wasn’t driving myself (or others) crazy, and my results were predictable based on my actions.

Insulin is a very necessary and natural thing in our bodies and I would strongly advise finding the best Endocrinologist you can to help make the best choice(s) for you regarding your lifestyle in conjunction with where you want your sugars to be. You sound like you are doing very well, and it would appear that you are quite vigilant, which is also necessary and great.

Keep up the good work and try and find a good Endocrinologist before you need one!

Love Always
Anonymous Diabetic

3

Cathy, My ideas/thoughts are why would you want to go on insulin if you are doing so well? When you’re happy with having lost weight?
ok, so now I got to the line that FBS is 130. Are you eating after supper?
The way not to gain weight is to do what you’re doing and keep the basal insulin dose to the lowest that the FBS is 100 - everyday.
Obviously you have your own insulin that’s not working quite to the extent you’d like it to.
I have been on insulin 10 years and no weight gain.
I have been unable to exercise during parts of that time and still no weight gain. Because if one doesn’t exercise, one has to lower the insulin dose further. Do you mind having to hit the math? That’s what it takes. And if you take it after meals, besides the morning and night split of the basal, it takes: Recording exact carbs, exact I:C ratios, tests 7x daily, & small number doses, researching your body to find out what THAT particular food did to your BG.
You’ll have to let us know if the endo gives you insulin and what happens!

4

Not true that a T2 on insulin can’t go off it. If you match insulin to carbs correctly, you shouldn’t have weight gain. It’s excess insulin that causes the pounds (fat stores). As a T2, your insulin doses will be higher than a T1s. If you do happen to gain weight, lower carbs.

Lantus, a basal insulin, reportedly can cause weight gain, so request Levemir instead.

The most important factor in your health is getting your BG down.

5

I think that if you get enough test strips and are committed, and it sounds like you are pretty tough to be doing what you have done and are continuing to do. You should be able to take a small enough insulin dosage to take the edge off the higher BG and improve your overall control without gaining weight. I am not 100% sure re T2, as I am T1 but I am pretty sure it can be done. I think you are likely onto something with the carb. I am not that low carbwise but I also run a lot. I hardly ever swim but that kills my BG so if you work that into your insulin routine, you should be able to keep the weight off? Another thing is that it sounds like you are dedicated to being active and I’m not sure if doctors always believe you and do an age/ weight calculation to determine your dosage.

If it’s too much, and you are running low and having to eat more to fight off lows, don’t hesitate to back off say 10% and see if it works better? If it works better but not perfect, adjust again? I think that a lot of docs don’t see that many active people (if the national statistics for everyone, not just PWD are credible) so they are challenged making that calculation. My doc got really close with the pump but it was a shade too high and I think that it’s because I was more active than the average bear, at the time? Maybe also because I was ignoring the dietician’s recommendation to eat 30-45G/ meal and 15-30G/ snack?

6

My waking BG is higher than I’d like, if I can’t get it under 100 with another few months of low carb (30g/day) and exercise don’t get me there then I’ll try a nightly shot of slow acting insulin to see if it gets me there. I’m a type 2 and other than my waking numbers, the BG is generally ok.

7

I went on insulin last december. Before insulin, I followed a strict low carb diet (stricter than you) and was taking three medications. And I still had A1cs in the 6s. I “chose” insulin. My blood sugars are the best they have been since diagnosis, my last A1c was 5.6%. I have actually lost a couple pounds over the last 9 months. And while I have had a few mild hypos, I’ve never been concerned about needing assistance. And I actually think I have “healed” a bit, my insulin requirements have actually dropped a bit. I doubt I will go off insulin. I am diabetic. I will always need help to attain normal blood sugars and insulin works great, much better than any medication ever did. I am happy I moved to insulin.

8

I went on insulin in November at MY request. I have lost 30lbs. It is wonderful!! I am type 2 and on an insulin pump. I struggled with my #'s for years until going on the insulin. It has been beautiful!! For me, the pump has been better than injections. Each of us are different and what works for one may not work for the other. Good luck with whatever you decide.
Marty

9

When I started insulin my doctor told me something that made sense and I have tried to remember his advice. He said don’t increase you food intake to keep up with your insulin dose instead decrease your insulin dose to match your food intake. If you have to often eat more to keep your BG level from going low you will gain weight.

Insulin can make you gain weight because it helps turn carbs into fat but it looks like you have that carb thing under control with your diet and exercise. My thinking is that if you have no excess carbs floating around then there will be none to turn into fat.

Insulin is a powerful drug which takes effort to use but the results can be very satisfying.
It tends to keep you honest about you treatment because it requires lots of testing to avoid highs and lows but the increased testing helps you to recognize what works and what doesn’t work with your diet.

Good luck with whatever you and your doctor decide and remember that you have a large family here to help you.

10

No it is absolutely not true that once you start insulin you can’t come off it.

In fact it might be just the trick to get you back under control. There has been several studies showing Type 2’s going on insulin for a short period of time gave their pancreas a break and later when they resumed orals it resulted in much better control. Even if you have to stay on insulin for longer than you want or even from now on it is not the end of the world. Lower blood sugar is the name of the game and any way you need to do that should be an option.

Weight gain with insulin is common but can be minimized. Just continue to watch your diet to keep the amount of insulin needed at a minimum. Whatever keeps your glucose in control should be pursued.

11

Insulin is totally adjustable and can be sized to carbs eaten.



Pills are pain in ■■■ and like using hammer - one size fits all and you have to eat extra to match up

to any excess body insulin generated by pill.



I found insulin shots vastly better and tigher control and able to maintain diet and not gain weight.

count carbs to size shot size.



I use humalog lispro - 4 units breakfast, lunch and dinner.'



Also on metformin.

oh yes pancreas working well.

12

I think there are a lot of people that look bad on insulin because it’s a shot or because of being insulin dependent. I don’t mind needles so insulin to me is easier than the side effects of most pills. I took pills for years, and slowly my Dr. put me on a long acting and a short acting and still I was all over the board… I am now on a pump and I am glad not to have to inject so many times a day. I won’t lie it’s an adjustment in your life no matter what you choose but the numbers are the most important part. If it helps it is worth it in the long run. RIght?

13

Interesting comments.

Long acting insulin - 75/25 with 12 hour interval are right pain in ■■■. Short acting insulin much easier and tracks a meal
and digestion time and one gets to change again after short interval. 12 hour humalog is like the 10.5 hour glyburide - both pains kin the ■■■.

Pill you have no idea how much extra insulin gets generated on a pill. WIth shot you get to control.

Either by pill or needle one is on insulin. Ony diff on pill is that ones own pancreas is used.

If ones pancreas is still working and I found mine kicking butt, it is much easier to use needle and calibrated shots and in fact add dose after eating so that one does not get big low from pancreas doing its job during meal and injected insulin at same time. I wait till I see BG climb up to 140 and above showing gut digesting and providing glucose and that
way I do not get premautre lows.

Here again; if pancreas still working - pills are pain in ■■■.

14

I DID ask to be put on insulin, and the reason was simple: Glucotrol, a sulfonylurea, was not doing a bloody thing after 5 months of trial. My fastings were around 180 and postprandials were around 250, and although the doc thought that was all right, I DIDN’T!

At the time, there were no other drugs to try, so insulin was the only answer. But it sounds like, even with the newer meds, you’re not getting the results you want, although your numbers don’t look THAT bad – one reason your doc MAY be reluctant to put you on insulin. (Not putting you down, just trying to anticipate how your doc may react so that you can go prepared to argue!)

Some people DO gain weight on insulin – it’s a major fear for Type 2’s and their docs. In my case, though, I LOST weight, I think because I was no longer so hungry and eating the refrigerator. At the time, I was clearly producing insulin, just not enough. I think other people’s comments on not feeding the insulin and knowing your ratios are right on the money.

Another thing to think about is reducing the carbs further. I’m averaging about 60g a day, and I have cut out all grain products as well as potatoes, corn, and peas. If I would give up the Greek yogurt, I could get my carb count even lower, but the yogurt has done my bowels a lot of good, so I accept the carbs.

Type 2 is a tough battle, not to mention how the arthritis complicates matters. I hope you get what you need! :slight_smile:

15

excellent response and fully responded too.

With the pills you have to eat sufficient or get lows.

With insulin, one gets full control, can reduce carbs and wit hearty exervise loose weight.

Mentality of pills is fine for those who have it work. For me - pain in ■■■.

The comment about BG numbers and how high and not accepting the high numbers is critical.

The higher numbers usually indicate body is loaded up with glucose and insulin resistance being held on by elevated numbers. ie body muscle cells constantly topped off with glucose and no room for more glucose and BG numbers elevated.

Cutting back on carbs and increasing hearty exercise and fixing any medical issues - leaky liver etc is key to getting BG back down and clearing out excess glucose around body is super critical.

lap band, bariatric surgery/bypass, small intestine liner and tight (staravation ) all point to hauling back on calories load input gives body opportunity to heal and get back in control. Leaving calorie inpout elevated simply ensures BG will remain out of whack and insulin resistance remains trapped on.

Hunter gatherer gene digestion system was optimized 10,000 years ago for poor and low volume food supply with bouts of starvation. AFter second world war we have tons of high grade farm food and each and every day - easy to overload calories to body.

On top of that we have cars, lap top computers, video games and HD TV - satellite couch potato games, exercise all dropping energy burn.

The results seem obvious.

In my case, syopping leaky liver, reduced cars and 1200 calorie diet and one to two miles walking daily all helped me to
stop the actos, drop excess insulin/starlex ,stop body rot and eye damage.

16

I am type 2 and take Lantus and Metformin. I have been able to continue losing weight with the Lantus. Lantus or a basal is great for the fasting bgl. I never want to give up my Lantus…LOL

17

I didn’t ask to be put on insulin but I did ask to stop the oral medication on top of it. I was having a lot of swings that I couldn’t control where with insulin it was much more control able. I start with slide scale just to treat blood sugars over 150 usually due to medications.

18

I’ve been in your shoes. I was originally diagnosed with T2 and was just put on Metformin. Early last year, I began to lose weight. I was taking my meds regurally and sticking to a diet. I went to my doc and my A1C was 12.0!!! Very bad! It upset me. So he increased my Metformin and put me on Amaryl. Very stupid with my opinion. Two months later no improvement with my sugars. I would wake up and my fasting would be 300…and it would be like this for months. So I finally went to the ER because helpful people on this site would tell me that I might be going into DKA. So I went to the ER. I was pretty much asking to be put on insulin because I couldn’t control it with TWO medications. Now, today, I am completely insulin dependent. I am on Lantus and Humulin R. I have much better control now. But, lately, I’ve been thinking about going on the pump for more stable control. If you think insulin is right for you, just go to your endo. I did, and he finally put me on insulin because he didn’t like my A1C results. Good luck!

19

Levemir can also reportedly cause weight gain. It is less on average than Lantus and NPH but still does cause weight gain per the manufactuer.

Per the Levemir PI:
In trials of up to 6 months in patient with Type 1 and Type 2 diabetes LEVEMIR was associated with somewhat less weight gain than NPH…

If you actually look at the studies there is little weight gain for type 1’s (presumably since they were already on insulin) but anywhere from 1.5 to 6 pounds in the Type 2 segment of the studied groups.

20

Sounds like a classic case of LADA, which is really Type 1. Just ask Melitta about it. I’m sorry you had to go through the torture of misdiagnosis!!! :frowning: