Controlling Diabetes Strategy

rated by 0 users
Answered (Not Verified) This post has 0 verified answers | 14 Replies | 4 Followers

Top 500 Contributor
Male
3 Posts
RalphTomaccio posted on Sat, Nov 26 2011 4:02 PM

I've had type 2 diabetes for about 11 years now and have been taking both glipizide and metformin, diet and excercise to control it. My A1C is usually between 6.5 and 7. After more than 30 years with the same doctor, I have changed my primary care physician and during our first appoinment he stated that he believes it's better to start insulin earlier than later when diagnosed with diabetes. His theory and analogy is that the pills squeeze the pancreas to produce more insulin and, when forced to do so, wears the pancreas out to the point of it no longer functioning. By taking insulin, it eases the work of the pancreas and helps it live and produce whatever it can for a longer period.

Have any of you been told anything similar and what are your thoughts on the subject? Any pros and cons of his suggestion?

All Replies

Top 25 Contributor
120 Posts
amrad replied on Sun, Nov 27 2011 12:38 AM

I think your new Dr. is trying to nicely say that you need to go on insulin therapy because your A1C #'s are high, and the pills are not working for you. I would ask what insulin regime he has in mind, a shot at each meal, or once a day.

Top 10 Contributor
Male
137 Posts
Tor replied on Sun, Nov 27 2011 3:59 AM

As someone who's been managing my diabetes type II for 13 years I've followed a number of discussions on this subject. Personally I'm glad I haven't reached the stage where I need to inject insulin, and the longer it can be delayed, the better. For two reasons. 1. Anecdotal stories about side effects of injecting insulin long term 2. Real, documented stories about the quickly apparant weight gain problems people have when going on insulin. Given that insulin resistance and type II diabetes are closely tied to body weight, and that the way insulin works is to convert excess blood sugars to fat which is stored in the body, the potential for a downhill slide is certainly there. Of course injecting insulin can be necessary, for type I diabetes and in some cases with diabetes type II, but the medical evidence I've heard does not support injecting as any form of first or even second line of defence against insulin resistance/type II.

Tor

Top 500 Contributor
Male
3 Posts

amrad,

Thanks for your reply. I was aware of what the dr. was trying to tell me. I'm just looking for the opinions and experiences from other type 2 patients as to the value of making this change and find out if this is or is not the way to go. My previous understanding of controlling diabetes was that you do what you can with diet and exercise.  If that doesn't work, add oral medication. When that doesn't work, then to insulin. What my doctor explained to me was that he believes in going straight to insulin in the interest of preserving the pancreas.

Tor,

You may be right as to not wanting to go on insulin. But, based on a lot of responses I have been getting on two other diabetes forums, many people that have moved to insulin are glad they have and would never go back.

Thanks for your posts. I hope others will contribute as well. So far, it appears it's not as "cut and dry" as I thought it might be.

 

 

Top 10 Contributor
Male
137 Posts
Tor replied on Mon, Nov 28 2011 1:51 AM

Thanks for the update Ralph.

Diabetes management is most definitely not a case of one solution that fits all. I do understand that for some people it would be a relief to replace a strict diet and exercise and medication regime with a few injections of insulin every day. On the other hand, there are benefits that go with the diet and exercise routine that do not fit into a syringe. Fresh air, a general feeling of well being, and overall improved health are among them.

As for your doctor's advice, that remains between you and your doctor to decide. However, the theory that somehow managing through diet and exercise and/or meds results in wear and tear on the pancreas is a novel, and certainly not mainstream, theory. What is well known though is that packing excess weight for a long time,  results in increased insulin resistance and therefore a greater strain on the pancreas. And from what I've heard, weight gain is virtually inevitable for anyone after starting on insulin injections.

Tor

Top 10 Contributor
Male
374 Posts
Simi_Papa replied on Mon, Nov 28 2011 1:56 AM

Not everyone gains weight when going on insulin.  I started on Levemir 6 months ago and my weight has gone down in that time frame.  There is a percentage of people that do gain weight on insulin, but that percentage is small.

Bill

"May the Force be with you!"

Diagnosed in 1997; Off all meds except Metformin!! Smile

www.nvhealthy.com

Top 10 Contributor
172 Posts
Madman replied on Mon, Nov 28 2011 9:44 AM

I started insulin almost a year ago....I gained 5lbs, of which 3 have since been lost.  I have much better control on insulin, and feel a lot better too.

 

Just my experience.

Top 10 Contributor
Male
137 Posts
Tor replied on Wed, Nov 30 2011 8:18 AM

Well all I have to go on is what my doc told me and what I've seen online, and that is that insulin works by converting sugar that is not needed for current activity, to fat which primarily is stored on the belly. That fat on the belly increases what is called insulin resistance.

 

Top 10 Contributor
172 Posts
Madman replied on Wed, Nov 30 2011 8:45 AM

It may depend on what kind of diabetes you have, what your endogenous insulin production level is, and what your activity level is.

Top 500 Contributor
Male
3 Posts

I want to thank everyone who has responded to my inquiry. I've posted this same question on three different forums and, to be honest, I'm not certain how much the replies have helped me come to any conclusions as they have been so varied and many at opposite ends of the spectrum. In general, they have ranged anywhere from "I wish I had been put on insulin sooner" to "no way would I want to go on insulin". I know differences of opinion are normal, but I did hope there might be more of an obvious "leaning" to one believe than the other.

Please feel free to continue to post your feelings as I still welcome all comments.

Top 500 Contributor
Male
3 Posts
PRB replied on Fri, Feb 17 2012 12:04 PM

Insulin is superior to pills, but only if you are willing to (1) change your life to make insulin fit into it; (2) expend the effort necessary to learn how insulin and your body work together; and (3) never eat anything between meals or without testing and injecting first.

 

I have been on Lantus and Novolog insulin since 2003.  Before insulin, I was on pills.  I will always remember not wanting to use my blood sugar meter because I did not want to know that my blood sugar was higher than it should be and that I had no way to bring it back down.  That was a very frustrating time for me.  Insulin was the answer, and I sure wish I had started it years earlier.

 

Insulin is not an easy alternative.  It is harder than pills and exercise, but the rewards are great if you put in the effort.  When I started taking Lantus and Novolog, I put myself on a strict three meals a day regiment with absolutely no snacking between meals unless I needed the sugar to keep from going low.  This method works wonders.  After learning my body's insulin needs, I was able to keep my blood sugars within a rather tight preprandial range of between 80 and 110 nearly all the time.  My first few A1cs were below 5 and I have never had an A1c above 5.3.

 

My tight control is possible because my system had already processed all the food from my previous meal and used up all the Novolog insulin from the previous injection before I take my preprandial bold sugar reading and decide how much Novolog to inject for the next meal.

 

For the last nine years, I have not had to deal with the frustration of high blood sugar readings and no way to fix them.  I feel so much better about sitting down to a meal.  I do not have to feel guilty about eating something when my blood sugar is already too high.  It is like having a heavy weight taken off my shoulders.

 

Roy

 

 

Top 50 Contributor
Female
27 Posts
Camilla replied on Sat, Feb 18 2012 10:07 AM

Do you eat low carb?

Top 200 Contributor
4 Posts
SueOscar replied on Fri, Apr 13 2012 10:43 PM

Yes, that is the new theory behind starting people on insulin therapy for tighter control and easing the pancreas workload.  Better control earlier makes for better outcomes.  I watched a webinar of The Endocrine Society and the doctors said that too many times too many doctors wait too long before starting their diabetic patients on insulin therapy after they are on oral meds for some time and their blood sugars creep up to out of control. 

Not Ranked
1 Posts
Suggested by Tor

Used car sales in Gauteng, South Africa. Cars Auto Buy is closed car dealer network in Gauteng region, provides with latest available deals for demo & used cars for sale in Pretoria, Johannesburg and other Gauteng area. Second hand motor car dealers online. http://www.carsautobuy.co.za/

Top 50 Contributor
51 Posts
Answered (Not Verified) ckdsite replied on Wed, May 2 2012 5:34 AM
Suggested by ckdsite

The hemoglobin A1C blood test is my favorite of all type 2 diabetic tests. It doesn't require fasting. It can be done in the doctor's office with a single fingerstick just like a glucose monitor.

You get results in six minutes. Best of all, it lets you know how your blood sugar has been doing over the past two or three months.

It sounds perfect. But it isn't. For diabetes management a type 2 diabetic needs to know what blood sugar levels are all the time.

Daily blood testing is still necessary, because a type 2 diabetic needs to know his glucose levels every day, not just every three months.

A great HBA1C reading does not mean there have been no hyperglycemic or hypoglycemic episodes in the last few months. So the hemoglobin A1C cannot replace daily checks with your glucose monitor and good log book records.

Page 1 of 1 (15 items) | RSS