Replies to This Discussion

Permalink Reply by Anonymous Diabetic on September 12, 2011 at 1:13pm

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

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Permalink Reply by Leo2 on September 12, 2011 at 1:13pm

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!

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Permalink Reply by Gerri on September 12, 2011 at 1:21pm

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.

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Permalink Reply by MossDog on September 20, 2011 at 4:57pm

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.

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Permalink Reply by acidrock23 on September 12, 2011 at 1:24pm

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?

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Permalink Reply by Joe_h on September 22, 2011 at 8:38am

+1 I'm T2 diagnosed in 96 my a1cs run 6.5-7.0 for the last couple years and i asked about going on insulin to get off all the oral meds I take now and he said I could but would require more testing and more precautions against lows. my exercise, diet and meds are working for me now so I'm going to stick with it but if this plan starts failing i'm ready to move onto whatever does work

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Permalink Reply by jims on September 22, 2011 at 9:00am

very interesting argument.

Worst lows I ever had were on starlix pills and watching my diet closely and pill plus my body over produced the insulin.

I suspect your comments plus many other good folks like youself are pointing out the lack of decent knowledge
and control data for typ2 insulin resistant diabetics. I too had to dig like hell to get my hands around.

Interestingly in Europe, Doctors got to insulin for patients well before pills.

As a layman after 30 years of crap, I suspect the unfortunate " Insulin solves all" and just hammer with pills really does not help all type2 insulin resistant diabetics and industry needs to catch up and get better data. and realize type 1 approaches while critical and necessary for type 1's is really not the overall answer for type 2.

Type 2 insulin resistant diabetes is not a single organ pancreatic disease that hammering with insulin does not really fix even if you could use some boosting of your body's insulin production.


And if all you need is some boosting of insulin pills are useless.

Good luck with your doctor and best wishes in your search.

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Permalink Reply by jah.ini on September 12, 2011 at 2:56pm

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.

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Permalink Reply by Brian (bsc) on September 12, 2011 at 5:18pm

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.

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Permalink Reply by marty on September 12, 2011 at 5:27pm

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

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Permalink Reply by Stemwinder on September 12, 2011 at 5:59pm

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.

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Permalink Reply by Chris Reid on September 13, 2011 at 7:59am

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.

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