Insulin

Debbie Sue · #1 (**permalink**) 07-18-2008, 06:44 AM

When I was dx'd, my bg was in the 500 range at my pcp's office, then 300 range at the endo's office a few days later. I wonder why they didn't put me on insulin to get my #'s down quicker? I was given Metformin and Actos. (I no longer take Actos) I've read many threads in here where docs have or should put their new patients on insulin to bring their #'s down quickly. In your opinion, were my #'s not high enough to warrant insulin?

My bg #'s are really settling into the 'low mode' and I'm feeling so much better now. I'm into my 7th week of treating this disease and I've modified my diet and exercise too. I would like to see my #'s go below 100, but they are balancing around the 110-125 range for a typical day.

fgummett · #2 (**permalink**) 07-18-2008, 07:09 AM

Probably because most Doctors tend to take a conservative approach with Type 2 D. What you read on here is from folks who are probably more up to date than many Doctors; on the latest studies and treatments... call it a vested self-interest... we have more motivation to find out about our D.

With that said... there may also be a case to argue that by the time your sugars are already high it has taken many weeks/months/years to get them there and it may be prudent to also lower them slowly; your body has adjusted to being high and too rapid a drop could potentially cause damage. That is not to say that insulin could not be used cautiously to get the desired effect. Folks instinctively shy away from insulin 'cos it means needles, but those who know realise that it is one of the best ways to correct a high BS. In many cases, we could only be talking about a short course until the eating-habits, increased-activity, and other medications kick in.... or maybe like me you find the insulin preferable to the pills and stick with it.

BrianSCohen · #3 (**permalink**) 07-18-2008, 07:17 AM

Debbie Sue,

Really good question. You would have been a perfect candidate to a quick course of insulin. There does seem to be some really good reasons to use insulin to quickly give type 2 diabetics with high blood sugars a quick way of normalizing their blood sugars. Often, their pancreas are stressed and it takes a while to get things back to normal. Clearly, if a type 2 with high blood sugars is still struggling to get back into a safe range after a week or a couple weeks, I believe doctors should consider an insulin course.

The counter argument is that starting off with insulin as a first line of treatment can mislead a diabetic on their treatment strategy. I believe for both type 1 or type 2 diabetics, the primary strategy is to employ diet and exercise to manage blood sugars and then to apply medications and insulin as needed to maintain tight control. Jumping right into insulin can lead a newly diagnosed type 2 to falsely consider diet and exercise to not be important components of blood sugar management. This could be a real problem.

You on the other hand have clearly not made this mistake.

pdxdennisj · #4 (**permalink**) 07-18-2008, 07:27 AM

I may be naive but I think most docs do what they feel is best for the patient. I was Dx'ed with a bg of 327 by a research clinic (Gladstone Lipid Clinic) in San Francisco. The initial approach was to see if it could be controlled with diet and exercise - and it was for about a year and a half. I brought my numbers down into the normal range as I lost weight. I just couldn't keep the weight off and as it increased my numbers went up and meds oral were added which controlled my D for about 13 years at which time I went on insulin/Byetta. Dont go for an atom bomb when a pea shooter might work.

.

fgummett · #5 (**permalink**) 07-18-2008, 07:33 AM

I feel I should add that there are of course, many dedicated Doctors out there who do read up all the latest studies, treatments etc... but of necessity they still have to take a conservative approach... they may be constrained by policy, guidelines etc... and do not have the same freedom to "experiment" on ourselves that we have

xMenace · #6 (**permalink**) 07-18-2008, 07:38 AM

Type 2 is an insulin resistance problem. Why put more insulin in your body when you already have enough? Instead they treat the resistance.

It would be dangerous to have double the insulin you need when the metformin does kick in.

Debbie Sue · #7 (**permalink**) 07-18-2008, 07:40 AM

I don't want insulin.

I would like to be med-free and do this with diet and exercise, under doc's supervision of course. Maybe by Sept. I can have lost more weight and the endo will consider less meds.

Debbie Sue · #8 (**permalink**) 07-18-2008, 07:41 AM

Quote:

Originally Posted by xMenace

Type 2 is an insulin resistance problem. Why put more insulin in your body when you already have enough? Instead they treat the resistance.

It would be dangerous to have double the insulin you need when the metformin does kick in.

That's why I'm here... to learn and you just helped.