type 2 insulin only?

lorilei · #1 (**permalink**) 12-03-2008, 03:02 PM

This is a just wondering.....I was speaking to a guy with type 2today who was dx'd 13 yrs ago (approx age now is early 40's). he is on insulin only....and his BG is still over 200 all the time...i was wondering of my type 2friends here, if part of the type 2 problem is resistance... shouldn't he be on something to increase his sensitivity? Or does type 2 eventaully max out the pancreas as well??? No, he does not fit the typical 1.5 profile..so i don't think that is playing into this.

I did recommend that he speak with his doc (or switch docs as obviously this is a dangerous long term problem), log onto this forum to educate himself among the "smart people," and showed him the copy of the Think like a Pancreas book (he is one of the few people that I have actually discussed diabetes with in the first person...besides you all

)

fgummett · #2 (**permalink**) 12-03-2008, 03:18 PM

Other than brief a trial with Metformin - could not tolerate side effects - I have been on insulin only for my Type 2 going on 5+ years now. I can't say that I ever had a problem "covering" my carbs with insulin and have managed to maintain a good to excellent BG level for most of that 5 years. That is not to say anything about weight gain or what my lipids looked like

For the longest time I was using around 130u of basal + bolus daily, but now that I have cut the carbs I am down to about 30u of basal only as I rarely if ever need to bolus or correct.

lorilei · #3 (**permalink**) 12-03-2008, 04:29 PM

thanks for the response, Frank...i think my thought was that his bg is still over 200 most of the time...his basal (levemir i think) is more than 50 units am and pm ( i swear that is what he said...but he is a big guy). his bolus was humolog...i did not get the feeling that he had a real good feel for the insulin to carb ratio...more like he was following a set amt of bolus per meal...he was kinda vague and i got the impression that he had basically given up on any serious management...i was just wondering if he was still resistant...with all of his insulin needs and what he termed was a "low carb diet."

fgummett · #4 (**permalink**) 12-03-2008, 05:08 PM

Sounds about right Lori, Type 2 with Insulin Resistance eating the typical low-fat/high-carb diet or suffering from carb addiction will likely need large amounts of extra insulin - as compared to Type 1 amounts of insulin.
I have been there myself.
Oral meds to combat the IR may help, but based on my own experience, I have to suggest that going very low-carb may well be the better solution.
To my thinking it was hyperinsulinemia (sic?) that got me into this problem in the first place so the best solution is to minimise the need for insulin and the only way I know to do that - while maintaining good BGs - is very low-carb.
Of course, as everyone here keeps saying, YMMV... but I figure there are just some folks (myself included) who have a very low tolerance for carbs and need to avoid them.

I also don't think that very low-carb is a bad deal: I eat really well with lots of eggs, steak, cheese, dark chocolate, cream, butter, Romaine lettuce and much more! My weight is falling, I am no longer hungry all the time, my BG and lipids are spectacular!

BTW Type 2 can indeed eventually max out the Pancreas and can leave a body Insulin Dependant, while still being Insulin Resistant. In the same kind of cross-over there are now Type 1's carrying excess weight and developing IR.

h a · #5 (**permalink**) 12-03-2008, 05:22 PM

That many years ago type 2s were not given much info. However, by your description, he is NOT TAKING CARE OF HIMSELF AND HE THINKS THE INSULIN TOBE MAGIC AND RESOLVE ALL THE TROUBLE. Oh boy, will he get a shock one day soon with complications. Sounds like an over doseto cover his non carb count , heavy meals and no weight control. mANY GPS DON'T ASK THE QUESTIONS t2 need except still on your insulin. For years had problems and they looked elsewhere, never checking for diabetes until the complications came and an insurance application showed diabetesand ll the complications. Yes, he is putting aBIG BIG burden on his pancreas and liver - the pancreas will stop production and in between are the flareups. Not fun. Hopefully he'll wise up or change doctors.

Lloyd · #6 (**permalink**) 12-03-2008, 06:10 PM

A year ago August I stopped my metformin for 3 weeks, as a test. My insulin requirements more than doubled.

I went right back on Metformin with insulin (pump).

-Lloyd

lorilei · #7 (**permalink**) 12-03-2008, 10:38 PM

HMMMMM...thanks for the input guys, and yes, imo I think he might need quite a bit more education..I so rarely get to talk with someone so young, who is so out of control, before all the complications hit...i guess some people have even bigger issues of avoidance and denial! i haven't really been in this position yet...he is not one of my actual patients, so i did allow my self to share some personal info with him. Wish i could help him, before it's too late..