[Tribbles]

Originally Posted by georgepds

Lloyd, thanks for the info. I always thought insulin was the sine qua non of BG control, but it looks like that is not the case

--G

You can combine oral and insulin, it's not an either / or. Equally you can add other injections such as Byetta or Symlin which will also reduce the amount of insulin you need by address other control points. The aim is control but the means needs to be tailored to each individual. Metformin helps because it reduces insulin resistance, and more importantly it reduces the amount of glucose your liver puts out so you don't need to take insulin to cover that glucose.

Insulin always works but isn't always the most effective method in Type 2. Sometimes there are better options.

[volleyball]

Originally Posted by shaq786

Help! I am trying to understand what they did in this paper and I have a very simple question for you. Is there a such thing as a type 2 diabetic that is on insulin therapy ONLY with no oral meds?



I ask because in this study they looked for Type 2 Diabetics using long and fast acting analogues but not taking oral antidiabetic meds. They did not explain any further than that. My understanding was that if you are a Type 2 Diabetic and care about your health, you will take your oral meds and MAYBE the insulin depending on your condition...

Every possible combination has a person that will benefit from it, so all is likely to be prescribed.

Originally Posted by georgepds

Lloyd, thanks for the info. I always thought insulin was the sine qua non of BG control, but it looks like that is not the case

--G

apples and oranges between pills and insulin. Yeah they are both fruit and can satisfy you but in different ways

Originally Posted by Tribbles

You can combine oral and insulin, it's not an either / or. Equally you can add other injections such as Byetta or Symlin which will also reduce the amount of insulin you need by address other control points. The aim is control but the means needs to be tailored to each individual. Metformin helps because it reduces insulin resistance, and more importantly it reduces the amount of glucose your liver puts out so you don't need to take insulin to cover that glucose.

Insulin always works but isn't always the most effective method in Type 2. Sometimes there are better options.

Good explanation

[Lloyd]

Originally Posted by Tribbles

You can combine oral and insulin, it's not an either / or. Equally you can add other injections such as Byetta or Symlin which will also reduce the amount of insulin you need by address other control points. The aim is control but the means needs to be tailored to each individual. Metformin helps because it reduces insulin resistance, and more importantly it reduces the amount of glucose your liver puts out so you don't need to take insulin to cover that glucose.

Insulin always works but isn't always the most effective method in Type 2. Sometimes there are better options.

A big part of the advantage of insulin is that you can vary the dosage, both bolus (with meals) and basal.

Anything that helps you need less insulin is fine, as long as your body reacts predictably to whatever else you take (or do). If your reaction is variable, then you are not going to know how much insulin to use.

-Lloyd

[foxl]

I have noticed a recent trend in the literature toward earlier use of insulin -- it provides more precise blood sugar control (I suspect this may have to do with increased reliance on A1c's), and some people believe it provides better beta-cell preservation -- whether that is linked to autoimmune D (including undiagnosed LADA in people considered Type 2's) only is also a matter of speculation.