Insulin: Good or Bad?

John Crowley
By John CrowleyCA Latest Reply 2008-10-21 09:38:54 -0500
Started 2008-05-25 03:46:10 -0500

Ginnetteb made a comment on another discussion that reminded me of a topic I wanted to bring up with the whole community.

Ginetteb wrote: I think that once you take insulin, type 1 or 2, you're doomed.

As the parent of a type 1 son, I'm unfamiliar with the "fear" of insulin. But as I've gotten to know more type 2's, it seems there is a common belief that going on insulin is a terrible thing.

From my perspective, insulin is a great tool in the diabetes treatment arsenal. And it seems that if other medications have not produced good blood sugar control, insulin injections (while not as convenient or easy) can provide excellent control for all people with diabetes.

Maybe you all can help me understand your perspective on insulin.


6 replies

Avera
Avera 2008-10-21 09:38:54 -0500 Report

I don't really have too many thoughts on this topic except to say I was at first afraid of all the "old wives tales I had heard. But after researching myself I learned.

caspersmama
caspersmama 2008-10-19 12:28:17 -0500 Report

I am on insulin and am having great numbers, but it is not from the insulin. It is from all the other things I do. My Doctor and I have a goal to be off of the insulin within 6 months. So for me it was there when I needed it but I will make this goal.

NamVet - 21894
NamVet - 21894 2008-10-19 11:51:31 -0500 Report

Not me! I wish to God I had gone on Insulin 40 years ago..
I would be dead now with Insulin.
My VA DR. get putting it off, till I forced the issue. 5 years now and I have lost weight, walking, better health. Pills were not doing it, my numbers alone was proving it!!
NamVet

tmana
tmana 2008-06-11 08:44:00 -0500 Report

A few more things to consider regarding insulin — in particular, analog insulin: Allie Beatty (of Allie's Voice) notes in her March 24 blog entry (http://alliesvoice.com/2008/03/24/allies-voic...) that the pH of most insulins is either too acidic, or not closely-enough regulated to prevent beta cell destruction. She reiterates the potential destructive properties of analog insulins in today's blog post, http://alliesvoice.com/2008/06/10/allies-voic...

tmana
tmana 2008-05-25 12:18:51 -0500 Report

Depending on one's health-care team and the initial numbers at diagnosis, there are three ways of treating T2 diabetes: diet-and-exercise, oral medications, and insulin.

***Note that T2 is in many ways an umbrella term that covers several different underlying causes of elevated BG: Insulin Resistance (IR), in which the body is unable to work with its own insulin; Impaired Glucose Tolerance (IGT), in which the body takes longer to process glucose; and insufficient insulin production, either because of obesity or through beta-cell death. There appear to be several other hormonal causes of T2 presentation (see the news articles in this forum discussing the effects of bariatric surgery on non-obese T2 patients).

***Note also that this view of T2 as an umbrella presentation rather than a single condition is not one I have encountered as typical within the medical field.

Before the advent of oral antidiabetic medications, there were only two methods of treating adult-onset diabetes: diet, and insulin. Most of the time, the (usually geriatric) patient would be given a trial by diet before considering insulin therapy.

At the time I was diagnosed in 2002, the protocol had changed to immediately introduce medications to lower the benchmark numbers (fasting BG, fructosamine, A1C) to "normal" first, along with medical nutrition therapy (diet), and then to back off the medications only if warranted (i.e., if the patient started becoming consistently hypoglycemic).

Two years later, at an ADA Diabetes Expo, I audited a session presented by an RN/CDE who discussed the progression of diabetes. She stated that T2 does not show up clinically until over half the beta cells have died, and that they will continue to die off at a rate more accelerated than that of a non-diabetic. It was therefore a normal progression of living with diabetes to require increasing dosages of oral medications, and the addition of a second and third oral medication. Once this combination became ineffective, insulin therapy would be started. The reason for withholding insulin therapy was the fear of the patient developing insulin resistance, which was considered a foregone conclusion of insulin therapy.

In short, insulin therapy was considered the T2 therapy of last resort.

Between then and now, a few things have changed:

We no longer believe that complete beta cell destruction is a foregone conclusion of T2 diabetes.

We understand that in many cases of T2 — especially those coupled with obesity — the progression of T2 diabetes can be retarded, halted, or seemingly reversed by strict attention to diet and exercise, and weight loss.

Studies have shown that in cases of severe or uncontrolled T2, early adoption of insulin therapy can avert or delay the development of complications of diabetes.

We understand that IR can be mitigated by diet and oral medications, even with concurrent insulin therapy.

I hope this gives you a better view of why many T2s consider insulin therapy a therapy of last resort, and why that view may no longer be justified. Please also consider that views long held are difficult to change, and it may take several years (and a lot of Big Pharma campaigning) to convince many T2s that early adoption of insulin therapy can be a positive and appropriate choice.

Carlos T. Las Marias
Carlos T. Las Marias 2008-06-05 01:39:35 -0500 Report

this comment makes sense, that is why I am highly considring to go on Insulin because my FBS runs 130-150 for the last yr but my A1C is still 6.9. My most pressing problem is the IBS side effect of Amaryl and Metformin.

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