Insulin: Potential Negative Consequences of Early Routine Use in Patients With Type 2 Diabetes.
Over the years on many occasions people have said to me, why don't you eat the same as non diabetics and use insulin. Some comments or suggestions from people trying to be helpful and some from people who should know better, including healthcare professionals and fellow diabetics. One individual who considers himself a healthcare guru, went as far as to describe me and fellow lowcarbers as "carb cripples" I have always taken the view, I will use injected insulin only when I have no other choice. The day may come when I will have no other choice. If and when that day comes, I will keep insulin levels to the absolute minimum. I will stick with my lowcarb regime, to keep insulin levels very low. Don't get me wrong, insulin should not be feared, but it should be respected. There are many reasons for making my decision to delay injected insulin. Check out this paper for some of those reasons. Yet again low carb high fat proves to be the only sane option.
It would seem logical that the ideal treatment for type 2 diabetes should be early and continuing insulin therapy. Unfortunately, there are several characteristics of insulin treatment and insulin action in type 2 diabetes that limit the usefulness of insulin treatment and that suggest that chronic insulin therapy is best used in the later stages of diabetes when there is an absolute deficiency of insulin.
Starting insulin therapy early in the course of chronic treatment of patients with type 2 diabetes would imply that there are unique benefits to insulin treatment. As addressed above, there is little evidence to support such a view. Insulin treatment is neither durable in maintaining glycemic control nor is unique in preserving β-cells. Better clinical outcomes than those that occur with other antihyperglycemic regimens have not been shown. The downside of insulin therapy is the need to increase the dose and the regimen complexity with time, the increase in severe hypoglycemia, and the potential increase in mortality as well as the potential increased risk for specific cancers.
Full paper here.
Eddie
It would seem logical that the ideal treatment for type 2 diabetes should be early and continuing insulin therapy. Unfortunately, there are several characteristics of insulin treatment and insulin action in type 2 diabetes that limit the usefulness of insulin treatment and that suggest that chronic insulin therapy is best used in the later stages of diabetes when there is an absolute deficiency of insulin.
Starting insulin therapy early in the course of chronic treatment of patients with type 2 diabetes would imply that there are unique benefits to insulin treatment. As addressed above, there is little evidence to support such a view. Insulin treatment is neither durable in maintaining glycemic control nor is unique in preserving β-cells. Better clinical outcomes than those that occur with other antihyperglycemic regimens have not been shown. The downside of insulin therapy is the need to increase the dose and the regimen complexity with time, the increase in severe hypoglycemia, and the potential increase in mortality as well as the potential increased risk for specific cancers.
Full paper here.
Eddie
4 comments:
I recommend you read this response from some professor who is trying to ban the next episode of Catalyst, regarding the great con of statins and cholesterol.
http://www.abc.net.au/news/2013-10-28/professor-says-abc-catalyst-episode-could-result-in-deaths/5050866
Thanks Lisa
See new post.
Regards Eddie
I agree that insulin should not be feared when completely necessary although it's not a magic bullet for all diabetics as many type 2's may be suffering with a fair degree of insulin resistance and I have read of type 2's who are having to inject in excess of 300 units of insulin per day which will ultimately cause more weight gain and even more insulin resistance and a vicious circle evolves,personally I feel type 2's should have a c-pep test before being started on insulin and of course if the measured level is low due to a complete lack of functioning Beta cells then insulin therapy and low carbing is the way forward with treatment,if the C-pep levels were high then a Ketogenic diet instead would be very prudent for weight loss,BG control and improved insulin sensitivity.
Paul
I have always fought being put onto insulin before it is absolutely necessary and for the reasons given in this article. a few years ago Drs practices in my area were offered financial incentives to put patients onto insulin. My Hba1C was in the low 6 and falling and I was being pressurised to go on to insulin. It was fairly obvious to me that while I was still producing insulin however irregularly this would be very difficult don’t any of them do joined-up thinking?
Kath
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