February 24, 2017

Newly Diagnosed Type 2, Start Using Insulin

I have written about being on insulin and probably will again. It is a shame that more people do not use insulin and even more shameful that many doctors will not encourage their patients to use insulin. Probably the most disturbing is that fact that many physicians actually use insulin as a threat to keep their patients on oral medications and to get them to work harder at controlling their diabetes.

This failure as these professionals call it is of their own making and is making more patients wonder where these doctors got their medical license. When the current “pill cure” generation passes, these doctors are going to face an Internet savvy group of patients that will call them out on their threats and stop using these deadbeat doctors.

A few doctors and some endocrinologists are starting to use insulin when some patients are first diagnosed. Though not enough are doing this, this will allow the pancreas to recover or rest, and bring a greater degree of control immediately. Doing this allows stopping the progression toward complications faster and this is a valid concern. Being on insulin at the start does not mean that you have failed or that you will need to be on insulin for the rest of you life. That will depend on the stage of your diabetes when diagnosed and the lifestyle changes you make. Please read the thoughts of David Mendosa on this topic.

Many patients started on insulin are able to get off and on to oral medications. Most are encouraged to change their lifestyle and be serious from the beginning about exercise and nutrition. A number of the patients have successfully gotten off all medications and are controlling with nutrition and exercise. In talking to a few individuals, they were very concerned when started on insulin, but with the faster lowering of their A1c and stricter control of their diabetes, they are satisfied that this was a way they would not have thought about, but did work well for them. Of the three persons I have talked with, only one was still on oral medications. The other two are off all diabetes medications.

One of the individuals I was able to talk with admitted that he had to overcome his extreme dislike for needles, but since he was always going to need to test, the needles were just another hurdle he had to overcome. He also felt that since the doctor was not threatening him, but encouraging him, that maybe he should listen and learn.

They did emphasize that it was important to receive from the start, the meetings with the nutritionist or diabetes dietitian to get the lifestyle change underway. This more than anything, they felt created the success they were experiencing. They admitted that it was difficult at the start, but as more of the changes were introduced with the reasons for the change also instilled with the change, they learned how to adapt and that they did feel better and wanted to continue what they were learning.

They were also happy that they had been allowed to experiment with lower carbs and different foods. I then asked if they were they told they must eat a minimum number of carbs? All three agreed that they had been told that a number of carbs was suggested. Then all three felt that this was the last time the number of carbs was pushed. They felt that the nutritional value was more important than a set number of carbohydrates in all discussions. A balanced diet was the main topic and when a couple of them wanted to experiment with a lower carb restriction, only the nutritional values of what they wanted to eat was the topic.

Yes, the number of carbs was taken into account, but they felt that then the dietitian was more interested in teaching them the way to determine the nutritional values of the foods and where to substitute to not harm the overall nutritional value and still stay at the carbohydrate value they had chosen. This was a big eye opener for me and restores a little of my respect for some dietitians.

Just don't let a dietitian say I need a minimum number of carbohydrates, as at that point, I admit, I tune them out and forget the rest of the class. I am happy for the success these individuals were having and that they will remember what to do and the reasons for doing it. This is the place of the support people and this example should be more widespread than it is today.

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