Can't have insulin when you are type 2

[Blossomflowers]

I am speechless. I have Diabetes so know a thing or two but this is not about me. My DP has recently been diagnosed and runs very high levels most of the time, He went for a blood test to check levels in preparation for review. He talked with the nurse who has sagely advised him that he will not be going on insulin as he is type 2 and still producing some. I am staggered at this ignorance.

Book in to see your gp and ask for a diabetic specialist nurse referal?

beta.nhs.uk/conditions/type-2-diabetes/understanding-medication/?WT.mc_id=organic_split

It says here that insulin is usually not used until things are worse and something like metformin will be prescribed first.

Type 1 and Type 2 are quite different. The longer you can avoid needing insulin the better in my opinion. Type 2 can be somewhat controlled with diet and other drugs. Once you're on insulin it's a bit of a spiral with your body becoming less and less sensitive to it.

Well, it isn't ignorance. Type 2 means you are becoming resistant to the insulin your body produces (whereas Type 1s no longer produce any insulin at all). There are numerous ways to combat T2 through drugs and also diet.

Type 2s CAN have insulin but it certainly isn't the first step in the treatment plan.

Because of ignorance I ended up in hospital because I was not on insulin. Specialist was shocked I was not taking it. Partner on Metformin and diet but still runs levels at 17 - 18 which is damaging. I get sick of crap advice you are given. Yes will get him to see a nurse who knows what she is talking about.

Which type do you have OP

I would assume that if he's been recently diagnosed, the medics will still be adjusting / assessing his medication to get him to acceptable levels.

If you do speak to medical professionals about it, I hope you'll be a bit more diplomatic than you have been here

Well T2 diabetics can have insulin, but there's a whole load of stuff a DSN would try first before commencing insulin. Nothing to do with ignorance and more to do with ladders of therapy. You may want to familiarise yourself with the NICE guidelines for Type 2 diabetes management before you accuse the nurse of ignorance

They might try gliptins, glitazones, acarbose, sulphonylureas etc long before an insulin trial.

If he's recently diagnosed and still struggling to manage his blood sugars and diet, then going straight on to insulin would be rather premature and contrary to current guidance.

Imuslin is usually step 3 or 4 - Metformin, then a SU or Dpp iv or other oral drugs then insulin. So she was right - would be unusual to start it immediately unless very symptomatic

Insulin is the only resort for T1s and the last resort for T2s. But I do know quite a few T2s who are on Insulin. But they all tried a variety of other options first.

What type do you have Blossomflowers ?

Insulin is rarely prescribed for T2, at least not as a first resort, this isn't unusual

Insulin is prescribed when the patient can't or won't change their diet and other medication isn't effective enough.

Diet and lifestyle changes with tablets are a first resort.

Should the patient prove resistant to change or there's a reason for the continuing high sugars, then insulin is prescribed.

This guy is a bit of an big pharma axe grinder, but a large portion of what he's describing is good stuff.

bloodsugarbasics.com/type-2-diabetes-preventable-reversible/

Unless there's an issue with the pancreas, Type 2 should be managed with a low carb, low sugar diet.

Ginger I am type 2 and know lots of people who are on insulin. I am active of normal weight healthy diet yet still had highs in the mid 20's. This is not about me but about a stupid statement made by a health professional "you are not given insulin if type 2" Yes I agree there are lots of things to try first but her statement is incorrect.

But he probably won't be given insulin, not yet anyway, so she's right.

what she probably meant is you aren't given insulin as a first-line treatment if you're type 2

Type 2 here and been on the courses offered but was also a gestational Diabetes person too

Insulin is not the first port of call with type 2 at all - diet and fitness ie lifestyle come first - diet to curb excessive carb consumption (sugar and white carbs mostly) and get yourself on an even keel, exercise to use up sugars in your bloods a bit better, as well as potentially lose weight and gain back some production capacity (a pancreas surrounded by fat (ie apple shaped fat - big belly) eventually just gives up the ghost - BUT if you lose the weight it can kick back into action (hence all these stories of being "cured" when in reality it goes into a stasis and is likely to happen again later either as weight goes back on or the pancreas struggles as it is at the end of the day faulty). Exercise really helps as it uses the excess energy but also keeps heart and lungs healthy and boosts both the immune system and increases the metabolism - all helping.

Insulin is used as a very last resort in the end stages of the disease. Before then they will try something like metformin and now also other drugs to help you access the insulin you are resistant to.

The other thing to watch is if you have cholesterol issues or high blood pressure the controls on these are tighter with diabetes so medication for these may need to be upped to lower levels.

Make sure you look after feet and lower legs too and any sign of cuts or damage to the skin should be watched closely - for type 2s with higher blood sugar readings it is much easier for infection to set in and harder to deal with it - so vigilance with foot and lower leg health (ulcers, spots, athletes foot, veruccas etc) is needed as well.

Also its worth looking at the different types of diabetes - they are even now saying Alzheimers may be a form of it (something to do with the brains resistance to insulin apparently not looked into it myself)

And ignore anything the NHS tell you about diet for type II.

Have a look at a low carb high fat way of eating and see what you can do to impact your blood sugars.

I think some of you are missing the point. I completely agree that there are lots of things to try before resorting to insulin. I do not disagree But to make a statement that type 2 are not given Insulin is misinformed Finally oh I know the advise I was given at the beginning was staggering, things like a low carbdiet does not work, measuring your blood sugar is a waste of time to mention a couple. I was lucky enough to meet a expert in the field and she was brilliant, she put me on insulin nothing else seemed to work. I get sick and tired of people thinking diabetes is your fault. I have had comments like oh you are diabetic, do you eat lots of sweets. I am a size 12, healthy, energetic 52 year old who has a very good diet. I was diagnosed in my 40's. all woman bar 1 in my family are diebetic. Just saying

What does your good diet tend to consist of? It's true that it can often be well managed with diet, that's not blaming it's just a statement of fact. Obviously for some people it might not work but generally ime when it doesn't people are still eating plenty of rice, pasta, starchy veg etc, even if they are lowering sugar.

She probably just didn't word it very well I'm sure she didn't mean he would never have insulin but that he wouldn't right now. We don't know the context if he asked about insulin and she said Oh you won't be having that she probably meant in the context of now rather than ever.

jenala you might be right but I have been subject to such stupid comments I am maybe quick to judge and think the worst. I agree some people have little idea about diet, I do. Have always been a big foodie and very familiar with carb counting, I have to do this off the top of my head now on insulin. My concern is rubbish advice is dished out and people accept it they believe if this is a health worker they should listen to them. Maybe we should start a thread about daft advice. Trouble with this disease is that is tends to vary from person to person

This is not about me

Exactly. So the therapy used for you isn't automatically suitable for your DH. She's worded her sentence a bit clumsily but it seems that you actually know what she meant and are determined to be outraged anyway.

I think you were very quick to judge to be honest.

Blossomflower - did they test you for LADA or MODY?

Low carb diets DO work, sometimes even for type 1. Look at facebook page type1grit, a brilliant page for support for type 1 and type 2.

I agree op, there's a lot of misinformation about diabetes, whether type 1,2, mody or lada. Can you h get referal to a DSN? At least they know what they're doing. I find most GP surgeries haven't got a clue about diabetes, my GP even said to me "I bet you know more than I do" . Have you tried Diabetes UK website? They have a very good, supportive forum, for advice, support or general rant