Question:
I've been "developing" diabetes for the past couple of years. It
started with IGT (140 to 185 postprandial) and normal (85-95) fasting
numbers, but now my numbers average 110 fasting and have been known to
enter the low 200s an hour after eating. Since I'd prefer not to go
low carb, if possible, this seems to mean that I need some sort of
medication. But everything I've read about has so many side effects
and contraindications, except for insulin. Why not insulin for early
diabetes? I've read that early use can save beta cells. Anybody
know about this? Also, if this is true, why don't doctors recommend
insulin more frequently?
Answer:
When I first read "Diabetes Solution" by Dr. Richard K. Bernstein, M.D., he
wrote about pleading with his newly diagnosed patients to begin insulin
early. His view, however, urges early insulin with a low carb diet and an
intensive regimen of multiple daily injections of small doses to achieve a
normal blood sugar profile.
There is research showing that beta cell function can be preserved with
early insulin therapy, particularly if you can halt overproduction of your
own insulin which is linked with weight gain and increasing insulin
resistance.
However, there is a concern that Type II's who are not adhering to a diet
and exercise regimen can gain weight with insulin injections and begin
injecting more and more insulin to counteract increasing insulin resistance
as they develop heart problems and an increased cancer risk because of
hyperinsulinemia.
If you're looking to insulin as a means of eating more carbs, you could wind
up like a very overweight Type II neighbor of mine who injects huge amounts
every day. His health is not good.
I elected to start early insulin tx with a 5.3 A1C on orals only. I'm glad
I'm on insulin, but I watch what I eat and exercise religiously to keep my
weight down. Insulin gives me dependable, predictable control.
