I ran into an article the other day from Diabetes Care called “The Potential Negative Consequences of Early Insulin Therapy.” and decided that this would be a good article to feature on here. Now this stuff is all well known, but there’s a huge segment of the scientific community and just about all of the medical community that doesn’t understand this properly, and even though the treatment of the topic in this article only touches on some of the concerns here, it’s always good to see this topic brought up.
The fact that the article starts out with the statement that “the lack of insulin secretion characterizes all hyperglycemic states” was pretty disturbing though and displays a complete lack of understanding of hyperglycemia actually.
If we’re going to want to fix the problem, then it’s important to have a good understanding of what the problem is, and it is very clear that with type 2 diabetics, the problem is not due to a lack of insulin secretion, and especially not a lack of insulin in our blood.
It does mention that type 2 diabetics have a delayed insulin response to glucose, and that part is definitely true, and it’s something we can easily quantify by just doing a glucose challenge test. When we look at these tests, the typical presentation is insulin rising more slowly but rising much higher than normal and staying higher for a lot longer than non diabetics.
Throughout this time, the higher insulin levels are not sufficient to produce normal blood sugar, and this is what we call insulin resistance. So how could anyone even think that a lack of insulin characterizes type 2 diabetes when we don’t have such a lack, we have the opposite actually, too much, and even that fails to produce normal blood sugar typically?
So while the paper points out that it seems logical that we want to increase insulin secretion even further, peripherally actually, through insulin injection, this would be twisted logic indeed. There is some elementary logic here though which assumes that if blood sugar is high than if insulin levels were even higher, then blood sugar could be lowered, and that part is true, but we cannot afford to be thinking just on this level, we need to think deeper than that, and this is the part that they typically miss.
So no one will argue that insulin injections can be used to lower blood sugar. We’re entitled to ask what may happen if we do that though, which this paper does to some degree anyway, to their credit, and this is the first step toward even trying to gain an understanding of how to best treat our disease.
The problem of seeing type 2 diabetes as simply a disorder of hyperglycemia still remains though, and the next step is to look into the pathology of the disease itself, not just one of its obvious presentations, and this is where we start getting a glimpse at how hyperinsulinemia isn’t just not the treatment, it’s the problem itself, it’s even the underlying disease itself, with high blood sugar just being one of several negative manifestations of this.
Unfortunately though, we usually are satisfied at comparing different insulin therapies, for instance the article mentions the fact that injected insulin has been shown to offer some benefits over oral insulin secretagogues, which isn’t surprising since increasing our own insulin secretion is even more dangerous, which is well known to those who understand the pathology of hyperinsulinemia, where our own insulin is more toxic to our organs since it gets delivered in a much more concentrated form.
This argument is a lot like saying beer is better for an alcoholic because it’s weaker and one can drink it and ingest less alcohol, where the real question ought to be how we correct the disease itself, the alcoholism, which won’t be successfully treated by giving someone more alcohol. This is exactly analogous to giving someone with the disease of high insulin more insulin.
One of the ways that people get fooled by this is not only focusing on blood sugar levels exclusively, they also focus on beta cell function, and anything that lowers blood sugar for a time is going to be beneficial to beta cells. There’s a lot more to managing diabetes than this though and beta cell dysfunction is a primary defect of type 1 diabetes actually, not type 2.
Beta cells do downregulate in the presence of higher levels of insulin though, that’s only natural and a desirable phenomenon actually, which they would understand if they realized that we have too much insulin already with type 2 diabetes, and the last thing we should be wanting is even more. So the pancreas turns this down over what the normal response would be given our blood sugar levels, because otherwise our disease would progress much faster, we’d be choking on our own insulin even more.
The bottom line here though is that from making our underlying disease worse, the hyperinsulinemia, there are a number of things that happen besides it being harder and harder to manage our blood sugar over time. This one gets missed by just about everyone though, they just think, well that’s just the nature of the condition, they don’t consider the fact that the therapy accelerates the progression of the disease, and when the treatments fail, they think we’ve gotten worse in spite of them instead of to some degree because of them.
So of course when you raise insulin levels even more, there’s the risk of hypoglycemia, and type 2 diabetics are the last people to ever be at risk for this, much less so than non diabetics actually, unless we raise their insulin levels up further that is with medications. So all of the risk here is medication induced of course.
Weight gain is an obvious problem, even though we close our eyes to that for the most part, with blood sugar management being seen as more important, but this is a real disease that we need to be much more concerned about than we are now, and high insulin is responsible for the epidemic we see nowadays period, and if we raise it up, well people are going to gain even more weight.
The biggest threat to type 2 diabetics is cardiovascular disease, and if a treatment worsens that, then this is clearly not the way to go. If it increases cancer risk as well, which this paper mentions, then that’s another problem. If you are more likely to die, that’s a freaking problem I’d say.
It is little comfort when you are sitting there, fat, with heart disease or cancer, but you can say, well my A1C was in target. Sadly though, even this goes away, where patients are unable to maintain the targets anymore even on all the meds the doctors will dare give them, and this is actually quite common. Even if they do stay in the suggested ranges, they are setting themselves up for an early grave, unwittingly.
I read a story about a man who couldn’t pay his power bill and had his power cut off, he could no longer work because his legs and feet became so ulcerated that he could only hobble around and had to go on disability.
What little money he had, he bought a generator, because he needed to keep his fridge running to keep his insulin cold. He’d been injecting faithfully for years and nothing will stop him from continuing on yet this is where he has ended up.
This article does not go anywhere near far enough in its condemnation of the overuse of insulin injection in type 2 diabetes, but every little bit helps.
It’s so sad how so many people are so brainwashed that they don’t realize that they are being used by corporate “medicine” to pay with their wallets, their health, and even their lives, in the name of profits. Billions and billions sold.
Thank God a few people are now waking up to some of this, although like McDonalds, a few detractors won’t matter that much to their bottom line, but more and more voices are being added all the time. The movement toward a more holistic approach to treating type 2 diabetes and toward a better understanding of it has been growing by leaps and bounds lately, and while the overall picture remains grim, there’s a lot of hope out there as well.