In my last post, we got familiar with these basic principles:
- Type 2 Diabetes shows up when you become insulin resistant, a process that typically develops over many years.
- Insulin resistance is the body’s way of adapting to too much insulin.
- Too much insulin results from a frequent pattern of eating foods rich in carbohydrates.
- Insulin resistance drives itself because you need more insulin to overcome the resistance, which in turn causes more insulin resistance.
If you want to read the full post, click here.
For Part 2, I want you to fully grasp these concepts so that we can critically evaluate the medications you might be offered at your doctor’s office.
I want to point out that even though Type 1 Diabetes and Type 2 Diabetes are completely different disease processes, we approach them similarly oftentimes in treatment.
People with Type 1 Diabetes do not produce any insulin and do not have insulin resistance. They are quite sensitive to insulin, which you can learn from simply looking at their insulin doses in comparison to people with Type 2 Diabetes. When there is resistance, insulin requirements multiply.
When you have a person with insulin resistance as the main feature of their disease, does it make sense to give them more insulin?
Why do we do this?
There are a couple of reasons:
- Elevated blood sugars over prolonged periods of time are very toxic to the body. They wreck havoc on your small blood vessels and your nerves, leading to a variety of serious consequences. Using medications such as insulin to bring these down not only helps you feel better, but helps you avoid moving toward these complications at a rapid speed.
- National guidelines for the treatment of Type 2 Diabetes recommend prescribing insulin after metformin if the A1c is very high (>9%).
- It is one of the only verified safe treatments for Type 2 Diabetes in pregnancy when the stakes are high.
All this is well and good except for the problem that it doesn’t make the diabetes any better. In fact, it makes it worse because it worsens the insulin resistance.
And there are risks to using insulin, such as:
- Insulin is a FAT STORAGE HORMONE.
- Insulin is a high risk medication. It is the cause of tens of thousands of emergency department visits annually due to severe low blood sugars.
- Insulin drives hunger and blocks weight loss. Insulin encourages sodium and water retention and can drive up your blood pressure.
For those of you that have been prescribed medications for Type 2 Diabetes, you have probably noticed that the number of meds and the doses of the meds you have had to take to control your diabetes has slowly increased.
There are actually a number of medications that promote insulin that are not injectable insulin. I could give you a clue that would help you guess which ones they are: 
They cause weight gain.
Remember how I mentioned that both obesity and Type 2 Diabetes are caused by the same thing: too much insulin?
These are the medications (other than injectable insulin) that will cause weight gain and promote insulin’s release or its activity in the body:
- Sulfonylureas: Glipizide, Glyburide, and Glimepiride are the most common
- Thiazolidinediones: Pioglitazone
- Meglitinides: Repaglinide and Nateglinide
What’s been very interesting to see in the 2019 iteration of the American Diabetes Association’s Standards of Care for Diabetes is the preference given to therapies that do NOT increase insulin.
Newer agents on the market such as GLP-1 agonists (like Victoza, Trulicity, and Ozempic) as well as SGLT2 inhibitors (like Jardiance and Invokana) are touting evidence that people who use these meds seem to have less heart attacks and kidney failure.
Now take a moment to consider: These meds don’t increase insulin. Interesting, right?
Wouldn’t it be worth considering how to get the insulin LOW instead of HIGH? There are NO meds on the market that are based on this strategy. Only dietary strategies can accomplish this, and they can be POWERFUL.
I know, it’s weird that I’m a pharmacist and I find these meds to be pharmaceutical bandaids. They do not address the cause of Type 2 Diabetes. They just cover it up and make you think you’re “controlling” your disease.
And the more you know, the more you want to know, right? I’m sure you have a bunch of burning questions to ask me!
Well–get yourself over to my website. Sign up for my emails and join my Facebook community. Snap up a FREE mini consult with me. Do yourself a real favor and have me coach you through reversing your Type 2 Diabetes.
It will be the best investment you ever made. 
