The Pros and Cons of Taking Insulin

While it Does Help Glucose Control, It Can Have Other Not So Beneficial Effects

High on the Glycemic Index. Getty IMages

Insulin. If you have type I diabetes, your body never made insulin. You need it and likely will require it for the rest of your life. If you have Type II Diabetes, there is a twofold reason your doctor may ask you to start taking insulin: your blood glucose levels are sub-optimal despite the medications your doctor prescribed for your diabetes. In those with Type II Diabetes, there can also be fatigue of the "beta cells" of the pancreas (whose job is to produce insulin) as well as increasing insulin resistance.

At this point your doctor talks with you and starts you on insulin to get your blood glucose levels under control. 

(For the purposes of this blog post, I am going to talk about Type II Diabetes, although there may be some overlap for those with Type I Diabetes). 

What is the scenario that commonly occurs after beginning insulin? That individual will increase their insulin dosing to where it is needed to achieve "acceptable glucose control." For some people. it may mean 30 to 40 units  of long acting insulin a day with increased amounts of short acting insulin with meals. After a period of time, the blood glucose levels become better controlled. Your glucose levels are now acceptable, and your glycosylated hemoglobin levels are fantastic. All's well that ends well, right?

Not so fast.

For many, the "trauma" of taking insulin (i.e.,having to do insulin injections) is often motivation to try and begin an exercise program.

S/he will begin to take the nutrition classes, count their carbohydrates and do what they can to get healthy. They discover that when they are on insulin, it becomes near impossible to lose weight despite everything they are doing. 

They are not doing anything wrong. Their physiology is altered. Insulin is termed an "anabolic hormone" meaning that it promotes weight gain. If you're needing to take 30-40 units of insulin a day in order to help normalize your blood glucose levels, that is a lot of insulin.

This can increase your tendency to not only gain weight, but also try to lose weight as discussed in the above scenario. 

You are on insulin, and you being to notice that your blood pressure is higher than what you were previously measured at. You swear to your doctor/health care professional that you are taking your blood pressure medications on a regular basis and that you have been watching your diet. You reiterate that you have been sticking to an exercise program and that it has been difficult to lose weight. Your doctor states that if your blood pressure is at the same level on the next couple of visits, that s/he may need to prescribe for you a "blood pressure lowering medication." You think and wonder that that you didn't begin to have all of these problems until you started insulin

Insulin can raise your blood pressure. There is a double whammy here: not only is there often insulin resistance which can raise blood pressure levels but insulin itself can also elevate the blood pressure as well. The weight gain associated with insulin also can elevate blood pressure.

So begins a vicious "physiologic cycle" of insulin resistance, insulin, weight gain, and if the blood glucose levels are uncontrolled, even more insulin........and the cycle continues...

What Can You Do?

You need to break the cycle. You need to find a way to lower the insulin dosing, if you can. Let me finish this post with a brief story....  

There is this amazing person that I have known for awhile. This person has Type II Diabetes and is obese. This person is older in their fifties, This individual had gone to diabetic education classes and learned about carbohydrate counting and was aware of the good foods and bad foods to eat and felt that the classes were valuable, but this individual still had difficulty applying these principles to their own situation. I gave this person a recommendation to read the book The End of Diabetes.

This person read the book, and began adopting a low glycemic diet and as able to lower the insulin dosing by 50 percent after about three months and had lost an amazing twenty five pounds in that time.

When we sat down to talk, I had asked this person what the difference was between the book and the classes. This person's answer was "focus and context." The goal of many diabetic education classes, this person felt, was to learn how to "deal with diabetes." This person's goal was to "eliminate it." With that  perspective, this person was able to incorporate half of what this individual read in the book. That still made a difference.......This person's blood pressure is fantastic and is off two out  three blood pressure medications that this person was taking.

Please understand that in this blog post  I am in no way suggesting to let your blood glucose levels be uncontrolled. Certainly diabetes is associated with a number of complications. All I am saying is to recognize the pros and cons of insulin and realize that with a little thinking outside of the box, and with a change in focus and perspective you can achieve your health goals.  

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