Re: Insulin vs. Pills & Diet

April 4, 2000

Gretchen Becker submitted another cogent observation re doctors' seeming

reluctance to prescribe insulin for type 2's ...

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A Yale Med School professor wrote in a Sept. 1999 article in a medical

magazine: " Whenever possible, patients with type 2 DM should avoid insulin

in favor of diet and oral agents. Injected insulin ceates hyperinsulinemia,

which is harmful in itself. Endogenous insulin secreted into the portal

system tends to cause less peripheral hyperinsulinism, with its attendant

complications, than injected insulin does. Furthermore, the greater the

proportion of insulin under endogenous control, the lower the risk of

hyoglycemia. "

I know this will raise the hackles of some on this list. Unfortunately,

because this is not a research journal, but the kind that is sent free to

doctors, supported by drug companies that want to sell them drugs (I get

these magazines because the intended recipient died 5 years ago and his

family can't shut off the supply of magazines), there are no references to

support his statement that hyperinsulinemia " is harmful in itself. "

Nevertheless, GPs may read articles like this and take them as gospel truth,

which may be one reason they don't suggest insulin for type 2s right away.

The author of the article is Alfred J. Padilla, Assistant Clinical

Professor of Medicine, Yale University School of Medicine, New Haven, Conn.,

if anyone wants to try to learn more.

PS Another interesting comment in the article is that with the Rezulin-type

drugs (I think he means Rezulin itself, although he doesn't specify), " Liver

disease is a far less usual complication, but it can occur unpredictably,

with an incidence comparable to that seen with the statins used to treat

hyperlipidemia. " But I've not seen a lot of public outcry about the statin

drugs. Why are people focusing on DM drugs?

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