Resistance is futile!?!

I cannot believe that it has been a year since I embarked on this journey of blogging.  I guess you could say that I was on hiatus. In all honesty, work, life and the ever present diabetes got in the way.  It is now time to treat this endeavor like a job and work it every day. That means giving attention to creating posts of interest and insight and getting them up at least weekly. Now, on to the show…

Let’s rewind to December 2015.  I had been seeing my new PCP for about a year. Prior to that I was going to a free clinic for my care.  They sent me to an endocrinologist associated with their care model but we did not see eye to eye on their style of diabetes management.  My PCP and I have a pretty good patient:doctor relationship and when I saw him in December the topic came up of whether I had had a c-peptide or insulin antibody lab work performed? Since I hadn’t, he went ahead and wrote the order. Let’s try metformin and see if that helps. Off I went to the lab. Also, try reducing your carbohydrate intake.  Follow-up in March.

March rolls around and there I am sitting on the exam table once again.  The results are in: My body is producing no insulin on its own AND the insulin I am taking is all but being destroyed by my body, also known as insulin resistance. That is how that conversation started. There in black and white was the evidence that I was insulin resistant AND a Type 1.  My PCP agreed that that was what it said.   The metformin had not been effective at the starting dose so we decided to try upping the dose. See you in 6 months.

Once again back in the exam room. In the interim Kwikpen was released. This is a U-200 insulin – which means 1 unit of U-200 is equal to 2 units of U-100. I had already been on Toujeo (a U-300 glargine insulin) with no great impact on my numbers.  This is where our relationship hit a wall.  I had written down what had occurred in my health over the last six months including office visits with the other members of my diabetes care team and any medications I needed refilled, discontinued or written.  I am not sure what part of that summary flipped the switch but my PCP shook his head and got up from his stool and said to me “We need to have a come to Jesus meeting, Tim!” At this point he was bobbing in place, short of jumping up and down.  “You are taking entirely too much insulin. Do you realize that you are taking a toxic medication? You need to take less insulin.”  Those statements were repeated several times.  I looked at him and told him that I was aware of the actions of insulin but I was also aware that what I was taking was not being utilized because of the insulin antibodies. So what is the answer? (If you are not already sitting down, please have a seat.)  He paused, sat down at his desk and pulled out several stapled print outs.  “Here. You should read these. You should sincerely consider fasting.”  I was dumb-struck.  OK. I was not sure how to respond.  The print outs were transcripts from several YouTube videos from a physician in Australia who has his Type 2 patients fast for up to 5 days a week. Every week.  Of course they all tout losing weight and reversing their insulin resistance.  He sat back down and said he really thought I should consider that because the answer was not more insulin.  He returned to my summary then looked up again.  “I will not renew your Toujeo.  The prior authorization is time consuming for my staff and I do not want you taking more insulin.”  We agreed on me getting a flu vaccine and he left the room.  See you in six months.  A few minutes later he returned and handed me a copy of Richard Bernstein’s book “Dr. Bernstein’s Diabetes Solution.”  “I know you are a type 1 but this may help.”

When I returned home and had cooled down I made a decision that has changed my life – No, I did not start fasting; I called the endocrinologist’s office and made an appointment.  If more insulin was not the answer then I wanted to hear it from the endocrinologist.  I was given an appointment for October 18.  and in the interim I read Dr. Bernstein’s book.  If anyone was going to have an opinion on insulin resistance being treated by decreasing insulin intake, it was going to be Dr. Bernstein.


The next episode I will tell you how my life changed on October 18th 2016.  Until then, be well or at least as well as you can be.


Tim, the DiabetesDude

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