When my wife was diagnosed with T2D, we went through the typical process many do - meet with a dietician, learn what to eat and how much, learn about insulin types and injections, etc. etc. She followed the process to the letter, and what we saw was the insulin injections make you gain weight, weight gain causes more insulin resistance, more insulin resistance means more insulin, more insulin means more weight gain, and on and on you go in this cycle that gets worse over time.
We researched more and more and found cutting out carbs heavily helped more than anything else, but she still needed some insulin. When mounjaro started getting a lot of attention, she tried that along with metformin. With those two drugs combined, she was able to get completely off insulin. She lost the weight gain from the 2 years of insulin, which reduced her resistance. She started having hypoglycemia and was able to reduce the metformin by half to get back to normal levels.
Her A1C is now 5.5 and has been < 6 for over a year now. Although the metformin was recommended by her endocrinologist, both the carb change in diet and trying mounjaro was something she had to take upon herself, none of her docs told us about this.
It's an absolute shame, and it feels like you're meant to be kept sick if you go strictly by the guidance from the ADA and even the doctors.
The doctors didn't tell you to cut all the carbs you can and went straight to "take insulin until it's low enough goodbye"??? That's fucking wild, I couldn't make it seconds into being diagnosed type 2 with an A1C of ~20% without being bombarded about diet to the point I almost couldn't get any information besides "change your diet and try metformin and we'll see what other options make sense once we know that impact". I can see why the doctors had not been pushing tirzepatide in that timeline though, in the timeline "mounjaro started to get a lot of attention" was really "mounjaro was approved as safe to treat diabetes with by the FDA".
Insulin can "cause" weight gain because having diabetes means your cells stopped absorbing the sugar from your blood properly. "Fixing" the diabetes with insulin means your cells start absorbing the energy you eat like they are supposed to, which means gaining weight again if input > output energy. On the other hand metformin and tirzepatide are also effective as weight loss drugs + lowering carb intake prevented the root problem that was "causes" weight gain with insulin in the first place.
I'm hoping I can lower my metformin dosage this next checkup as well, fingers crossed.
We researched more and more and found cutting out carbs heavily helped more than anything else, but she still needed some insulin. When mounjaro started getting a lot of attention, she tried that along with metformin. With those two drugs combined, she was able to get completely off insulin. She lost the weight gain from the 2 years of insulin, which reduced her resistance. She started having hypoglycemia and was able to reduce the metformin by half to get back to normal levels.
Her A1C is now 5.5 and has been < 6 for over a year now. Although the metformin was recommended by her endocrinologist, both the carb change in diet and trying mounjaro was something she had to take upon herself, none of her docs told us about this.
It's an absolute shame, and it feels like you're meant to be kept sick if you go strictly by the guidance from the ADA and even the doctors.