How NOT to treat diabetes

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By the mid 1990s, the landmark DCCT trial has established the paradigm of glucotoxicity, in type 1 but not in type 2 diabetes. Still euphoric from the trial’s success, it seemed only a matter of time before tight blood glucose control was proven beneficial in type 2 diabetes as well.
Nobody stopped to consider exactly how giving insulin to hyperinsulinemic patients was going to help. Nobody paused to consider that insulin toxicity might outweigh glucotoxicity. So, borrowing heavily from the type 1 diabetes playbook, the use of insulin is increasingly used for type 2 diabetes as well. Continue Reading →
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