I have a history of Polycystic Ovary Syndrome and insulin resistance, and since my hysterectomy my blood sugars have been in the diabetic range for type 2 diabetes, so I have started Glucophage on my doctor’s advice. Since I know I will be eventually on insulin anyway, I would rather skip the whole Glucophage thing and just start insulin, but my endocrinologist says that’s not a good idea.What would be the disadvantage of starting insulin treatment? I have a *very* strong family history, and my 55 year old father who has had type 2 diabetes for 15 years is in his last months of life, living on dialysis.

Glucophage [metformin] has the advantage of treating blood sugars and minimizing weight gain, compared to other agents, including insulin. It may be true that insulin would also treat high sugars, but it would be more difficult to use for mild elevations in glucose, and it will probably cause weight gain. The proof is in the result. If the Glucophage is successful, and your sugars normalize, I think it is reasonable to ride it out and continue the treatment. There is no evidence to suggest that normal blood sugars on insulin are superior to normal blood sugars on Glucophage.

By taking better care of yourself at an earlier age, the hope is that you can be spared any end-organ complications, such as kidney problems. I would suggest end-stage renal failure is not a sure thing for all people with diabetes. This includes those with a family history of renal failure from diabetes.

JTL