Negative on the tech. DM2 is insulin resistance, not shortage of pancreas insulin, initially. When you get to needing insulin it's becuse sugar is not kept down with the ladder. It's then termed IDDM2. It's not the insulin (injections) itself causing the dependancy. Can it be that the DM2 progressed so far, or the compliance is so low, or diet/exercise/other needed medication? Yes. Optionanally the inevitable decline of the pancreas can make it so you develop acidose, and need insulin to stay out of it, sure.
See above. Direct to insulin in DM2 is not a standard regime. But is it DM2? Can be some rare variants inbetween dm2 (normal levels of insulin, bet tissue sensitivity to insulin is down) and dm1 (production probkem, pancreas not producing enough insulin) - blood works and/or antibody tests is usuall the start - or the doc thought it was a debut of DM1, in which case insulin is the one and only treatment. For DM2: It's usually: change of diet and exercise. Then pharma firstline = metformin. Then add any number of sglt-2 inhib/sulfo/dpp-iv inib/pio. All of these more or less work by increasing insulin sensitivity or excreting excess sugar = the base problem in DM2. Then add/mono with ozempic. If this is not enough, then a new strategy with some or none of the above combined with insulin might be viable option. The regime is individualized, are your morbidly obese, do you work night, are you demented (kek), old, in risk of amputations, bad eyes, etc etc. I suspect your docs may be biased towards whatever gives kickbacks/stock/whatever -
Cad
schooled me earlier in how this is not the case (any more?). Either the doc thought she was a severe case of dm2, or it was a debut of dm1 which it could've been, thought it was too dangerous to wait for the ladder to take effect, or thought it was an in-between variant, or was lazy or just wanted to sell some insulin, no idea. I'd strongly consider getting a second opinion regardless if they suggest insulin as mono in a dm2, I think.
