Blood glucose disregulation caused by rapamycin tends to happen to people if they are dosing at higher levels, on a continual basis (i.e. daily dosing), over a longer period of time. As you can see from our survey of users - it doesn’t seem to happen very frequently with weekly dosing:
See full survey here: Rapamycin User Poll / Survey - Please Respond - #4 by RapAdmin
Another survey here: Rapamycin User Survey #2 - Please Respond
Some percent of people experience this type of issue (typically at moderate levels) when dosing rapamycin once per week as is typically done in longevity applications, but exactly what percent is not known - our survey suggests around 5%, but its hard to know how accurate that is. People here report it periodically, but I have not personally experienced it (Been taking rapamycin almost 4 years now).
So - you may or may not experience it, and the higher the dose, the more requently you take it, and the longer you take it for, the higher the risk.
Generally this is believed to happen because of mTORC2 inhibition - which similar to the blood glucose disregulation, only typically happens to people taking higher doses of rapamycin, frequently, over a longer period of time (e.g. weeks, or months). More reading on this issue of mTORC2 inhibition and side effects here: Evidence that mTORC2 inhibition is detrimental, by Dudley Lamming
and here: Bryan Johnson's Longevity Protocol - Your Thoughts? - #372 by RapAdmin
Some people find that Acarbose or Canagliflozin address this issue when they do experience it. You don’t have to use Metformin. Other people, if they run into this issue either decrease the frequency of dosing, or dosing level - and this reduces or eliminates the issue.
See more info here: Acarbose - Details On Another Top Anti-Aging Drug
And Here: Canagliflozina – Outro medicamento antienvelhecimento de destaque
More reading on this topic here:
While we don’t know for sure if rapamycin-induced blood glucose disregulation is harmful or not, it seems reasonable to try to avoid the situation until we know for sure.
Fasting and rapamycin: diabetes versus benevolent glucose intolerance
https://www.nature.com/articles/s41419-019-1822-8
Full paper here:
and
Rapamycin/metformin co-treatment normalizes insulin sensitivity and reduces complications of metabolic syndrome in type 2 diabetic mice
https://onlinelibrary.wiley.com/doi/full/10.1111/acel.13666