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Insulin for Type 2 Diabetes: Another Tool for Blood-Sugar Control

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Gabbay1By Robert A. Gabbay, MD, PhD, Special to Everyday Health

In 1920, when Dr. Frederick Banting and medical student Charles Best extracted the hormone insulin from the pancreas, they revolutionized the world of diabetes care.

Insulin works by moving the sugar or glucose obtained from food into your body's cells, which is then used for energy. People with diabetes either don’t make enough insulin, or their bodies don't effectively use the insulin they produce.

While insulin is commonly associated with the treatment of type 1 diabetes, many people with type 2 diabetes use insulin as a regular part of their diabetes therapy. But some people with type 2 diabetes view the use of insulin as a failure. This is not the case. The reality is that for some  with type 2 diabetes, insulin is simply a necessary and beneficial addition to their diabetes management.

When prescribing insulin to my patients with type 2 diabetes, I often get the following questions:

Why would someone who has been controlling their type 2 diabetes with diet and exercise need to start taking insulin?

There are several reasons why patients with type 2 diabetes would require insulin, even if they hadn’t needed it before:

  • Temporary insulin usage:Situations like pregnancy, surgery, broken bones, cancer, or taking steroidal medicines (like prednisone) can require some people to take insulin for a short time.
  • Permanent insulin usage:If the pancreas becomes unable to produce enough insulin, as often happens with aging, people can become insulin-resistant due to weight gain or chronic emotional or physical stress. To put it simply, there are circumstances when pills are no longer sufficient to control type 2 diabetes.

So it’s not usually “bad” behavior that would cause someone to start insulin?

That is correct; however, not sticking to a healthy diet and exercise plan could result in high blood glucose levels that only insulin can control.

Is insulin dosage different for someone who has type 2 rather than type 1 diabetes?

Insulin doses vary for both types, with either type potentially requiring very little or a lot of medication. It all depends on a patient’s weight, eating habits, exercise levels, other illnesses, and level of insulin resistance.

Can someone start taking insulin and then not need to take it anymore?

Sometimes, but only people with type 2 diabetes. Additionally, in some cases, people can stop taking insulin if they reduce their weight and/or exercise more. Also, if any of the temporary situations listed above resolve, you may be able to stop taking insulin.

That being said, at Joslin Diabetes, Center where I work, we never view taking insulin as a failure. Instead we see insulin as a way for patients with type 1 or type 2 diabetes to control their blood sugar and prevent complications.

Robert A. Gabbay, MD, PhD, is chief medical officer and senior vice president of Joslin Diabetes Center, an independent institution affiliated with Harvard Medical School, and the world's largest diabetes clinic, research center, and provider of diabetes education. Joslin is dedicated to ensuring that people with diabetes live long, healthy lives, and to offering real hope and progress toward diabetes prevention and, ultimately, a cure.

Last Updated:12/4/2014
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Date: 10.12.2018, 20:37 / Views: 95465


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