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Can You Get Off Insulin Once You Start?

Type 2 Diabetes Faqs

Type 2 Diabetes Faqs

Common questions about type 2 diabetes: How do you treat type 2 diabetes? When you have type 2 diabetes, you first need to eat a healthy diet, stay physically active and lose any extra weight. If these lifestyle changes cannot control your blood sugar, you also may need to take pills and other injected medication, including insulin. Eating a healthy diet, being physically active, and losing any extra weight is the first line of therapy. “Diet and exercise“ is the foundation of all diabetes management because it makes your body’s cells respond better to insulin (in other words, it decreases insulin resistance) and lowers blood sugar levels. If you cannot normalize or control the blood sugars with diet, weight loss and exercise, the next treatment phase is taking medicine either orally or by injection. Diabetes pills work in different ways – some lower insulin resistance, others slow the digestion of food or increase insulin levels in the blood stream. The non-insulin injected medications for type 2 diabetes have a complicated action but basically lower blood glucose after eating. Insulin therapy simply increases insulin in the circulation. Don’t be surprised if you have to use multiple medications to control the blood sugar. Multiple medications, also known as combination therapy is common in the treatment of diabetes! If one medication is not enough, you medical provider may give you two or three or more different types of pills. Insulin or other injected medications also may be prescribed. Or, depending on your medical condition, you may be treated only with insulin or injected medication therapy. Many people with type 2 diabetes have elevated blood fats (high triglycerides and cholesterol) and blood pressure, so you may be given medications for these problem Continue reading >>

Why Do I Find It So Hard To Lose Weight?

Why Do I Find It So Hard To Lose Weight?

There are lots of myths about weight gain, weight loss and dieting, but the most damaging is that it’s all about willpower. “If only I had a stronger willpower”, people say to themselves, “I would eat more healthily and become slim again”. If you believe that then you will also believe that if you are fat then it is all your own fault. So, you go on a diet and when it fails (which many do) then naturally you blame yourself. You get depressed, gorge on carbs and give up. The fact is that experts who work in weight loss management are well aware that weight loss is about far more than simply trying to eat fewer calories. Most overweight people have a metabolic problem, one that makes them hungry all the time. The normal feedback mechanisms that tell you that you are full no longer work. Willpower fails because you are up against one of the most basic drives we have, hunger. This metabolic problem will not only stop you losing weight, it will also lead to serious health problems such as high blood pressure, heart disease and diabetes. Unless you do something about it this is a problem that will get worse over time. Once you solve the metabolic problem (and the good news is that it can be solved) your appetite will shrink and you will find it not only easier to lose weight but to keep it off. It starts with developing Insulin resistance At the heart of weight gain is the hormone, insulin. One of the main reasons why so many people struggle to lose weight is not because they are idle or greedy but because their muscles have become resistant to insulin. Insulin is a hormone produced by your pancreas. It controls your blood sugar levels, but it does far more than that. It also controls fat storage. When you eat a meal, particularly one that is rich in sugary carbs, y Continue reading >>

Why Drug Weaning Is Important

Why Drug Weaning Is Important

Author's Perspective: Ironically, because I was on insulin, it was actually easier to wean off the insulin than it would have been to wean off the diabetic pills. Why? Because I could safely reduce my insulin dosage by one unit at a time and not have any negative reactions or blood glucose spikes. But my endocrinologist told me that I was going through the "honeymoon period" and would eventually be back on insulin ... well, he's still waiting for me to go back on insulin ... :-) I should point out that I was more motivated to get off the insulin because of my fear of needles. :-) I believe that if I had been taking pills, I would have felt morecomfortable and, therefore, would not have been as motivated to want to get off the pills. Drug weaning is the process of slowly reducing the dosage of a specific drug without harming the body and eventually reaching a dosage level of zero. Drug weaning is important because it prevents your body's cells from becoming biochemically dependent on the drugs, chemicals and toxins contained within the prescription medications that you're taking. Drug weaning is also important because it helps to reverse your diabetes and prevent the onset of diabetic complications. So, what should you do when you start our diabetes program? When and how should you start to (safely) wean off the medications? Concerning your medications, for legal reasons and for health reasons, we can't tell you specifically to stop taking your medications. There are just too many factors to consider when it comes to how everyone responds to different medications. Key factors include your age, your medical history, your blood test results, how long you've been diabetic, how long you've been taking meds, and what specific meds you're taking. Other key factors include your Continue reading >>

Ask Dr. Stork: Can I Avoid Insulin Shots For My Type 2 Diabetes?

Ask Dr. Stork: Can I Avoid Insulin Shots For My Type 2 Diabetes?

Q: My doctor says I may need to start insulin shots for my type 2 diabetes. Can I avoid this? –Maria A. Murphy, 63, Worcester, MA A: It's possible. Let me tell you a quick story: My dad was diagnosed with elevated blood glucose (prediabetes) a while back and was too embarrassed to tell me. When I finally found out from my mom—6 months later!—I realized that nobody had talked to him about lifestyle changes he could make to improve his health and blood glucose levels. We figured out a plan in which he started walking every day and cut out refined sugars, white flour, and other simple carbohydrates—and he was able to get off his diabetes medication within a few months. Ten years later, he's still off medication. [sidebar] What's the moral here? That the hands-down best treatment for type 2 diabetes—at almost any stage—is to make healthy lifestyle changes. If you can become more active; eat fewer processed, high-sugar foods; and drop excess weight, you may be able to avoid insulin altogether or possibly stop taking it if you've already started. That's because type 2 diabetes develops when your body becomes resistant to insulin in the bloodstream and can't use it to regulate blood sugar levels. With regular exercise and other positive changes, your muscles become more responsive to insulin. As you replace body fat with muscle, that lean muscle mass needs glucose for fuel, so it uses up excess sugar in your bloodstream and helps stabilize your blood sugar. (Check out the Wonder Workout for the ultimate plan to reverse prediabetes.) But never make changes to your medication on your own. You'll want to work hand in hand with your doctor to come up with a plan. Unfortunately, some patients do everything right and still need medication. But that doesn't mean your effo Continue reading >>

So You’re Ready

So You’re Ready

Indication BASAGLAR is a long-acting insulin used to control high blood sugar in adults and children with type 1 diabetes and adults with type 2 diabetes. Limitation of Use Important Safety Information Do not take BASAGLAR during episodes of low blood sugar or if you are allergic to insulin glargine or any of the ingredients in BASAGLAR. Do NOT reuse needles or share insulin pens, even if the needle has been changed. Before starting BASAGLAR, tell your doctor about all your medical conditions, including if you have liver or kidney problems, if you are pregnant or planning to become pregnant, or if you are breastfeeding or planning to breastfeed. BASAGLAR should be taken once a day at the same time every day. Test your blood sugar levels while using insulin. Do not make any changes to your dose or type of insulin without talking to your healthcare provider. Any change of insulin should be made cautiously and only under medical supervision. The most common side effect of insulin, including BASAGLAR, is low blood sugar (hypoglycemia), which may be serious and life threatening. Signs and symptoms may include dizziness or light-headedness, sweating, confusion, headache, blurred vision, slurred speech, shakiness, fast heartbeat, anxiety, irritability, mood change, or hunger. Do NOT dilute or mix BASAGLAR with any other insulin or solution. It will not work as intended and you may lose blood sugar control, which could be serious. BASAGLAR must only be used if the solution is clear and colorless with no particles visible. Always make sure you have the correct insulin before each injection. BASAGLAR may cause serious side effects that can lead to death, such as severe allergic reactions. Get emergency help if you have: Heart failure can occur if you are taking insulin together w Continue reading >>

Counseling Patients On How To Avoid Weight Gain From Insulin

Counseling Patients On How To Avoid Weight Gain From Insulin

A lot of people with type 2 diabetes delay going on insulin for as long as possible because they’ve heard horror stories about how much weight it can make them gain (or maybe they just don’t like shots), but people with type 1 don’t have a choice. While it is true that insulin treatment is often associated with weight gain and more frequent bouts of hypoglycemia (low blood sugar), the real question is, why? Some theories to explain insulin-induced weight gain are that when using insulin, your blood sugar is (usually) better controlled and you stop losing some of your calories (as glucose in your urine when your blood sugars exceed your urinary threshold) and that you may gain weight from having to eat extra to treat any low blood sugars caused by insulin. If you’re taking oral medications to lower your blood sugar and they are not working, however, insulin may be your main option for better control. A few research studies have looked at whether weight gain is simply a result of eating more when you’re on insulin. One such study found that weight gain was not due to an increase in food intake, but rather that your body may increase its efficiency in using glucose and other fuels when your glycemic control improves — making you store more available energy from the foods you eat as fat (even if you’re eating the same amount as before you went on insulin) (1). So, what can you do to avoid weight gain if you have to take insulin? First of all, you should try to keep your insulin doses as low as possible because the more insulin you take, the greater your potential for weight gain is. The best way to keep your insulin needs in check is to engage in regular physical activity. By way of example, some people with type 2 diabetes who were studied gained weight from Continue reading >>

Type 2 Diabetes And Insulin

Type 2 Diabetes And Insulin

People with type 2 diabetes do not always have to take insulin right away; that is more common in people with type 1 diabetes. The longer someone has type 2 diabetes, the more likely they will require insulin. Just as in type 1 diabetes, insulin is a way to control your blood glucose level. With type 2 diabetes, though, dietary changes, increasing physical activity, and some oral medications are usually enough to bring your blood glucose to a normal level. To learn about how the hormone insulin works, we have an article that explains the role of insulin. There are several reasons people with type 2 diabetes may want to use insulin: It can quickly bring your blood glucose level down to a healthier range. If your blood glucose level is excessively high when you are diagnosed with type 2 diabetes, the doctor may have you use insulin to lower your blood glucose level—in a way that’s much faster than diet and exercise. Insulin will give your body a respite; it (and especially the beta cells that produce insulin) has been working overtime to try to bring down your blood glucose level. In this scenario, you’d also watch what you eat and exercise, but having your blood glucose under better control may make it easier to adjust to those lifestyle changes. It has fewer side effects than some of the medications: Insulin is a synthetic version of a hormone our bodies produce. Therefore, it interacts with your body in a more natural way than medications do, leading to fewer side effects. The one side effect is hypoglycemia. It can be cheaper. Diabetes medications can be expensive, although there is an array of options that try to cater to people of all economic levels. However, insulin is generally cheaper than medications (on a monthly basis), especially if the doctor wants yo Continue reading >>

Can You Ever Stop Insulin?

Can You Ever Stop Insulin?

Once you begin using insulin to treat type 2 diabetes, can you ever get off it and go back to medications? — Anne, Minnesota For someone to go back to oral diabetes medicines after starting insulin, the pancreas must be able to produce enough insulin to maintain normal sugar levels. That being said, there are several instances in which insulin injections may be stopped. Here are a few: 1. In some individuals who have had untreated or poorly controlled diabetes for several weeks to months, glucose levels are high enough to be directly toxic to the pancreas. This means that the pancreas has not completely lost its ability to produce the critical level of insulin, but it does not work properly as a result of high glucose levels. In this instance, injected insulin can be used for several days or weeks to reduce glucose and help the pancreas to revert back to its usual level of functioning — a level that can control glucose supported by oral medicines. Once this occurs, insulin can be stopped. Remember, oral diabetes medicines work well only if the pancreas can still produce and release insulin. 2. Sometimes insulin is given during an acute illness such as an infection, when glucose levels can be high and the demand for insulin is greater than the pancreas can handle. After the illness is treated adequately, oral medicines can be started again. 3. Many obese individuals with diabetes who require insulin can reduce their dose or control their diabetes by taking oral medicines if they lose weight. However, the choice of insulin to manage diabetes does not always come after exhausting all oral or non-insulin options. Insulin has several advantages and is now more frequently introduced early in the management of type 2 diabetes. Continue reading >>

Metformin Forever

Metformin Forever

Metformin controls the insulin resistance of people who have type 2 diabetes so well that, if possible, all of us should be taking it. That’s what Roderic Crist, M.D., told me at the annual convention of the American Society of Bariatric Physicians in Denver this weekend. Dr. Crist specializes in family medicine in Cape Girardeau, Missouri. “Not everybody can take every drug,” he added, when I followed up our conversation by calling him at his office after he returned home. “But most of the time people can take metformin if they take it carefully.” Doctors increasingly prescribe it not only for type 2 diabetes but also for insulin resistance, polycystic ovary syndrome, and non-alcoholic fatty liver disease. Roughly one-third of Dr. Crist’s patients have diabetes. Well over half, if not two-thirds of the people he sees are insulin resistant. “I treat insulin resistance with that drug even if they aren’t fully diabetic.” he says. “If they have high triglyceride levels and low HDL levels, particularly if they are centrally obese, they should probably be on metformin. It helps slow the progression of the disease from one thing to the next.” But he goes further. He prescribes metformin to almost all of his patients who have type 2 diabetes — no matter how low their A1C level is. And he tells his patients that their levels should be 5.0 or less — not the American Diabetes Association’s less stringent recommendation of 7.0 or less. “If their A1C is at 5, their diabetes is in complete remission. So I have that as a goal.” And he still prescribes metformin to them after they reach that goal. “The two important issues are that it will prevent progression and it should be used in the earliest phases of insulin resistance. We vastly underutilize me Continue reading >>

Regular Exercise Got Me Off Insulin

Regular Exercise Got Me Off Insulin

Save for later When 64-year-old Eddie was told three years ago by his GP that if he didn’t stop smoking he risked amputation, he went home and had a think. Diabetes doesn't stop you working out I'd had a series of mini strokes and problems with walking turned out to be peripheral vascular disease. I had smoked all my life. Some time earlier, I was showing all the symptoms of Type 2 diabetes, but I did not know I had developed the condition at that point. I gave up smoking and then I went back to my GP and said ‘I know what I can’t do, but what can I do?’ I was offered a gym membership free for three months. At first it was hard but then I loved it. It was a case of lie on the couch all day or do something. I chose to do something. My brother who is Type 1 did not believe I was off insulin as he thought once on it you were on it for life and to tell the truth so did I. I had been checking my blood sugars once a week and handing them in to my GP and everything was fine. I was then told I did not need to do this anymore. Everything was fine for about a year then I was taken ill with some sort of virus. After this cleared I went back to the gym as normal. Then one Friday I was at the gym, but everything seemed more difficult than usual and one of the staff commented that I looked grey and my wife also commented on this. I went straight to the GP who took some bloods. I got a call about 5pm the doctor said he had handed in a new prescription for me to collect on the next day (Saturday). By now I was terribly thirsty and was drinking anything I could get my hands including sugary juice - coca cola and lemonade - which I knew I should not do, but did not by this time care. I was so thirsty I didn't want to swallow. I just wanted to pour it down my throat also at the sa Continue reading >>

The Odds Of Coming Off Insulin

The Odds Of Coming Off Insulin

I recently received a question by e-mail, and thought I’d share the question and my reply with readers. The writer asked: Wondering what the odds are of coming off insulin once you are on it? I am now on Byetta, Avandia and Glucotrol and my endocrinologist is trying to start a small dose of insulin. She says “maybe your pancreas needs a rest.” I’m afraid I would be on it forever. I replied: Before answering your question, I’d respond with a question of my own: what’s so awful about being on insulin therapy long-term? I know there are lots of reasons for people to be concerned about insulin therapy, some of which are valid (the possibility of hypoglycemia, and the chance for weight gain), and some of which are not – see my previous essay about the Top Ten Reasons not to start insulin therapy. You seem to have type 2 diabetes, based on your taking several standard diabetes medications. If your A1C remains elevated (or, worse, is going up), something else needs to be done. First on the list: be sure you are on the best possible meal plan, to lose any excess weight and control glucose and lipid levels optimally. If you haven’t spent time with a diabetes dietitian recently, you should. Second, if possible, increase your exercise level. If your meal plan and exercise program are already the best that you can possible handle, then insulin is definitely needed. Adding or switching pills would only be procrastinating, in my opinion. The main point for me to make is that taking insulin shots does not mean that you’ve somehow “failed” at controlling your diabetes. Type 2 diabetes is a progressive disorder, and eventually the beta cells of the pancreas will no longer be able to make sufficient insulin, no matter how hard you’ve worked at managing your diabet Continue reading >>

Questions And Answers - Medication And Insulin

Questions And Answers - Medication And Insulin

Q: I have type 2 diabetes and have been on insulin for a year now. I have lost some weight and my A1C has dropped from 9.5 to 6.5 but I am having a lot of lows ranging from upper 40's to 60's. I am wondering if maybe I might be able to get off insulin. I feel that my oral med is starting to work better now that my beta cells have had a rest. Can that be true? A: Yes, your cells are also in a better position to uptake glucose from the bloodstream now that you have decreased body fat. You should see your physician ASAP to get this adjusted. 40's are a dangerous range to be in. He/she may start weaning you off insulin, watching your levels along the way. Q: How much is blood sugar decreased for every unit of novolog insulin? A: A starting point is to consider that one unit of insulin will lower the glucose 50 points. This can vary from 30-100 points, depending on one's insulin sensitivity, exercise habits, food choices or other variables. Time will tell for you as you test and track your numbers to see if a pattern evolves. Q: What medication is used to replace metformin when liver enzymes are high and the endocrinologist discontinues this medication? A: Much will depend on the advancement of your diabetes and other medications you might be taking. Your physician might choose a meglitinide such as Prandin or an alpha-clucosidase inhibitor such as Precose. Insulin would be another choice. There are other meds and newer ones always in the mill. Some physicians keep their patients on Metformin if the enzyme levels are not too high. If your numbers are not too high and you are otherwise healthy, focus on lifestyle management. Losing body fat, if needed, can help to get things under control. Q: My bottle of insulin will expire next month. Can I still use it or do I need to thro Continue reading >>

Do You Worry About Getting Insulin Shots For Type 2 Diabetes?

Do You Worry About Getting Insulin Shots For Type 2 Diabetes?

When your doctor says you have type 2 diabetes, you may worry about getting shots of insulin to control the disease. But that’s seldom the first step, and some people don’t need insulin for years — or ever. When you have type 2 diabetes, your body doesn’t make enough insulin, as the body is unable to use it properly. Without insulin, blood glucose (sugar) levels rise. High blood glucose levels can damage your organs, including blood vessels, nerves, kidneys and eyes. But with lifestyle changes and medications, many people are staying healthier longer with type 2 diabetes. Endocrinologist Richard Shewbridge, MD, says there is lot you can do to live well with diabetes. What’s behind type 2 diabetes? Type 2 diabetes develops because the body becomes resistant to insulin. Insulin is a hormone made by the pancreas to turn blood sugar into energy. “Type 2 diabetes means the process to turn food into energy isn’t working as well,” says Dr. Shewbridge. Poor choices in diet and lack of exercise work to worsen insulin resistance, he says. And genetics can play a role, too. Additionally, people with type 2 diabetes tend to make less and less insulin over time and that causes a rise in blood sugar after meals. The role of eating right and exercising Many people with type 2 diabetes aren’t put on medication right away. Your doctor will likely suggest changes in your eating and exercise habits first. “Once someone is put on medication, they may need it for the rest of their life. But, they also can treat diabetes with a healthy lifestyle and exercise,” says Dr. Shewbridge. Healthier eating habits are a good place to start. “Cut out simple sugars. Eat less starchy bread, pasta, noodles and cereal. These foods don’t necessarily taste sweet, but they break down Continue reading >>

Stopping Diabetes Medicines

Stopping Diabetes Medicines

“I want to get off some of these drugs,” Ellen told me. “But my doctor says I need them. I’m on three for glucose, two for blood pressure, and one for depression. They’re costing me hundreds every month. What can I do?” Ellen is a health-coaching client of mine, age 62 with Type 2 diabetes. She works as an executive secretary in an insurance company. It’s stressful. She’s usually there from 8 AM until 6 PM or later and comes home “too tired to exercise.” She mentioned that just “putting herself together” for work every day requires an hour of prep time. “You have to look good for these executives,” she says. I asked about her drugs. She said she takes metformin (Glucophage and others), sitagliptin ( brand name Januvia), and pioglitazone (Actos) for diabetes, lisinopril (Privinil, Zestril) for blood pressure, simvastatin (Zocor) for cholesterol, and paroxetine (Paxil) for depression. Her A1C is now at 7.3%, down from a high of 9.9% a year ago, when she was on only two medicines. “I think the drugs are depressing me,” she said. “The cost, the side effects… I have nausea most days, I have cough from the lisinopril. That doesn’t help at work. I don’t know what’s worse, the drugs or diabetes.” What would you have said to Ellen? Although I strongly believe in reducing drug use, I told her what most experts say, that she can get off some, possibly all diabetes drugs, but it will take a lot of work. Asqual Getaneh, MD, a diabetes expert who writes for Everyday Health, says that doctors want to be “assured that an A1C will stay down” if a person goes off medicines. She says doctors usually won’t reduce medicines until A1C drops below 7.0%. In the ADA publication Diabetes Forecast, pharmacist Craig Williams, PharmD, writes, “Unf Continue reading >>

Diabetic Put Her Life At Risk To Lose Weight: Mother Stopped Taking Her Insulin Injections After Ballooning To 19 Stone

Diabetic Put Her Life At Risk To Lose Weight: Mother Stopped Taking Her Insulin Injections After Ballooning To 19 Stone

A diabetic mother whose weight ballooned during pregnancy put her life at risk when she stopped taking her insulin medication in a bid to slim down. Hayleigh Juggins ignored doctors' advice, halting the treatment for her diabetes having blamed the hormone for her weight reaching 19st. The 20-year-old was diagnosed with type one diabetes when she was 15 years old. When she fell pregnant three years later, she began taking high doses of insulin, which she claims led to rapid weight gain. By the time she gave birth when she was 19, she weighed 19st and was wearing size 22 clothes. Horrified, she decided to disregard doctors’ instructions to take insulin after each meal and subsequently found herself shrinking. Stable today at 10st 10lb, Miss Juggins says that despite being pleased at gaining her dream figure, she will never again risk serious damage to her health by going against medical advice. She said: ‘There was a war within me - on the one hand I was distraught at having gained so much weight during pregnancy, but on the other I knew what I was doing was bad for me. Indeed, experts stress that skipping insulin can have devastating consequences, including brain damage and death. Libby Dowling, Diabetes UK Clinical Advisor, said: 'Skipping insulin to lose weight is extremely dangerous. This is because if you haven't got enough insulin in your body your blood glucose will get too high, which can lead to devastating health complications. 'In the short term it can lead to diabetic ketoacidosis, an extremely dangerous condition that requires immediate medical attention and treatment in hospital, and can even be fatal. And in the long term skipping insulin can lead to complications such as blindness, stroke and amputations. 'It is crucial that people who are omitting the Continue reading >>

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