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Do All Diabetics Eventually Need Insulin?

Insulin Therapy For Type 2 Diabetes: How Doctors Use It And Adjust For Treatment

Insulin Therapy For Type 2 Diabetes: How Doctors Use It And Adjust For Treatment

Insulin therapy requires frequent dosage adjustments to maintain adequate blood glucose levels. Here’s information patients with type 2 diabetes can use. So your doctor told you that you need insulin therapy for your type 2 diabetes. This is a common problem and is likely to grow in the coming years. MORE FROM MICHIGAN: Subscribe to our weekly newsletter About 29 million people in the United States have type 2 diabetes, and 86 million more have prediabetes. About 1 in 4 people with type 2 diabetes is on insulin therapy; an additional 1 in 4 probably needs to be. What does it mean to be on insulin therapy? Could you have prevented this? Will insulin actually work? These are frequent questions people who need insulin therapy ask. As someone who has treated people with diabetes for years and has been working to improve the treatment’s effectiveness, I will do my best to help you answer these questions. I also have been working to develop a better way to personalize dosing for insulin. Insulin therapy for type 2 diabetes Diabetes is a condition in which your pancreas fails to secrete a sufficient amount of insulin to help you maintain normal blood glucose, or sugar in the blood, which is transported to various parts of the body to supply energy. There are many causes of insulin deficiency, but the most common is type 2 diabetes. The main risk factors for type 2 diabetes are family history, weight and age. In fact, most overweight and obese people in the Western world will never develop diabetes. Weight is an important, yet misunderstood, risk factor for diabetes. The foods you eat are usually less relevant than the weight itself. Most people in the world with type 2 diabetes do not fulfill the medical criteria of obesity; rather, their weight exceeds the capacity of the Continue reading >>

7 Scary Things That Can Happen When You Don't Treat Your Diabetes

7 Scary Things That Can Happen When You Don't Treat Your Diabetes

Swallowing pills, checking your blood sugar all the time, or sticking yourself with needles full of insulin probably doesn't sound like your idea of a good time. But taking steps to keep your diabetes under control is your best shot at preventing a slew of frightening complications. If you don't take care of yourself, "diabetes complications typically start within 5 years; within 10 to 15 years, the majority of patients will progress to have multiple health issues," says Betul Hatipoglu, MD, an endocrinologist at Cleveland Clinic. Fortunately, eating a nutritious diet, exercising, and taking your medication may not only stop complications from progressing, but can also reverse them, she says. Need motivation to stick to your treatment plan? Here's what can happen when you slack off. With type 1 diabetes, your body stops producing insulin, a hormone that regulates blood sugar; with type 2 diabetes, your body can't properly use the insulin you do produce. In turn, your HDL (or "good") cholesterol lowers, and your levels of harmful blood fats called triglycerides rise. Insulin resistance also contributes to hardened, narrow arteries, which in turn increases your blood pressure. As a result, about 70% of people with either type of diabetes also have hypertension—a risk factor for stroke, heart disease, and trouble with thinking and memory. (Add these 13 power foods to your diet to help lower blood pressure naturally.) Failing to control high blood pressure and high cholesterol, either with diet and exercise alone or by adding medications, accelerates the rate at which all your other complications progress, says Robert Gabbay, MD, PhD, chief medical officer at Joslin Diabetes Center in Boston. More than 4 million people with diabetes have some degree of retinopathy, or dam Continue reading >>

Diabetes Mellitus - Insulin Treatment In Dogs

Diabetes Mellitus - Insulin Treatment In Dogs

By Ernest Ward, DVM & Robin Downing, DVM, DAAPM, DACVSMR, CVPP Emergency Situations, Medical Conditions This handout provides detailed information on insulin administration. For more information about diabetes mellitus, see the fact sheets "Diabetes Mellitus - General Information", and "Diabetes Mellitus - Principles of Treatment". What is diabetes mellitus? In dogs, diabetes mellitus is caused by the failure of the pancreas to produce enough insulin to regulate blood sugar. This is Insulin Dependent Diabetes Mellitus (also called Type 1 Diabetes). This type of diabetes usually results from destruction of most or all of the beta-cells that produce insulin in the pancreas. As the name implies, dogs with this type of diabetes require insulin injections to stabilize blood sugar levels. What do I need to know about insulin treatment for diabetes mellitus? In diabetic dogs, the main treatment for regulating blood glucose is giving insulin by injection. Dogs with diabetes mellitus typically require two daily insulin injections as well as a dietary change. Although the dog can go a day or so without insulin and not have a crisis, this should not be a regular occurrence; treatment should be looked upon as part of the dog's daily routine. This means that you, as the dog's owner, must make both a financial commitment and a personal commitment to treat your dog. If are out of town or go on vacation, your dog must receive proper treatment in your absence. Initially, your dog may be hospitalized for a few days to deal with any immediate crisis and to begin the insulin regulation process. For instance, if your dog is so sick that he has quit eating and drinking for several days, he may be experiencing “diabetic ketoacidosis,” which may require a several days of intensive care. On Continue reading >>

Type 2 Diabetes

Type 2 Diabetes

Overview Diabetes is a lifelong condition that causes a person's blood sugar level to become too high. The hormone insulin – produced by the pancreas – is responsible for controlling the amount of glucose in the blood There are two main types of diabetes: type 1 – where the pancreas doesn't produce any insulin type 2 – where the pancreas doesn't produce enough insulin or the body's cells don't react to insulin These pages are about type 2 diabetes. Read more about type 1 diabetes. Another type of diabetes, known as gestational diabetes, occurs in some pregnant women and tends to disappear after birth. Symptoms of diabetes The symptoms of diabetes occur because the lack of insulin means glucose stays in the blood and isn't used as fuel for energy. Your body tries to reduce blood glucose levels by getting rid of the excess glucose in your urine. Typical symptoms include: feeling very thirsty passing urine more often than usual, particularly at night feeling very tired weight loss and loss of muscle bulk See your GP if you think you may have diabetes. It's very important for it to be diagnosed as soon as possible as it will get progressively worse if left untreated. Causes of type 2 diabetes Type 2 diabetes occurs when the body doesn't produce enough insulin to function properly, or the body's cells don't react to insulin. This means glucose stays in the blood and isn't used as fuel for energy. Type 2 diabetes is often associated with obesity and tends to be diagnosed in older people. It's far more common than type 1 diabetes. Treating type 2 diabetes As type 2 diabetes usually gets worse, you may eventually need medication – usually tablets – to keep your blood glucose at normal levels. Complications of type 2 diabetes Diabetes can cause serious long-term heal Continue reading >>

Get Unlimited Access On Medscape.

Get Unlimited Access On Medscape.

You’ve become the New York Times and the Wall Street Journal of medicine. A must-read every morning. ” Continue reading >>

Metformin Best For Type 2 Diabetes First Treatment

Metformin Best For Type 2 Diabetes First Treatment

HealthDay Reporter TUESDAY, Oct. 28, 2014 (HealthDay News) -- People newly diagnosed with type 2 diabetes who are initially given the drug metformin are less likely to eventually need other drugs to control their blood sugar, a new study suggests. The study found that, of those started on metformin, only about one-quarter needed another drug to control their blood sugar. However, people who were started on type 2 diabetes drugs other than metformin often needed a second drug or insulin to control their blood sugar levels, the researchers said. "This study supports the predominant practice, which is that most people are started on metformin," said lead researcher Dr. Niteesh Choudhry, an associate professor of medicine at Harvard Medical School in Boston. "Metformin might be more effective than others in controlling blood sugar," he noted. "Metformin, which is one of the oldest drugs we have and which the guidelines recommend as being the first drug to use, is associated with a lower risk of needing to add a second drug or insulin compared to any of three other commonly used classes of drugs," Choudhry said. The report was published in the Oct. 27 online edition of JAMA Internal Medicine. A hallmark of type 2 diabetes is insulin resistance, according to the American Diabetes Association (ADA). That means the body doesn't effectively use the hormone insulin. Insulin is produced by the pancreas and helps usher sugar from foods into the body's cells to be used as energy. When people have insulin resistance, too much sugar is left in the blood instead of being used. Over the long-term, high blood sugar levels can lead to serious complications, such as heart and kidney disease, according to the ADA. There are eight classes of oral type 2 diabetes medications, according to the Continue reading >>

Starting Insulin Treatment In Type 2 Diabetes

Starting Insulin Treatment In Type 2 Diabetes

Introduction The emerging epidemic of type 2 diabetes, coupled with finite health resources, requires the treatment of hyperglycaemia to be simple and efficiently managed. Type 2 diabetes is a progressive disease and eventually almost all patients will require insulin to maintain good glycaemic control. Knowing when and how to start insulin in general practice is central to the optimal management of type 2 diabetes. The need to start insulin therapy in a newly diagnosed patient with type 2 diabetes is relatively uncommon. It should be considered when there is considerable weight loss, severe symptoms of hyperglycaemia or the presence of significant ketonuria. Many of these patients can be converted back to oral drugs once glycaemic control has been established and there is some recovery of pancreatic β cell function. A more common problem is when and how to commence insulin in patients with type 2 diabetes who are in 'secondary failure'. The term secondary failure refers to the 'failure' of oral hypoglycaemic drugs to maintain glycaemic control. The United Kingdom Prospective Diabetes Study (UKPDS)1 clearly showed that most people with type 2 diabetes will experience progressive pancreatic β cell dysfunction, despite excellent control. The secondary failure rate in this study was 44% after six years of diabetes. Since the time of the UKPDS, targets for glycaemic control have become increasingly stringent so secondary failure of oral hypoglycaemic drugs now occurs much sooner and is almost invariable. The younger, the sooner, the better The key to when to start insulin is to identify the appropriate glycated haemoglobin (HbA1c) target for an individual patient. Despite the promulgation of various 'guidelines', there is no single HbA1c concentration which suits everyone 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 >>

Do All Type 2 Diabetics Eventually Need To Use Insulin At Some Point In Life?

Do All Type 2 Diabetics Eventually Need To Use Insulin At Some Point In Life?

Type 2 diabetes is controllable by oral anti hyperglycemic pills (hypoglycemic pills), but when the blood sugar is grossly out of control, or even combination of 2 or 3 drugs aren't working, insulin is the best option available. Also, it is a life saver for any type of diabetes with few side effects, major one being hypoglycemia. However, there are certain conditions where insulin has to be administered even in Type 2 diabetics, like- Pregnancy, where insulin is considered the safest drug for diabetics Surgery, which is a condition of stress for the body and insulin is required Infections and other stressful conditions where blood glucose levels are poorly controlled. Having mentioned the exceptions, Type 2 diabetes can be controlled without the use of insulin except under special circumstances. I tried searching for some epidemiological data to look for use of insulin among Type 2 diabetics, but couldn't find anything relevant. However, even if the person is switched to insulin, it can be reversed in most cases of Type 2 DM with better control of blood sugar and lifestyle modifications like increasing daily exercise, decreasing weight in case of obese which directly lead to decrease in insulin resistance! Continue reading >>

Insulin Injection Know-how

Insulin Injection Know-how

0- 1- American Association of Diabetes Educators Supported by BD Diabetes Care1 Understanding Insulin Welcome to the ranks of nearly 26 million Americans diagnosed with diabetes. By now you’ve probably been given enough information about diabetes to make your head spin. But two important facts should stand out: No doubt, you and your healthcare team will develop a plan for manag- ing your diabetes. The plan may include some changes to the way you eat, the way you move, and the medications you take. Even if insulin injections are not currently part of the plan, it is important that you familiarize yourself with the concept of taking insulin. Here’s why. DIABETES IS EVER-CHANGING Insulin is a hormone produced by the pancreas. Insulin’s job is to shuttle glucose (sugar) out of the bloodstream and into the body’s cells (the tiny components of all parts of our bodies). This helps to nourish the body’s cells and keep the blood sugar level from climbing too high. All people with type 1 diabetes require insulin—not just to control blood sugar levels, but simply to stay alive. The human body cannot survive without insulin, and people with type 1 diabetes produce little or no insulin of their own. Upon diagnosis, some people with type 1 diabetes still make a small amount of insulin. This is called a “honey- moon†phase. However, no honey- moon lasts forever. A� er a period of weeks or months, insulin injections almost always become necessary. DIABETES CAN BE CONTROLLED, AND IT IS VERY IMPORTANT TO DO SO.� Supported by BD Diabetes Care2 American Association of Diabetes Educators insulin injection know-how understanding insulin 2 More than 90% of people with diabetes have type 2 diabetes. Type 2 is very diff erent from t Continue reading >>

12 Myths About Insulin And Type 2 Diabetes

12 Myths About Insulin And Type 2 Diabetes

Insulin facts vs. fiction When you hear the word “insulin,” do you picture giant needles (ouch!) or pop culture portrayals of insulin users with low blood sugar (like Julia Roberts losing it in Steel Magnolias)? Either way, most people think of insulin as a difficult, painful, or potentially scary medical treatment. The problem is that if you have type 2 diabetes, you need to know the real deal before you can make an informed choice about whether or not this potentially lifesaving therapy is right for you. Here, we take a look at the facts and fiction about insulin when it comes to treating type 2 diabetes. Diabetics always need insulin Not necessarily. People with type 1 diabetes (about 5% to 10% of diabetics) do need insulin. If you have type 2, which includes 90% to 95% of all people with diabetes, you may not need insulin. Of adults with diabetes, only 14% use insulin, 13% use insulin and oral medication, 57% take oral medication only, and 16% control blood sugar with diet and exercise alone, according to the CDC. The point is to get blood sugar—which can be a highly toxic poison in the body—into the safe zone by any means necessary. Taking insulin means you’ve ‘failed’ “This is a big myth,” says Jill Crandall, MD, professor of clinical medicine and director of the diabetes clinical trial unit at the Albert Einstein College of Medicine, in the Bronx, N.Y. “Many people who try very hard to adhere to a diet, exercise, and lose weight will still need insulin.” The fact is that type 2 diabetes is a progressive illness, meaning that over time you may need to change what you do to make sure your blood sugar is in a healthy range. Eating right and exercise will always be important, but medication needs can vary. “A large percentage of people with ty Continue reading >>

Managing Diabetes Without Insulin – Is It Possible?

Managing Diabetes Without Insulin – Is It Possible?

It is widely believed that those with Type 2 diabetes may eventually need insulin if they have diabetes for long enough. However, only about 20-30 percent of people with Type 2 diabetes end up needing insulin injections. In this article, we will explore whether it is possible to manage your diabetes without insulin. If so, how can one do so and when they may eventually need insulin if other treatments do not work out? 1 Type 1 Diabetes disclaimer This article is not for people with Type 1 diabetes because it is imperative that people with Type 1 diabetes require insulin every day without question. A person with Type 1 diabetes produces very little, or no insulin. Without insulin, you cannot convert food into usable energy. Simply put, without insulin, a person with Type 1 diabetes cannot survive. 2 When Robert contacted TheDiabetesCouncil, he was concerned that one day he would have to take insulin shots for his Type 2 diabetes. He had heard a few of his friends with diabetes at church talking about how they had to take insulin injections. Robert was “afraid of needles,” and the thought of giving himself a shot scared him. Is Robert going to need to start taking insulin, or is there any way he can avoid it at this point? If he avoids it, what effects would this have on his health? Will he develop long term complications of diabetes if he doesn’t start giving himself shots of insulin? I suggest also reading these: At TheDiabetesCouncil, we decided to take a look at this particular question in depth, for Robert and for others with diabetes who might benefit from reading this information. Insulin isn’t the “bad guy.” Naturally, the fear of giving oneself an injection or “shot,” can increase anxiety and stress. But what if I told you that once you get past t Continue reading >>

Kidney Disease And Diabetes: What You Need To Know

Kidney Disease And Diabetes: What You Need To Know

March is National Kidney Month, a good time to check if you or your family are at risk for kidney disease or diabetes—conditions that affect millions of Americans. Your kidneys play a very important part in keeping you healthy. These two bean-shaped, fist-sized organs are located in the middle of your back, on either side of the spine. Their main job is to filter your blood to remove wastes that could damage your body. They also help to control blood pressure and make hormones that your body needs to stay healthy. Each kidney contains about one million tiny filters called nephrons. Inside each nephron are tiny blood vessels and urine collecting tubes. Most people develop kidney disease when the nephrons can no longer filter blood as well as they used to. Damage usually happens slowly, over many years. As more and more filters fail, the kidneys eventually are unable to keep the body healthy. At that point you need either dialysis or a kidney transplant. You should be tested for kidney disease if you have any risk factors. (See "Kidney Disease: Early Detection and Treatment" on page 9.) Early kidney disease has no symptoms, which means you can't feel if you have it. Blood and urine tests are the only way to know if you have early kidney disease. Proper treatment can help prevent further kidney damage and slow the progression of kidney disease. The earlier kidney disease is found, the sooner you can take medications and other steps that can keep your kidneys healthier longer. If you are at risk for kidney disease, there are steps to take to help protect your kidneys: Manage your diabetes Keep your blood pressure below 130/80 mmHg Take medicines as prescribed. If your body is unable to use blood sugar called "glucose" the way it should, you have diabetes. A healthy body u Continue reading >>

Understanding Type 2 Diabetes

Understanding Type 2 Diabetes

Diabetes is a chronic medical condition in which sugar, or glucose, levels build up in your bloodstream. The hormone insulin helps move the sugar from your blood into your cells, which are where the sugar is used for energy. In type 2 diabetes, your body’s cells aren’t able to respond to insulin as well as they should. In later stages of the disease your body may also not produce enough insulin. Uncontrolled type 2 diabetes can lead to chronically high blood sugar levels, causing several symptoms and potentially leading to serious complications. In type 2 diabetes your body isn’t able to effectively use insulin to bring glucose into your cells. This causes your body to rely on alternative energy sources in your tissues, muscles, and organs. This is a chain reaction that can cause a variety of symptoms. Type 2 diabetes can develop slowly. The symptoms may be mild and easy to dismiss at first. The early symptoms may include: constant hunger a lack of energy fatigue weight loss excessive thirst frequent urination dry mouth itchy skin blurry vision As the disease progresses, the symptoms become more severe and potentially dangerous. If your blood sugar levels have been high for a long time, the symptoms can include: yeast infections slow-healing cuts or sores dark patches on your skin foot pain feelings of numbness in your extremities, or neuropathy If you have two or more of these symptoms, you should see your doctor. Without treatment, diabetes can become life-threatening. Diabetes has a powerful effect on your heart. Women with diabetes are twice as likely to have another heart attack after the first one. They’re at quadruple the risk of heart failure when compared to women without diabetes. Diabetes can also lead to complications during pregnancy. Diet is an imp Continue reading >>

What Is Insulin And Why Do Some Diabetics Need To Take It?

What Is Insulin And Why Do Some Diabetics Need To Take It?

Question: What is insulin and why do some diabetics need to take it? Answer: Insulin is a hormone. It's made by certain cells in the pancreas, which are called the beta cells of the pancreas, and the beta cells from the pancreas are part of these little islets called the Islets of Langerhans. That's where insulin normally comes from, and in type 2 diabetes there is always some insulin coming out from those beta cells; in type 1 diabetes, you tend to lose the beta cells and make no insulin. Since 1921 or so, though, insulin has been available as a pharmacologic approach, so you can take insulin by injection, and you can replace what's not being made in the pancreas. Who needs insulin? Well, it really is two situations. First of all, in type 1 diabetes, insulin is always necessary because the beta cells in the pancreas are not making any insulin. So, people with type 1 or juvenile onset diabetes always need insulin injections. In type 2 diabetes, you may also need insulin if your pancreas has sort of worn out to the point that it's not making anywhere near enough insulin, and you do need insulin injections. Type 2 diabetes often can be treated by different pills that might improve the insulin release by the pancreas or improve the response of the body to insulin, but eventually even type 2 diabetes may simply not be making, the pancreas may not be making enough insulin, and the person may need insulin by injection. Next: What Causes Diabetes? Previous: What Is Gestational Diabetes And Can It Hurt My Baby? Continue reading >>

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