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Do You Have To Take Insulin With Type 2 Diabetes?

Type 2 Diabetes: What Is It?

Type 2 Diabetes: What Is It?

When it comes to your body, you probably spend more time thinking about your hair than your hormones. For some people, though, a problem with a hormone called insulin causes a health condition called type 2 diabetes (pronounced: dye-uh-BEE-tees). Diabetes is a disease that affects how the body uses glucose (pronounced: GLOO-kose), a sugar that is the body's main source of fuel. Your body needs glucose to keep running. Here's how it should work: Glucose from the food gets into your bloodstream. Your pancreas makes a hormone called insulin (pronounced: IN-suh-lin). Insulin helps the glucose get into the body's cells. The pancreas is a long, flat gland in your belly that helps your body digest food. It also makes insulin. Insulin is like a key that opens the doors to the cells of the body. It lets the glucose in. Then the glucose can move out of the blood and into the cells. But if someone has diabetes, either the body can't make insulin or the insulin doesn't work in the body like it should. The glucose can't get into the cells normally, so the blood sugar level gets too high. Lots of sugar in the blood makes people sick if they don't get treatment. There are two major types of diabetes: type 1 and type 2. Each type causes high blood sugar levels in a different way. In type 1 diabetes , the pancreas can't make insulin. The body can still get glucose from food, but the glucose can't get into the cells, where it's needed, and glucose stays in the blood. This makes the blood sugar level very high. With type 2 diabetes, the body still makes insulin. But a person with type 2 diabetes doesn't respond normally to the insulin the body makes. So glucose is less able to enter the cells and do its job of supplying energy. When glucose can't enter the cells in this way, doctors call Continue reading >>

Insulin And Type 2 Diabetes: What You Should Know

Insulin And Type 2 Diabetes: What You Should Know

Insulin and Type 2 Diabetes If your health care provider offered you a medication to help you feel better and get your blood sugar under control, would you try it? If so, you might be ready to start taking insulin. Does insulin immediately make you think of type 1 diabetes? Think again. Between 30 and 40 percent of people with type 2 diabetes take insulin. In fact, there are more people with type 2 diabetes who take insulin than type 1 because of the much larger number of people with type 2. Experts believe even more people with type 2 should be taking insulin to control blood sugar -- and the earlier, the better. With an increase in people developing type 2 at a younger age and living longer, more and more people with type 2 will likely be taking insulin. "If you live long enough with type 2 diabetes, odds are good you'll eventually need insulin," says William Polonsky, Ph.D., CDE, associate clinical professor of psychiatry at the University of California, San Diego; founder and president of the Behavioral Diabetes Institute; and author of Diabetes Burnout: What to Do When You Can't Take It Anymore (American Diabetes Association, 1999). Producing Less Insulin Naturally Over Time Research has shown that type 2 diabetes progresses as the ability of the body’s pancreatic beta cells to produce insulin dwindles over time. Your beta cells -- the cells in the pancreas that produce insulin -- slowly lose function. Experts believe that by the time you're diagnosed with type 2 diabetes, you've already lost 50-80 percent of your beta cell function and perhaps the number of beta cells you had. And the loss continues over the years. "About six years after being diagnosed, most people have about a quarter of their beta cell function left," says Anthony McCall, M.D., Ph.D., endocri Continue reading >>

Insulin: Who Needs It And Who Doesn't?

Insulin: Who Needs It And Who Doesn't?

Does getting a diagnosis of diabetes automatically mean you will need to start taking insulin? The answer depends on the type of diabetes and how much your condition has progressed. People with type 1 diabetes require supplemental insulin because their bodies can no longer produce insulin themselves. However, type 2 diabetes is different. Less than one-third of those with type 2 diabetes take insulin. The CDC puts the number at about 28 percent. Some experts have long believed that more patients with type 2 diabetes should be on insulin in order to reach their blood glucose and lipid (cholesterol) targets. When you are diagnosed with type 2 diabetes you will probably wonder if, or when, you will need insulin. You may fear injections or you may believe that needing insulin represents a personal failure. So, you resist taking the drug, even when you need it. Whether or not a person with type 2 diabetes needs insulin is based on individual circumstances. The first step? Knowing the facts. Does Everyone With Diabetes Need Insulin? Type 1 and type 2 diabetes are conditions in which you don't have enough insulin or don't react to it well enough to remove glucose from the blood. This creates two problems: High blood glucose levels A lack of stored glucose, the body’s major fuel source The difference between type 1 and type 2 diabetes lies in the cause of this condition. Beta cells, found in the pancreas, produce the body’s insulin. In type 1 diabetes, most of those beta cells have been destroyed, limiting the supply of insulin. As a result, individuals with type 1 diabetes must take insulin to control their blood glucose levels. In type 2 diabetes, the pancreas may still produce insulin, but it either produces insufficient amounts or the body resists the insulin itself. Di Continue reading >>

Type 2 Diabetes And Insulin

Type 2 Diabetes And Insulin

Getting Started When most people find out they have Type 2 diabetes, they are first instructed to make changes in their diet and lifestyle. These changes, which are likely to include routine exercise, more nutritious food choices, and often a lower calorie intake, are crucial to managing diabetes and may successfully lower blood glucose levels to an acceptable level. If they do not, a drug such as glyburide, glipizide, or metformin is often prescribed. But lifestyle changes and oral drugs for Type 2 diabetes are unlikely to be permanent solutions. This is because over time, the pancreas tends to produce less and less insulin until eventually it cannot meet the body’s needs. Ultimately, insulin (injected or infused) is the most effective treatment for Type 2 diabetes. There are many barriers to starting insulin therapy: Often they are psychological; sometimes they are physical or financial. But if insulin is begun early enough and is used appropriately, people who use it have a marked decrease in complications related to diabetes such as retinopathy (a diabetic eye disease), nephropathy (diabetic kidney disease), and neuropathy (nerve damage). The need for insulin should not be viewed as a personal failure, but rather as a largely inevitable part of the treatment of Type 2 diabetes. This article offers some practical guidance on starting insulin for people with Type 2 diabetes. When to start insulin Insulin is usually started when oral medicines (usually no more than two) and lifestyle changes (which should be maintained for life even if oral pills or insulin are later prescribed) have failed to lower a person’s HbA1c level to less than 7%. (HbA1c stands for glycosylated hemoglobin and is a measure of blood glucose control.) However, a recent consensus statement from Continue reading >>

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 >>

Insulin Treatment For Type 2 Diabetes: When To Start, Which To Use

Insulin Treatment For Type 2 Diabetes: When To Start, Which To Use

Many patients with type 2 diabetes eventually need insulin, as their ability to produce their own insulin from pancreatic beta cells declines progressively.1 The questions remain as to when insulin therapy should be started, and which regimen is the most appropriate. Guidelines from professional societies differ on these points,2,3 as do individual clinicians. Moreover, antidiabetic treatment is an evolving topic. Many new drugs—oral agents as well as injectable analogues of glucagon-like peptide-1 (GLP1) and insulin formulations—have become available in the last 15 years. In this paper, I advocate an individualized approach and review the indications for insulin treatment, the available preparations, the pros and cons of each regimen, and how the properties of each type of insulin influence attempts to intensify the regimen. Coexisting physiologic and medical conditions such as pregnancy and chronic renal failure and drugs such as glucocorticoids may alter insulin requirements. I will not cover these special situations, as they deserve separate, detailed discussions. WHEN SHOULD INSULIN BE STARTED? TWO VIEWS Early on, patients can be adequately managed with lifestyle modifications and oral hypoglycemic agents or injections of a GLP1 analogue, either alone or in combination with oral medication. Later, some patients reach a point at which insulin therapy becomes the main treatment, similar to patients with type 1 diabetes. The American Diabetes Association (ADA), in a consensus statement,2 has called for using insulin early in the disease if lifestyle management and monotherapy with metformin (Glucophage) fail to control glucose or if lifestyle management is not adequate and metformin is contraindicated. The ADA’s goal hemoglobin A1c level is less than 7% for most Continue reading >>

The Truth About Insulin And Type 2 Diabetes

The Truth About Insulin And Type 2 Diabetes

Most people associate taking insulin with type 1 diabetes. However, some people with type 2 diabetes also need to take insulin. We talked with Andrea Penney, RN, CDE, Joslin Diabetes Center, to find out the truth about insulin and type 2 diabetes. Why would someone with type 2 diabetes who has been controlling their diabetes with diet and exercise need to start taking insulin? There are several reasons why someone would require insulin, even if they hadn’t needed it before. Temporary insulin usage– Some people need to take insulin for a short amount of time, because of things like pregnancy, surgery, broken bones, cancer, or steroidal medicines (like Prednisone). Permanent insulin usage - Sometimes the pancreas becomes unable to produce enough insulin. This happens frequently with aging. People can also become insulin resistant due to weight gain or chronic emotional or physical stress. Simply put, pills can no longer control diabetes. So, it’s not usually “bad” behavior that would cause someone to start insulin? Correct. However, non adherence to diet and exercise might 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? The doses will vary; either type may require very little or a lot of medication. It depends on weight, eating habits, exercise levels, existence of other illnesses and level of insulin resistance. Can someone start taking insulin and then not need to take it anymore? Absolutely! But only for those with type 2 diabetes. Often weight reduction and /or exercise can allow insulin to be stopped. Also, if any of the temporary situations listed above resolve, insulin might be stopped. Continue reading >>

Insulin Resistance And Beta-cell Failure In Type 2 Diabetes

Insulin Resistance And Beta-cell Failure In Type 2 Diabetes

Type 2 Diabetes Type 2 diabetes, sometimes called adult-onset diabetes, is the most common form of diabetes. It is commonly found in adults, but it is being seen more and more in young adults, too. Insulin is a hormone made by the pancreas. (More specifically, insulin is made by special cells in the pancreas, called beta cells.) The pancreas releases insulin to help the body use sugar. Insulin moves sugar to the cells, where it is used as energy. When blood sugar levels rise, such as after meals, the pancreas releases more insulin. When blood sugar levels are low, the pancreas releases less insulin. In type 2 diabetes, the body makes some insulin, but the body does not respond to it the way it used to. This is called insulin resistance. In addition to other factors, having too much body fat can contribute to insulin resistance. As a result of diabetes, the body needs more insulin to work. At first, the beta cells in the pancreas that produce insulin are able to keep up, and the pancreas churns out more insulin. But after a while, as more beta cells in the pancreas stop working, the pancreas is not able to keep up with the heavy demand, making less and less insulin until, in many people, it finally makes little to none. As a result of this lower amount of insulin, the sugar stays in the bloodstream, where it builds up and becomes too high. When blood sugar stays high for a long time, there’s a greater risk of developing some diabetes-related problems, like problems with the eyes (diabetic retinopathy) and the nerves in places like the hands and feet (neuropathy). This is why it is so important to keep blood sugar under control. People with type 2 diabetes need help controlling their blood sugar. The first things doctors usually suggest are diet, exercise, and often, di 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 >>

Why Insulin Can Become Necessary For A Person With Type 2 Diabetes

Why Insulin Can Become Necessary For A Person With Type 2 Diabetes

People with type 2 diabetes may require insulin when their meal plan, weight loss, exercise and antidiabetic drugs do not achieve targeted blood glucose (sugar) levels. Diabetes is a progressive disease and the body may require insulin injections to compensate for declining insulin production by the pancreas. That is why starting insulin treatment should never be seen as a failure. Starting insulin treatment should never be seen as a failure. Treatment with insulin may be added to an antidiabetic medication or completely replace it. Regardless of the treatment, lifestyle habits (diet, exercise, stress management) are essential to managing diabetes. Many people are reluctant to inject insulin for various reasons: Fear of pain or needles Guilt Impression that this is the “last resort” Fear of hypoglycemic attacks Fear of weight gain Memories of loved one who had to take insulin If this is the case, do not hesitate to discuss your concerns with a health care professional. Some of your fears may be due to false beliefs. Learning more about today’s insulin treatment will probably allay your fears. For many people, insulin is an effective way to achieve good blood-sugar control, which can prevent or delay certain diabetes complications over the long term. Every person with diabetes being treated with insulin should be trained by a health care professional. This training should include the different injection steps, as well as the treatment and prevention of hypoglycemia, which can occur in anyone on insulin. Research and text: Cynthia Chaput, Dietitian Scientific review: Louise Tremblay, Nurse. M. Ed. June 2014 - Revised May 2016 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 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 mayworry about getting shots of insulin to control the disease. But thats seldom the first step, and some people dont need insulin for years or ever. Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy When you have type 2 diabetes , yourbody doesnt 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 lotyou can do to live well with diabetes . Type 2 diabetes developsbecause the body becomes resistant to insulin. Insulin is a hormone made by the pancreas to turn blood sugar into energy.Type 2 diabetes means theprocess to turn food into energy isnt 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. Many people with type 2 diabetes arent 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 cerea Continue reading >>

“do I Need Insulin For My Type 2 Diabetes?”

“do I Need Insulin For My Type 2 Diabetes?”

After a type 2 diabetes diagnosis, there are four treatment options that you can discuss with your doctor: Diet & Exercise: Learning how to reduce the carbohydrates and overall calories in your diet along with regular exercise for weight loss. Losing weight helps improve insulin sensitivity (gaining weight promotes insulin resistance). For some people with type 2 diabetes, these changes can be enough to achieve healthier blood sugar levels. Oral Medications: There are a variety of oral medications (pills) for improving blood sugars in people with type 2 diabetes. They each are classified by their make-up and the impact on the body. While some pills increase natural insulin production, other pills are designed to decrease the amount of glycogen (which is eventually converted to glucose) secreted by your liver. The 6 primary classifications of pills are, Sulfonylureas, Meglitinides, Biguanides, Thiazolidinediones, Alpha-glucosidase inhibitors, and DPP-4 inhibitors. You may know some of the brand names, like Metformin, Avandia, or Januvia. Your diabetes healthcare team will help you determine the best fit for you. Injectable Medications: Known well as “Byetta” or “Symlin,” these medications are injected, but are very different than insulin. Symlin is known for helping with reducing blood sugars but also for promoting weight loss. Byetta works by increasing your own natural insulin production. Insulin: Lastly, there is insulin, which is administered with a syringe, pen, or pump. While most doctors will take you through the options above before prescribing insulin, this option might be exactly what you need. Insulin is the most powerful hormone in the body for regulating blood sugars, and as a person with type 2 diabetes, you either don’t produce enough to meet you 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 >>

Insulin For Type 2 Diabetes: Who, When, And Why?

Insulin For Type 2 Diabetes: Who, When, And Why?

Physicians who treat people with type 2 diabetes face difficult choices when selecting the best medical therapy for each patient. The decision process is further complicated by the fact that because type 2 diabetes is a progressive disease, therapeutic agents that were initially successful may fail five or ten years later. As recently as 1994, there were only two options for patients with type 2 diabetes: insulin and the sulfonylureas (such as glyburide and glipizide). The good news is that today, seven totally different classes of medications are available, as well as much better insulins. The bad news is that many physicians are more confused than ever, especially when faced with the option of combining two, three, or even more drugs at one time. In addition, the past several years have seen the advent of six combination drugs (such as Glucovance, Avandamet, and Janumet), with more on the way. Faced with this explosion of therapeutic options, many physicians are reluctant to start insulin therapy even when it is clearly indicated. Insulin Resistance and Deficiency in Type 2 Diabetes Most patients with type 2 diabetes suffer from two major defects: insulin resistance and beta cell “burnout.” Insulin resistance typically precedes outright diabetes by several years, appearing in adults and children who are overweight, sedentary, and have a genetic predisposition to diabetes. Patients with insulin resistance are often diagnosed with the metabolic syndrome, which predisposes them to both type 2 diabetes and cardiovascular disease. When food is ingested, insulin is secreted by the beta cells into the bloodstream. The insulin travels to the liver or muscles, where it attaches to receptors on the surface of the cells like a key in a lock. In non-diabetic people, this proc Continue reading >>

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