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Does Type 2 Diabetes Require Insulin

Managing Diabetes

Managing Diabetes

You can manage your diabetes and live a long and healthy life by taking care of yourself each day. Diabetes can affect almost every part of your body. Therefore, you will need to manage your blood glucose levels, also called blood sugar. Managing your blood glucose, as well as your blood pressure and cholesterol, can help prevent the health problems that can occur when you have diabetes. How can I manage my diabetes? With the help of your health care team, you can create a diabetes self-care plan to manage your diabetes. Your self-care plan may include these steps: Ways to manage your diabetes Manage your diabetes ABCs Knowing your diabetes ABCs will help you manage your blood glucose, blood pressure, and cholesterol. Stopping smoking if you smoke will also help you manage your diabetes. Working toward your ABC goals can help lower your chances of having a heart attack, stroke, or other diabetes problems. A for the A1C test The A1C test shows your average blood glucose level over the past 3 months. The A1C goal for many people with diabetes is below 7 percent. Ask your health care team what your goal should be. B for Blood pressure The blood pressure goal for most people with diabetes is below 140/90 mm Hg. Ask what your goal should be. C for Cholesterol You have two kinds of cholesterol in your blood: LDL and HDL. LDL or “bad” cholesterol can build up and clog your blood vessels. Too much bad cholesterol can cause a heart attack or stroke. HDL or “good” cholesterol helps remove the “bad” cholesterol from your blood vessels. Ask your health care team what your cholesterol numbers should be. If you are over 40 years of age, you may need to take a statin drug for heart health. S for Stop smoking Not smoking is especially important for people with diabetes beca 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 >>

Type 2s: Time For Insulin?

Type 2s: Time For Insulin?

Insulin has the most wonderful reputation among people with type 2 diabetes. Many view it the same way as moving to a nursing home (or Florida retirement community)… just one short step away from the grave. But nothing could be further from the truth. If anything, taking insulin keeps you as far away from the mortician as possible. Despite recent advances in medical therapy, insulin remains the most potent and effective treatment for elevated blood glucose. It is a more natural substance than pills (chemically similar to the insulin produced by the body), and lacks many of the potential side-effects inherent to oral medications. Today, there are more than 15 million people with type 2 diabetes in the United States, and more than 3 million take insulin. But many more people should probably be taking insulin. Here is why: Nature of the DiaBeast Type 2 diabetes is a progressive condition. It gets worse over time. It usually starts out as a state of mild insulin resistance: the insulin produced by the pancreas is not properly utilized by the body’s cells. This result is a gradual increase in the blood sugar level, which promotes increased insulin production by the pancreas. Eventually, the pancreas is unable to make enough insulin to overcome the insulin resistance, and glucose levels rise high enough to require medical treatment. All this time, the pancreas is working harder and harder to secrete as much insulin as possible. Just like a machine that is strained and overworked, the insulin-producing cells eventually burn out and cease to function. This is why the treatment for type 2 diabetes tends to become more aggressive over time. Initially, many people with type 2 diabetes can control their blood sugar through exercise (which improves insulin sensitivity) and a hea Continue reading >>

Type 2 Diabetes

Type 2 Diabetes

The pancreas lies at the back of the abdomen behind the stomach and has two main functions: to produce juices that flow into the digestive system to help us digest food to produce the hormone called insulin. Insulin is the key hormone that controls the flow of glucose (sugar) in and out of the cells of the body. Type 2 diabetes is caused by: insufficient production of insulin in the pancreas a resistance to the action of insulin in the body's cells – especially in muscle, fat and liver cells. Type 2 diabetes is strongly associated with being overweight, but it's less clear what causes it, compared to the Type 1 disease. Term watch Type 2 diabetes used to be called 'non-insulin dependent diabetes'. This is because insulin injections were not part of its treatment. As some people with Type 2 also now require insulin, the term Type 2 is preferred. In the first few years after diagnosis with Type 2 diabetes high levels of insulin circulate in the blood because the pancreas can still produce the hormone. Eventually insulin production dwindles. For reasons we don't understand, the effect of insulin is also impaired. This means it doesn't have its normal effect on the cells of the body. This is called insulin resistance. What is insulin resistance? Insulin resistance has a number of knock-on effects: it causes high blood glucose it disturbs the fat levels in the blood, making the arteries of the heart more likely to clog (coronary heart disease) The insulin-producing cells of the pancreas in people with Type 2 diabetes don't seem to come under attack from the immune system as they do in Type 1. But they are still unable to cope with the need to produce a surge of insulin after a meal. Normally, this insulin surge causes the body to store excess glucose coming in and so keeps 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 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 >>

Type 2 Diabetes: An Introduction

Type 2 Diabetes: An Introduction

SHARE RATE★★★★★ Type 2 diabetes (the full name is type 2 diabetes mellitus) is a disorder of metabolism, characterized by high blood glucose. It is the most common form of diabetes, accounting for over 90% of cases and is associated with older age, a family history of the disease, obesity, a prior history of gestational diabetes (a form of the disease that can occur in pregnant women), and certain ethnic backgrounds. The role of obesity in increasing risk for type 2 diabetes is particularly prominent. An estimated 80% of people with type 2 diabetes are obese or overweight.1 What goes wrong to cause type 2 diabetes? In type 2 diabetes, the main cause of elevated blood glucose is that the body loses the ability to use the hormone insulin effectively (this is sometimes called “insulin resistance”). Normally, insulin produced by the pancreas allows us to use the glucose we take in to satisfy our energy needs or store it away for later use. The root cause of insulin resistance in type 2 diabetes is not known, but something goes wrong with the ability of insulin to deliver glucose into cells. In most cases of type 2 diabetes, early in the disease, the pancreas produces a sufficient amount of insulin. However, over time, with type 2 diabetes, insulin production in the pancreas can also decrease. So, type 2 diabetes can involve two different mechanisms that interfere with how insulin normally functions, insulin resistance and decreased production of insulin by the pancreas.1,2 How is type 2 diabetes different from type 1 diabetes? Although both type 1 and type 2 diabetes are both characterized by elevated blood glucose, the cause behind this elevation is what distinguishes the two forms of diabetes. In type 1 diabetes an autoimmune process compromises the ability Continue reading >>

Type 2 Diabetes And The Insulin Pump

Type 2 Diabetes And The Insulin Pump

If you have type 2 diabetes and take multiple insulin shots, you may want to ask your doctor about the insulin pump. Insulin pumps are small, computerized devices (about the size of a small cell phone) that allow for a continuous flow of a rapid-acting insulin to be released into your body. The pumps have a small, flexible tube (called a catheter) with a fine needle on the end, which is inserted under the skin of your abdomen and taped in place. The devices can be worn on a belt or placed in a pocket. The insulin pump is designed to deliver a continuous amount of insulin, 24 hours a day according to a programmed plan unique to each pump wearer. The user can change the amount of insulin delivered. Between meals and overnights, a small amount of insulin is constantly delivered to keep the blood sugar in the target range. This is called the basal rate. When food is eaten, a bolus dose of insulin can be programmed into the pump. You can measure how much of a bolus you need using calculations based on the grams of carbohydrates consumed. When using an insulin pump, you must monitor your blood glucose level at least four times a day. You set the doses of your insulin and make adjustments to the dose depending on your food intake and exercise program. Some health care providers prefer the insulin pump for diabetes because its slow release of insulin mimics how a normally working pancreas would release insulin. One large study concluded the insulin pump is a safe and valuable treatment option for those with poorly controlled blood sugar. Another advantage of the insulin pump is that it frees you from having to measure insulin into a syringe. 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 >>

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 >>

Type 1 And Type 2 Diabetes: What’s The Difference?

Type 1 And Type 2 Diabetes: What’s The Difference?

If your child or someone you know has been recently diagnosed with type 1 diabetes, you may be wondering how the disease differs from type 2 diabetes — the form people tend to know more about. What causes type 1 versus type 2 diabetes? Are the symptoms the same? And how is each treated? Here to clear up the confusion with an overview of key differences — and similarities — between these two types of diabetes are experts Julie Settles, M.S.N., A.C.N.P.-B.C., C.E.N., a clinical research scientist at Lilly Diabetes, and Rosemary Briars, N.D., P.N.P.-B.C., C.D.E., C.C.D.C., clinical director and program co-director of the Chicago Children’s Diabetes Center at La Rabida Children’s Hospital. Causes Diabetes, or diabetes mellitus, as it’s formally known in medical terms, describes a group of metabolic diseases in which a person develops high blood glucose (blood sugar). The underlying health factors causing the high blood sugar will determine whether someone is diagnosed with type 1 or type 2 diabetes. Type 1 diabetes is an autoimmune disease in which “the body’s immune system starts to make antibodies that are targeted directly at the insulin-producing cells of the pancreas (islet cells),” explains Briars. Over time, the immune system “gradually destroys the islet cells, so insulin is no longer made and the person has to take insulin every day, from then on,” she says. As for why this happens, Settles notes, “The immune system normally fights off viruses and bacteria that we do not want in our body, but when it causes diabetes, it is because something has gone wrong and now the body attacks its own cells.” Triggering this autoimmune response is a complex mix of genetic and environmental factors that researchers are still trying to fully understand. O 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 >>

Insulin For Type 2 Diabetes: When, Why, And How

Insulin For Type 2 Diabetes: When, Why, And How

Blood sugar control is one of the most important parts of type 2 diabetes management. Although you may be able to treat the condition at first with oral medication and lifestyle changes, such as exercise and weight loss, most people with type 2 diabetes eventually need to take insulin by injection. "There are several scenarios in which insulin treatment should start, including in patients with significant hyperglycemia who are symptomatic," explained Alaleh Mazhari, DO, an associate professor of endocrinology at Loyola Medicine in Maywood, Illinois. "In these cases, the need for insulin may be short-term. Other situations include patients who are on multiple diabetic medications with uncontrolled diabetes, and uncontrolled diabetes in pregnancy, to name a few." Here's what you need to know about taking insulin in the short term and the long term. Insulin for Short-Term Blood Sugar Control Doctors use a blood test called a hemoglobin A1C test to measure average blood sugar control over a two- to three-month period. The treatment target for most people with diabetes is an A1C of 7 percent or less; those with higher levels may need a more intensive medication plan. "The American Association of Clinical Endocrinologists recommends starting a person with type 2 diabetes on insulin if their A1C is above 9 percent and they have symptoms," said Mazhari. Symptoms of type 2 diabetes include thirst, hunger, frequent urination, and weight loss. Research published in February 2013 in the journal The Lancet Diabetes & Endocrinology reviewed several studies that focused on the temporary use of insulin to restore sugar control in people with type 2 diabetes. The results showed that a two- to five-week course of short-term intensive insulin therapy (IIT) can induce remission in patients Continue reading >>

Understanding Oral Diabetes Medications

Understanding Oral Diabetes Medications

by Gail Brashers-Krug Today, almost 21 million Americans have diabetes, and more than 90 percent of those have type 2, or insulin resistant diabetes. Doctors often prescribe oral medications to treat type 2 diabetes, either alone or combination with insulin therapy. This article provides a guide to those oral medications. Which Diabetics Use Pills? With a few exceptions, diabetes comes in two types. Type 1 diabetes occurs when the body does not produce enough insulin on its own. To treat type 1, you must restore the proper amount of insulin—either by taking insulin (through injection or inhalation), or by receiving a transplant, either of an entire pancreas or of specialized pancreas cells, called islet cells. Type 1 cannot be treated with oral medications. Type 2 diabetes occurs when the body produces enough insulin, but gradually becomes insulin resistant—that is, loses the ability to process insulin. Type 2 is usually controlled first through diet and exercise, which improve your body’s ability to process its insulin. For most type 2 diabetics, however, diet and exercise changes are not enough. The next step is oral diabetes medication. Moreover, most type 2 diabetics eventually stop producing enough insulin, and often cease insulin production altogether. As a result, many type 2 diabetics will ultimately need insulin therapy in combination with their pills. How Do the Different Pills Work? Oral diabetes medications attack the problem in three ways. More insulin: Some pills stimulate your pancreas to produce more insulin. The first successful “diabetes pills” were the sulfonylureas (glyburide, glipizide, glimepiride, tolazamide, chlorpropamide, and tolbutamide). These are insulin secretagogues, that is, chemicals that cause your pancreas to produce more ins 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 >>

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