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How Does Insulin Work For Type 2 Diabetes?

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 2 Diabetes

Type 2 Diabetes

Insulin is a hormone produced in the pancreas by special cells, called beta cells. The pancreas is below and behind the stomach. Insulin is needed to move blood sugar (glucose) into cells. Inside the cells, glucose is stored and later used for energy. When you have type 2 diabetes, your fat, liver, and muscle cells do not respond correctly to insulin. This is called insulin resistance. As a result, blood sugar does not get into these cells to be stored for energy. When sugar cannot enter cells, a high level of sugar builds up in the blood. This is called hyperglycemia. The body is unable to use the glucose for energy. This leads to the symptoms of type 2 diabetes. Type 2 diabetes usually develops slowly over time. Most people with the disease are overweight or obese when they are diagnosed. Increased fat makes it harder for your body to use insulin the correct way. Type 2 diabetes can also develop in people who are thin. This is more common in older adults. Family history and genes play a role in type 2 diabetes. Low activity level, poor diet, and excess body weight around the waist increase your chance of getting the disease. Continue reading >>

Patient Education: Diabetes Mellitus Type 2: Insulin Treatment (beyond The Basics)

Patient Education: Diabetes Mellitus Type 2: Insulin Treatment (beyond The Basics)

TYPE 2 DIABETES OVERVIEW Type 2 diabetes mellitus occurs when the pancreas (an organ in the abdomen) produces insufficient amounts of the hormone insulin and/or the body's tissues become resistant to normal or even high levels of insulin. This causes high blood glucose (sugar) levels, which can lead to a number of complications if untreated. People with type 2 diabetes require regular monitoring and ongoing treatment to maintain normal or near-normal blood sugar levels. Treatment includes lifestyle adjustments, self-care measures, and medications, which can minimize the risk of diabetes-related and cardiovascular complications (eg, heart attacks and strokes). Learning to manage diabetes is a process that continues over a lifetime. The diagnosis of diabetes can be overwhelming at the beginning; however, most people are able to lead normal lives, and many patients become experts in their own care. This topic review discusses the role of insulin in blood sugar control for patients with type 2 diabetes. Separate topic reviews about other aspects of type 2 diabetes are also available. (See "Patient education: Diabetes mellitus type 2: Overview (Beyond the Basics)" and "Patient education: Self-monitoring of blood glucose in diabetes mellitus (Beyond the Basics)" and "Patient education: Hypoglycemia (low blood sugar) in diabetes mellitus (Beyond the Basics)" and "Patient education: Diabetes mellitus type 2: Alcohol, exercise, and medical care (Beyond the Basics)" and "Patient education: Preventing complications in diabetes mellitus (Beyond the Basics)".) IMPORTANCE OF BLOOD SUGAR CONTROL IN TYPE 2 DIABETES Keeping blood sugar levels in control is one way to decrease the risk of complications related to type 2 diabetes. The most common complication of type 2 diabetes is heart d 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 >>

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 >>

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 >>

What Does Insulin Do?

What Does Insulin Do?

The word “insulin” can instill fear in many people who have or who are at risk for diabetes. Some of the beliefs around insulin are that if you have to take it, you’ll go blind or lose a limb. Or that insulin causes you to gain weight. Or that it means your diabetes is worsening. While these beliefs are understandable, the reality is that they’re not true. In fact, insulin is a life-saving medication: without it, people with Type 1 diabetes wouldn’t be alive, and many people with Type 2 diabetes would be struggling. The discovery of insulin is so important that it’s often called one of the greatest medical developments of the 20th century. This week, let’s delve into insulin and learn more about how truly amazing it is! What exactly is insulin? Insulin is a hormone. It’s made in the beta cells of the pancreas, and one of its main roles is to help regulate, or control, your blood sugar. When there’s enough insulin in the body, it helps to keep your blood sugar from going too high. In people who don’t have diabetes, blood sugars are very carefully and tightly controlled, staying within a safe and healthy range. After a person without diabetes eats a meal or a snack, the pancreas releases insulin. The insulin then signals muscle, fat, and liver cells in the body to absorb glucose (sugar) from the bloodstream to be used for energy. In this sense, insulin is like a key that unlocks the doors of the cells to allow glucose to enter. You can also think of insulin as a “storage” hormone, since when there’s more glucose than the body needs, insulin helps the body store that excess glucose in the liver to be used at a later time. Insulin also signals the liver to stop releasing glucose into the bloodstream. Insulin also helps shuttle amino acids (from pro 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 >>

Managing Type 2

Managing Type 2

In type 2 diabetes, your pancreas is still working but not as effectively as it needs to. This means your body is building insulin resistance and is unable to effectively convert glucose into energy leaving too much glucose in the blood. Type 2 diabetes can sometimes initially be managed through lifestyle modification including a healthy diet, regular exercise and monitoring your blood glucose levels. Eating well helps manage your blood glucose levels and your body weight Exercising helps the insulin work more effectively, lowers your blood pressure and reduces the risk of heart disease. Regular blood glucose monitoring tests whether the treatment being followed is adequately controlling blood glucose levels or whether you need to adjust your treatment. The aim of diabetes management is to keep blood glucose levels as close to the target range between 4 to 6 mmol/L (fasting), this will help prevent both short-term and long-term complications. Your healthcare team including your doctor, specialist, dietician and Credential Diabetes Educator, can help you with blood glucose monitoring, healthy eating and physical activity. However, sometimes healthy eating and exercise is not enough to keep the blood glucose levels down. Type 2 diabetes is a progressive condition. As time progresses, the insulin becomes more resistant and the pancreas is less effective converting glucose into energy. To help the pancreas convert glucose into energy, people with type 2 diabetes are often prescribed tablets to control their blood glucose levels. Eventually it may be necessary to start taking insulin to control blood glucose levels. This is when your body is no longer producing enough insulin of its own. Sometimes tablets may be continued in addition to insulin. If you require medication as 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 >>

Type 2 Diabetes

Type 2 Diabetes

Print Diagnosis To diagnose type 2 diabetes, you'll be given a: Glycated hemoglobin (A1C) test. This blood test indicates your average blood sugar level for the past two to three months. It measures the percentage of blood sugar attached to hemoglobin, the oxygen-carrying protein in red blood cells. The higher your blood sugar levels, the more hemoglobin you'll have with sugar attached. An A1C level of 6.5 percent or higher on two separate tests indicates you have diabetes. A result between 5.7 and 6.4 percent is considered prediabetes, which indicates a high risk of developing diabetes. Normal levels are below 5.7 percent. If the A1C test isn't available, or if you have certain conditions — such as if you're pregnant or have an uncommon form of hemoglobin (known as a hemoglobin variant) — that can make the A1C test inaccurate, your doctor may use the following tests to diagnose diabetes: Random blood sugar test. A blood sample will be taken at a random time. Blood sugar values are expressed in milligrams per deciliter (mg/dL) or millimoles per liter (mmol/L). Regardless of when you last ate, a random blood sugar level of 200 mg/dL (11.1 mmol/L) or higher suggests diabetes, especially when coupled with any of the signs and symptoms of diabetes, such as frequent urination and extreme thirst. Fasting blood sugar test. A blood sample will be taken after an overnight fast. A fasting blood sugar level less than 100 mg/dL (5.6 mmol/L) is normal. A fasting blood sugar level from 100 to 125 mg/dL (5.6 to 6.9 mmol/L) is considered prediabetes. If it's 126 mg/dL (7 mmol/L) or higher on two separate tests, you have diabetes. Oral glucose tolerance test. For this test, you fast overnight, and the fasting blood sugar level is measured. Then you drink a sugary liquid, and blood s 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 >>

Prediabetes & Insulin Resistance

Prediabetes & Insulin Resistance

What is insulin? Insulin is a hormone made in the pancreas, an organ located behind the stomach. The pancreas contains clusters of cells called islets. Beta cells within the islets make insulin and release it into the blood. Insulin plays a major role in metabolism—the way the body uses digested food for energy. The digestive tract breaks down carbohydrates—sugars and starches found in many foods—into glucose. Glucose is a form of sugar that enters the bloodstream. With the help of insulin, cells throughout the body absorb glucose and use it for energy. Insulin's Role in Blood Glucose Control When blood glucose levels rise after a meal, the pancreas releases insulin into the blood. Insulin and glucose then travel in the blood to cells throughout the body. Insulin helps muscle, fat, and liver cells absorb glucose from the bloodstream, lowering blood glucose levels. Insulin stimulates the liver and muscle tissue to store excess glucose. The stored form of glucose is called glycogen. Insulin also lowers blood glucose levels by reducing glucose production in the liver. In a healthy person, these functions allow blood glucose and insulin levels to remain in the normal range. What happens with insulin resistance? In insulin resistance, muscle, fat, and liver cells do not respond properly to insulin and thus cannot easily absorb glucose from the bloodstream. As a result, the body needs higher levels of insulin to help glucose enter cells. The beta cells in the pancreas try to keep up with this increased demand for insulin by producing more. As long as the beta cells are able to produce enough insulin to overcome the insulin resistance, blood glucose levels stay in the healthy range. Over time, insulin resistance can lead to type 2 diabetes and prediabetes because the bet Continue reading >>

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 >>

Starting On Insulin In Type 2 Diabetes

Starting On Insulin In Type 2 Diabetes

Tweet If type 2 diabetes develops, your body’s ability to produce sufficient insulin may decrease and it may be appropriate to take insulin injections to control your diabetes. Some people may be apprehensive about switching onto insulin injections. Benefits of insulin injections Insulin is a stronger medication for lowering blood glucose levels and can help with the following aspects: Decrease the effects of symptoms of high blood sugar, such as fatigue and frequent need to urinate Reduce the risk of developing diabetic complications Decrease pressure on the pancreas to produce insulin Disadvantages of being on insulin injections Raises the risk of hypoglycemia Can promote weight gain Some people may be uncomfortable about injecting Could affect employment if you drive for a living The needles used for insulin injections are very slim and many people who start injections are surprised by how painless the needles are. How many injections will I need to take each day? A number of different injection regimes are available, ranging from one injection a day to multiple injections a day. Your health team will be able to help you to choose an injection regime that best fits in with your lifestyle. Learning to inject Your health team should instruct you on injection technique to ensure insulin is delivered correctly. Watch a video on how to inject insulin Blood glucose testing People starting insulin therapy may need to regularly test their blood sugar levels to monitor the effect that insulin is having and to help prevent low glucose levels (hypoglycemia) from happening. Watch our video on how to perform a blood glucose test Insulin therapy and hypoglycemia Insulin is a powerful medication for lowering blood glucose levels and can cause blood glucose levels to go too low if Continue reading >>

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