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Insulin Shots For Type 2 Diabetes

New Type-2 Diabetes Therapy Proves Better Than Traditional Insulin Injections

New Type-2 Diabetes Therapy Proves Better Than Traditional Insulin Injections

More than two-thirds of all type-2 diabetes patients do not achieve good control of their disease with the first-line medication metformin combined with second-line insulin shots. For the first time, a global research effort led by John Buse, MD, PhD, professor of medicine at the UNC School of Medicine and director of the UNC Diabetes Care Center, determined the efficacy of an alternative called IDegLira, which combines the basal insulin degludec (brand name Tresiba) and a drug called liraglutide (Victoza), a diabetes medication that activates GLP-1 receptors in the pancreas to stimulate insulin production. Published today in the Journal of the American Medical Association (JAMA), the researchers show that IDegLira injections were more effective than basal insulin glargine (Lantus) injections at reducing the average amount of blood sugar over the course of several months. The combination therapy was also associated with weight loss and a substantially lower rate of hypoglycemia – low blood sugar – compared with insulin glargine. “It’s quite remarkable that IDegLira can achieve such excellent control of diabetes in the toughest group of patients we treat.” “It’s quite remarkable that IDegLira can achieve such excellent control of diabetes in the toughest group of patients we treat,” said Buse, senior author and division chief of endocrinology at UNC. “Without a doubt, if I were a diabetes patient, I’d consult with my doctor about using IDegLira instead of basal insulin.” The UNC group collaborated with 75 diabetes treatment centers in 10 countries from September 2013 to November 2014 to enroll 557 patients with type-2 diabetes that had been uncontrolled with insulin glargine (20-50 units) and metformin (at least 1500 mg per day). The researchers ran Continue reading >>

Ask D'mine: Insulin Alternatives For Type 2 Diabetes

Ask D'mine: Insulin Alternatives For Type 2 Diabetes

Happy Saturday! Welcome back to Ask D'Mine, our weekly advice column hosted by veteran type 1, diabetes author and clinical educator Wil Dubois. This week, Wil dives into a question about the best "non-insulin" options for those in the type 2 world. Read on, for Wil's unbridled opinion (as usual)... {Got your own questions? Email us at [email protected]} Achat, type 3 from India, writes:Kindly advise me whether there is any alternative to insulin. My daddy was diagnosed with type 2 diabetes four to five years back and since then he is being treated with regular insulin. I therefore would like to know if there is substitute medicine to take orally as an alternative to insulin. Thank you. [email protected] D’Mine answers: You bet. All kinds of substitutes. There are tons of pills for type 2 diabetes. There are pills that coax the pancreas to produce more insulin. There are pills that keep the liver from releasing too much of its stored sugar. There are pills that fight the insulin resistance that is the foundation of type 2 diabetes. There are pills that make you pee the sugar out of your blood. There are pills that fight the digestive hormones that are running amok in the intestines. There are pills that keep you from digesting carbohydrates. There are pills that reduce digestive juices to lower blood sugar. There are pills that mess around with the central nervous system to lower glucose production in the body. There are so many pills that I’ve probably left some of them out. Most of these pills are made by several different manufacturers, and there are even many combo pills that have more than one of these medicines in them. Plenty of substitutes. Plenty of alternatives. But all of that said, why do you want an alternative to insulin for your daddy? Surely his doctor Continue reading >>

A Complete List Of Diabetes Medications

A Complete List Of Diabetes Medications

Diabetes is a condition that leads to high levels of blood glucose (or sugar) in the body. This happens when your body can’t make or use insulin like it’s supposed to. Insulin is a substance that helps your body use the sugar from the food you eat. There are two different types of diabetes: type 1 diabetes and type 2 diabetes. People with both types of diabetes need medications to help keep their blood sugar levels normal. The types of drugs that can treat you depend on the type of diabetes you have. This article gives you information about drugs that treat both types of diabetes to help give you an idea of the treatment options available to you. Insulin Insulin is the most common type of medication used in type 1 diabetes treatment. It’s also used in type 2 diabetes treatment. It’s given by injection and comes in different types. The type of insulin you need depends on how severe your insulin depletion is. Options include: Short-acting insulin regular insulin (Humulin and Novolin) Rapid-acting insulins Intermediate-acting insulin Long-acting insulins Combination insulins NovoLog Mix 70/30 (insulin aspart protamine-insulin aspart) Humalog Mix 75/25 (insulin lispro protamine-insulin lispro) Humalog Mix 50/50 (insulin lispro protamine-insulin lispro) Humulin 70/30 (human insulin NPH-human insulin regular) Novolin 70/30 (human insulin NPH-human insulin regular) Ryzodeg (insulin degludec-insulin aspart) Amylinomimetic drug Pramlintide (SymlinPen 120, SymlinPen 60) is an amylinomimetic drug. It’s an injectable drug used before meals. It works by delaying the time your stomach takes to empty itself. It reduces glucagon secretion after meals. This lowers your blood sugar. It also reduces appetite through a central mechanism. Most medications for type 2 diabetes are o Continue reading >>

Type 2 Non Insulin Therapies

Type 2 Non Insulin Therapies

Pramlintide is an injected medicine for people with diabetes. In type 1 diabetes, Pramlintide can be taken in addition to insulin to help control mealtime blood sugars. If you have type 2 diabetes, and lifestyle changes are not enough to control your blood sugar, typically, your provider will first start you on a single medicine. For people who are overweight, metformin is usually the first medicine prescribed. If the single therapy doesn’t work, additional medicines can be added. Many people require treatment with 2, 3 or more different medicines. If pill combinations don’t work, an injected medicine such as an incretin-based medicine, amylin analog or insulin may be prescribed. Medicine combinations are used because different drugs target different parts of your body’s sugar regulation system. Rarely, and usually due to other medical conditions, it may be necessary to start medical treatment of type 2 diabetes with insulin therapy. Usually, however, insulin therapy is the last treatment prescribed and is added only after the oral medications or non-insulin injections don’t work. There are six types of non-insulin medicines used to treat type 2 diabetes: Incretin based therapies: Pills and injections that reduce sugar production in the liver and slow the absorption of food In this section, you also can review: A Table of Non-Insulin Medications: A summary of all the oral medications and non insulin injected therapies including the common doses and side effects. Self-assessment Quiz Self assessment quizzes are available for topics covered in this website. To find out how much you have learned about Treatment of Type 2 Diabetes, take our self assessment quiz when you have completed this section. The quiz is multiple choice. Please choose the single best answer to Continue reading >>

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

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

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

“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 >>

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 Pump Therapy For Type 2 Diabetes

Insulin Pump Therapy For Type 2 Diabetes

The Simple Truth About Insulin Pump Therapy You have type 2 diabetes, but diabetes shouldn’t rule your life. You want to manage your sugar levels well, but with shots, you must deal with frequent challenges to keep your sugar levels under control. You wish there was an easier way to manage insulin dosing without compromising your health. You’re not alone. MiniMed insulin pump therapy helps you achieve better control by providing convenient insulin delivery that’s easy for you to manage. Only MiniMed insulin pump therapy is clinically proven to reduce A1C better than multiple daily shots for people with type 2 diabetes.4 Studies have shown that A1C reduction can significantly reduce the occurrence of long-term complications.5, 6 With MiniMed insulin pump therapy, you can worry less about your risk for long-term complications, such as: You are a candidate for MiniMed insulin pump therapy if: You are taking three or more insulin injections per day. You may be taking additional medications for your diabetes management, beyond just insulin. Your healthcare provider informed you that your A1C is elevated and your diabetes is not well controlled. You find it challenging to follow your prescribed insulin regimen for diabetes management. What is a pump and how does it work? The MiniMed insulin pump is an external device about the size of a cell phone that you can easily carry on a belt, place inside a pocket or wear under your clothes. The pump contains insulin and delivers it in a continuous and precise flow through a thin, flexible tube called an infusion set. The end of this tube sits comfortably under the skin and is replaced every two to three days. Basal rate You can program your insulin pump to continuously deliver tiny and precise amounts of insulin 24 hours a day. Continue reading >>

Insulin Therapy For Type 2 Diabetes 'may Do More Harm Than Good'

Insulin Therapy For Type 2 Diabetes 'may Do More Harm Than Good'

A new study published in the journal JAMA Internal Medicine suggests that for older patients with type 2 diabetes, medications to lower blood sugar levels may "do more harm than good." Approximately 25.8 million people in the US have diabetes, with type 2 diabetes accounting for 90-95% of all cases. Type 2 diabetes is characterized by insulin resistance - the inability of the body to produce enough insulin or use the hormone effectively, which causes high blood sugar levels. Over time, high blood sugar levels can cause kidney, eye or heart diseases, nerve damage or stroke. Diagnosis of type 2 diabetes is usually determined through a blood test that measures hemoglobin A1c levels in the blood. This test reveals the average level of glucose the patient has had in their blood over the past 3 months. In the US, type 2 diabetes is diagnosed when hemoglobin A1c levels reach 6.5% or higher. The higher A1c levels are, the greater the risk of other health problems. Sometimes the condition can be managed through changes in diet, but other patients with type 2 diabetes may need medication - such as insulin or metformin - to help lower their blood sugar levels, and ultimately, reduce the risk of diabetes complications. But the researchers of this latest study, from University College London (UCL) in the UK, the University of Michigan Medical School and the Ann Arbor Veterans Affairs Hospital, MI, claim that the benefits of such treatment - particularly for people over the age of 50 - may not always outweigh the negatives. "In many cases, insulin treatment may not do anything to add to the person's quality life expectancy," says study co-author John S. Yudkin, emeritus professor of medicine at UCL. "If people feel that insulin therapy reduces their quality of life by anything more t Continue reading >>

Treatment

Treatment

Treatment for diabetes aims to keep your blood glucose levels as normal as possible and control your symptoms to prevent health problems developing later in life. If you've been diagnosed with type 2 diabetes, your GP will be able to explain your condition in detail and help you understand your treatment. They'll also closely monitor your condition to identify any health problems that may occur. If there are any problems, you may be referred to a hospital-based diabetes care team. Making lifestyle changes If you're diagnosed with type 2 diabetes, you'll need to look after your health very carefully for the rest of your life. This may seem daunting, but your diabetes care team will be able to give you support and advice about all aspects of your treatment. After being diagnosed with type 2 diabetes, or if you're at risk of developing the condition, the first step is to look at your diet and lifestyle and make any necessary changes. Three major areas that you'll need to look closely at are: You may be able to keep your blood glucose at a safe and healthy level without the need for other types of treatment. Lifestyle changes Diet Increasing the amount of fibre in your diet and reducing your sugar and fat intake, particularly saturated fat, can help prevent type 2 diabetes, as well as manage the condition if you already have it. You should: increase your consumption of high-fibre foods, such as wholegrain bread and cereals, beans and lentils, and fruit and vegetables choose foods that are low in fat – replace butter, ghee and coconut oil with low-fat spreads and vegetable oil choose skimmed and semi-skimmed milk, and low-fat yoghurts eat fish and lean meat rather than fatty or processed meat, such as sausages and burgers grill, bake, poach or steam food instead of frying 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 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 >>

Type 1 Diabetes Faqs

Type 1 Diabetes Faqs

Do I need to take insulin for the rest of my life? Yes. People with type 1 diabetes are not making enough insulin from their own bodies. Most people inject insulin at least four times a day. However, the insulin pump, or continuous subcutaneous insulin infusion (CSII), is slowly replacing frequent injections as a preferred delivery system. With the pump, a new catheter is inserted every few days under the skin, and insulin is continuously infused into the body. The pump is not the final word in insulin delivery systems, and there are clinical trials underway testing both a patch and a nasal spray as possible insulin delivery systems. Will exercise help control my diabetes? In general, exercise can be beneficial in the management of type 1 diabetes, in addition to taking insulin and eating a healthy diet. To exercise safely and reduce the risks, always consult with your doctor about exercise guidelines. Can I stop taking insulin if I eliminate candy and cookies from my diet? Even if you eliminate concentrated sources of carbohydrates (foods that turn into sugar in your bloodstream) like candy and cookies, you always need to take insulin when you have type 1 diabetes. Check with your doctor about any insulin dose adjustments that may be required if you change your diet. Do I need to monitor my blood sugar even when I’m feeling fine? Feeling fine is no guarantee that your blood sugar levels are in the target range. Remember, symptoms do not appear right away. Without regular blood sugar monitoring, serious damage can happen to your eyes, kidneys, feet – even your brain – without your knowing. If your sugar levels are out of line, consult your doctor. I have type 1 diabetes. Are my children at risk? Yes, but the risk is low. Although type 1 diabetes is a genetic disea 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 >>

What Are The Side Effects Of Insulin Shots?

What Are The Side Effects Of Insulin Shots?

Insulin is at the center of the diabetes problem. In people with type 2 diabetes, the body does not use insulin effectively. The pancreas compensates by overproducing insulin, and in time, it simply cannot keep up with the demands of the body to keep glucose levels down. To provide enough insulin to the body to manage blood glucose levels, many diabetics are advised to take insulin shots. The insulin in these injections is a chemical that is produced artificially to resemble the insulin made in our pancreas. This insulin works just like natural insulin by escorting sugar from our blood into our cells. Type 2 diabetics deal with a condition known as insulin resistance. It is a phenomenon where cells aren’t sensitive to the action of insulin (escorting blood glucose into cells) and hence, do not respond to it. This leads to the accumulation of glucose in the blood and is called hyperglycemia. Supplemental insulin given to Type 2 diabetics helps the body ‘muscle’ sugar out of the bloodstream and into cells. Insulin injections are used to regulate blood sugar differently for the different diabetes-types: For people who have type 1 diabetes – Their bodies cannot make insulin and therefore they aren’t able to regulate the amount of glucose in their bloodstream. For people who have type 2 diabetes – Their bodies aren’t able to produce enough insulin, or use it effectively. The insulin shots are used because the blood sugar cannot be regulated with oral medications alone. They also stop the liver from producing more sugar. Every type of insulin available in a drug store works in this way. They, mainly, differ in two ways – How quickly they begin to work For how long they can regulate blood sugar levels Mechanism of Action Regulating the process in which glucose Continue reading >>

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