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When Is Insulin Required For Diabetes

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 >>

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 >>

When Should Insulin Be Started?

When Should Insulin Be Started?

Q. Will my patient with type 2 diabetes require insulin? A. It varies from patient to patient. However, type 2 diabetes is a progressive disease marked by gradual loss of beta cell function and most patients will eventually require insulin therapy.1 This should be viewed as part of the pathophysiology of the disease and not as a failure on the part of the patient or healthcare provider. Insulin should be discussed early with patients who are beginning to show progression of their diabetes to ease the transition when the time to start insulin therapy arrives. This time should be considered part of a larger conversation between provider and patient, and not seen as a turning point down a path to the many severe complications of diabetes. Q. Is there a specific hemoglobin A1c (HbA1c) at which insulin must be started? A. No. Insulin, like all treatments for diabetes, should be started and adjusted to achieve a reasonable goal HbA1c for the patient. The American Diabetes Association (ADA) previously recommended that a patient’s HbA1c not be allowed to exceed 8%, creating an “action point” for escalation of therapy. However, population studies have shown that the burden of hyperglycemia due to reluctance to start or advance therapy is significant and put patients at risk of earlier complications.2 Newer guidelines recommend advancing therapy to a goal HbA1c, which is individualized to the patient’s needs (under 7% for most patients).3 If a patient’s HbA1c rises above target and does not respond to 2 or more oral hypoglycemic agents,4 changes in their regimen should be made sooner rather than later to prevent unnecessary hyperglycemia. If insulin is needed to achieve this goal, it should be started right away rather than waiting to see if other treatments will work w 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 >>

Facts About Diabetes And Insulin

Facts About Diabetes And Insulin

Diabetes is a very common disease, which, if not treated, can be very dangerous. There are two types of diabetes. They were once called juvenile-onset diabetes and adult diabetes. However, today we know that all ages can get both types so they are simply called type 1 and type 2 diabetes. Type 1, which occurs in approximately 10 percent of all cases, is an autoimmune disease in which the immune system, by mistake, attacks its own insulin-producing cells so that insufficient amounts of insulin are produced - or no insulin at all. Type 1 affects predominantly young people and usually makes its debut before the age of 30, and most frequently between the ages of 10 and 14. Type 2, which makes up the remaining 90 percent of diabetes cases, commonly affects patients during the second half of their lives. The cells of the body no longer react to insulin as they should. This is called insulin resistance. In the early 1920s, Frederick Banting, John Macleod, George Best and Bertram Collip isolated the hormone insulin and purified it so that it could be administered to humans. This was a major breakthrough in the treatment of diabetes type 1. Insulin Insulin is a hormone. Hormones are chemical substances that regulate the cells of the body and are produced by special glands. The hormone insulin is a main regulator of the glucose (sugar) levels in the blood. Insulin is produced in the pancreas. To be more specific, it's produced by the beta cells in the islets of Langerhans in the pancreas. When we eat, glucose levels rise, and insulin is released into the bloodstream. The insulin acts like a key, opening up cells so they can take in the sugar and use it as an energy source. Sugar is one of the top energy sources for the body. The body gets it in many forms, but mainly as carbohydr Continue reading >>

What Type Of Diabetes Requires Insulin Injections?

What Type Of Diabetes Requires Insulin Injections?

People with Type 1 diabetes always require insulin injections in order to control blood sugar readings because they make little or no insulin. Insulin is also prescribed for Type 2 diabetes when oral medications or other injectable meds are not controlling blood sugar levels adequately. Anyone taking insulin of any kind is at risk for hypoglycemia (low blood sugar). Taking insulin does not mean you have a “bad type” of diabetes. The purpose of using insulin is to get the best management of blood sugar readings as close to normal blood sugar readings as possible to help avoid complications from diabetes. Type 1 diabetes is an autoimmune disease that results in destruction of the insulin producing cells. People with this type of diabetes must take insulin. Type 2 diabetes is a multimolecular disorder that causes 2 things (at least). First insulin secretion is inadequate. It may be the amount or the way it is secreted. Second most people with this type of diabetes also have a resistance to the insulin they do put out. So it's a double whammy. There are three factors that come into play that might determine the need for insulin: physical activity, dietary intake and age. A lot of exercise, a proper diet to control weight may minimize the amount of medication you need for many years but this is a progressive disorder and as you get older so does your ability to produce insulin. Sooner or later, even under the best of circumstances you will need insulin. Now, it may be of advantage to start insulin way before that time to keep your blood glucose normal which leads to a better quality of life and reduce risk for complications. Actually, all types of diabetes (type 1, type 2 and gestational) can require insulin injections. With type 1 diabetes, a person's beta cells stop pr Continue reading >>

Injecting Insulin

Injecting Insulin

Tweet Injecting insulin is an essential part of the daily regime for many diabetics. Although insulin that can be inhaled is now available and approved, the reality is that most type 1 diabetics (and type 2 diabetics who require insulin) will have to continue injecting insulin until it is more common. Does injecting insulin hurt? Needle technology for insulin injection has become much better in recent years, meaning that the injection process, although not pain-free, does not hurt as much as it used to. Many patients still find injecting insulin to manage their diabetes an unpleasant process, however. Is injecting insulin and having diabetes going to change my life? Unfortunately, having diabetes does lead to lifestyle complications. For insulin therapy to be effective, it is necessary to make certain lifestyle changes. These should include: eating healthily exercising regularly testing blood glucose regularly and following a strict insulin regimen Although adhering to all these changes does influence your daily routine, the benefits for diabetics are enormous. Into what part of my body should I inject insulin to best help my diabetes? The abdomen is the most common site for injecting insulin. For some people, this site is not suitable, and other sites must be used. These include the upper arms, the upper buttocks and the outside of the thigh. All of these sites are most effective because they have a layer of fat to absorb the insulin better. This process directly injects insulin into the subcutaneous tissue. These areas also have fewer nerve endings, meaning that they are the least painful areas in which to inject. Should I switch the site where I inject insulin? Your healthcare team should be able to help you to decided the best places to inject insulin, when you shou 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 >>

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 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 >>

Clinical Approach To The Patient With Diabetes Mellitus And Very High Insulin Requirements.

Clinical Approach To The Patient With Diabetes Mellitus And Very High Insulin Requirements.

Abstract A number of patients with diabetes require very high (> 2 Ukg⁻¹ day⁻¹), or extremely high (> 3 Ukg⁻¹ day⁻¹), insulin doses for the management of their hyperglycemia. Unfortunately, many of the physicians who treat these patients limit themselves to prescribing ever higher doses of insulin, without questioning why. Furthermore, when the insulin requirements get to be extreme, demanding an explanation, clinicians are frequently lost in a sea of literature where there is not a single paper dealing with this problem systematically. A systematic approach to the evaluation of these patients is necessary to facilitate an appropriate diagnosis, select the most reasonable therapy, and hopefully improve the long-term outcome of these patients. This manuscript intends to provide the clinician with a review of the literature pertinent for the differential diagnosis, work-up, and management of these patients. We will review the definitions of insulin sensitivity during normality, the various degrees or categories of insulin resistance, and the expected insulin requirements during each of these states. Subsequently, we propose a simple alphabetic mnemonic approach to help remember the differential diagnosis, and a clinical algorithm to help guide the work-up of these patients. Lastly, we briefly discuss general management considerations in these conditions. Continue reading >>

How Are Handicapped People Requiring Reliable Access To Medical Supplies, Such As To Self-cath To Urinate Or Insulin And Syringes To Treat Diabetes, Able To Survive In 3rd World Countries And Warzones?

How Are Handicapped People Requiring Reliable Access To Medical Supplies, Such As To Self-cath To Urinate Or Insulin And Syringes To Treat Diabetes, Able To Survive In 3rd World Countries And Warzones?

With huge difficulty and a great deal of absolutely ingenious innovation. Or we just die. Kids with type 1 diabetes don't get to high school age without meds. Continue reading >>

Is Glucose A Disaccharide? If So, Why?

Is Glucose A Disaccharide? If So, Why?

Answer Wiki Types and origin of carbohydrates There are four families of carbohydrates: monosaccharides, disaccharides, oligosaccharides and polysaccharides. Each family is distinguished by the number of simple sugar molecules that the compounds. monosaccharides The monosaccharide molecule represents the carbohydrate base unit. There are more than 200 in the wild. They differ between them by the number of carbon atoms in the composition of the molecule. mettants in a called the original prefix greek representing the number of carbon atoms of the cycle, followed by the suffix "venture" qu'ils'agit indicating a sugar. For example, monosaccharides to 3 carbon atoms are called trioses, tetroses 4 carbons, 5-carbon pentose, hexose carbons 6 and 7 carbons the heptoses. The most important monosaccharides diet are: glucose, fructose and galactose. Glucose, also called dextrose or blood sugar, occurs naturally in foods, but it can also come from the digestion of complex carbohydrates. The body can also synthesize glucose through gluconeogenesis, a mechanism which synthesizes glucose from non-carbohydrate carbon skeletons of compounds such as glycerol, pyruvate, lactate, or certain amino acids. Gluconeogenesis occurs primarily in the liver. Glucose is absorbed directly through the small intestine without digestion (without intervention of digestive enzymes). Once in the blood, glucose can: either be used directly by cells to produce energy, and it is the case that if the organization has an immediate need for energy. either be stored as glycogen in the muscles and liver, and it is the case that when the body is to reduce the glycogen reserves during physical effort, for example, either be turned into fat to be stored in fat cells, liver or mammary glands as reserve fat. More gluc Continue reading >>

Side Effects Of Taking Insulin When You Don't Need It

Side Effects Of Taking Insulin When You Don't Need It

Insulin-dependent diabetics take insulin injections because their pancreas no longer produces insulin. Insulin helps cells absorb glucose, the body’s main energy source, from the blood. All Type 1 diabetics, formerly called juvenile diabetics, and some Type 2 diabetics, formerly called adult-onset diabetics, need insulin because their bodies no longer produce enough of the hormone. Without insulin to remove glucose from the blood, blood glucose levels rise, a condition called hyperglycemia. Taking too much insulin or taking insulin when your body already makes enough removes too much glucose from the blood, a condition called hypoglycemia, or low blood sugar. Video of the Day All cells require glucose to function. When you eat, carbohydrates in the food break down in the intestines into glucose. The blood absorbs the glucose. When this happens, your blood glucose levels rise. In response to the increase in blood sugar, the pancreas releases insulin. Insulin facilitates a cell’s ability to remove glucose from the blood and utilize it for energy. If your body has already released enough insulin and you take more, too much glucose is removed from your blood and you become hypoglycemic. Taking an overdose of short-acting or intermediate-acting insulin is more dangerous than taking too much long-acting insulin, eMedTV explains. Taking insulin when you don’t need it causes symptoms such as sweating, shaking, headache, irritability, nervousness, anxiety, weakness, dizziness, hunger, tremors, nausea, and difficulty concentrating or thinking. For diabetics, the treatment for hypoglycemia is to eat something containing quickly absorbed glucose, such as candy or special glucose tablets. If you have a hypoglycemic reaction and take glucose, follow up with a snack containing b Continue reading >>

Insulin: The Holy Grail Of Diabetes Treatment

Insulin: The Holy Grail Of Diabetes Treatment

Insulin is a hormone made by beta cells in the pancreas. When we eat, insulin is released into the blood stream where it helps to move glucose from the food we have eaten into cells to be used as energy. In people with type 1 diabetes, the body produces little or no insulin as the cells that produce insulin have been destroyed by an autoimmune reaction in the body. Insulin replacement by daily injections is required. In people with type 2 diabetes the body produces insulin but the insulin does not work as well as it should. This is often referred to as insulin resistance. To compensate the body makes more but eventually cannot make enough to keep the balance right. Lifestyle changes can delay the need for tablets and/or insulin to stabilise blood glucose levels. When insulin is required, it is important to understand that this is just the natural progression of the condition. RMIT University have produced a short overview of insulin, a drug that keeps in excess of one million Australians alive. Watch the video to understand why insulin is important and why so many Australians rely on it to stay alive. Copyright © 2015 RMIT University, Prepared by the School of Applied Sciences (Discipline of Chemistry). At this stage, insulin can only be injected. Insulin cannot be given in tablet form as it would be destroyed in the stomach, meaning it would not be available to convert glucose into energy. Insulin is injected through the skin into the fatty tissue known as the subcutaneous layer. You do not inject it into muscle or directly into the blood. Absorption of insulin varies depending on the part of the body into which you inject. The tummy (abdomen) absorbs insulin the fastest and is the site used by most people. The buttocks and thighs are also used by some people. While i Continue reading >>

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