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Why Do Some Diabetics Not Need Insulin Injections?

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 >>

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 >>

Facts About Insulin Treatment

Facts About Insulin Treatment

Insulin is an essential hormone. Without it, the body cannot control or properly use glucose (sugar) – one of its main energy supplying fuels. How does insulin help diabetes? People with type 1 diabetes produce inadequate amounts of insulin, so insulin replacement is their key treatment. Without adequate insulin replacement, people with type 1 diabetes will see their blood sugar levels rise and the body will start to burn up its fat stores. In a few days this leads to a condition called diabetic acidosis, which is life threatening. Too much insulin, on the other hand, leads to such low levels of blood sugar that it causes a condition called hypoglycaemia. The symptoms include paleness, shaking, shivering, perspiration, rapid heartbeat, hunger, anxiety and blurred vision. In some cases it can cause loss of consciousness (hypoglycaemic coma) and convulsions. In type 2 diabetes the problem is not a lack of insulin output, but increasing resistance of your cells to the effects of insulin. In the early years, the body compensates for this insulin resistance by increasing the output of insulin from the pancreas gland. Ultimately, the pancreas becomes unable to cope. About 30 per cent of people with type 2 diabetes eventually need treatment with insulin. The longer a person has type 2 diabetes, the more likely they will have to start insulin treatment at some point. There are four main kinds of injectable insulin. The type of insulin you use will depend on your individual needs and lifestyle. Rapid-acting insulin analogues start working within 10 or 15 minutes and last between 2 to 4 hours. Examples are insulin aspart, insulin aspart and insulin glulisine. Short-acting insulin, eg Actrapid: soluble insulin starts working within 30 to 60 minutes and lasts six to eight hours. Continue reading >>

Why Do Some People With Type 2 Diabetes Who Are Using Insulin Have Poor Glycaemic Control? A Qualitative Study

Why Do Some People With Type 2 Diabetes Who Are Using Insulin Have Poor Glycaemic Control? A Qualitative Study

Strengths and limitations of this study The major strength lies in the fact that reasons for poor glycaemic control were uncovered from the perspectives of people with type 2 diabetes with sustained hyperglycaemia for more than 1 year despite insulin use, through in-depth interviews. Issues such as difficulty of adhering to regular meal and medication times, fear of hypoglycaemia, needles and pain, and lack of knowledge about and self-efficacy in diabetes care were found to be barriers to glycaemic control in people with type 2 diabetes using insulin. Issues such as social stigma, ethnicity, socioeconomic factors, family, friends, healthcare system and healthcare providers did not emerge as reasons for poor glycaemic control despite insulin use. The recruitment of participants was conducted in a single hospital, and therefore the involvement of healthcare systems in poor glycaemic control cannot be further explored. The fact that the interviews were conducted in the hospital environment may have influenced the participants to give a socially desirable response. However, they were informed that their responses would not affect their medical care and would be kept confidential. Insulin has been identified as the most effective glucose-lowering agent; however, it has been shown that many people with diabetes who are using insulin still fail to achieve glycaemic control.1 ,2 The challenges of achieving glycaemic control in people with diabetes using insulin are: the progression of the disease; the impact of hypoglycaemia and weight gain; the burden of polypharmacy; lack of resources in provision of diabetes self-care education and support of patients; and the inherent limitations of subcutaneous exogenous insulin administration.3 Other predictors of poor glycaemic control i Continue reading >>

Should I Use Diabetes Pills Or Insulin?

Should I Use Diabetes Pills Or Insulin?

Diabetes affects the way your body breaks down food. Treatment depends on which type of diabetes you have. In type 1 diabetes, your pancreas stops producing insulin. Insulin is a hormone that helps regulate glucose, or sugar, in your blood. Type 2 diabetes starts with insulin resistance. Your pancreas no longer produces enough insulin or doesn’t use it efficiently. Every cell in your body uses glucose for energy. If insulin isn’t doing its job, glucose builds up in your blood. This causes a condition called hyperglycemia. Low blood glucose is called hypoglycemia. Both can lead to serious complications. A variety of pills are available to treat diabetes, but they can’t help everyone. They only work if your pancreas still produces some insulin. They can’t treat type 1 diabetes. They aren’t effective in people with type 2 diabetes when the pancreas has stopped making insulin. Some people with type 2 diabetes can benefit from using both pills and insulin. Some pills to treat diabetes include: Biguanides Metformin (Glucophage, Fortamet, Riomet, Glumetza) is a biguanide. It lowers the amount of glucose in your liver and boosts insulin sensitivity. It may also improve cholesterol levels and might help you lose a little weight. People normally take it twice per day with meals. You can take the extended-release version once per day. Potential side effects include: upset stomach nausea bloating gas diarrhea a temporary loss of appetite It may also cause lactic acidosis in people with kidney failure, but this is rare. Sulfonylureas Sulfonylureas are fast-acting medications that help the pancreas release insulin after meals. They include: People usually take these medications once per day with a meal. Potential side effects include: irritability low blood glucose upset st 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 >>

Life With Insulin Injections

Life With Insulin Injections

When you have to start using insulin to control your diabetes, the thought can seem overwhelming. How can you learn when you need injections? How will the shots affect your job, social life, and hobbies like sports or traveling? The truth is that most insulin users can do just about anything they want. Once you get the hang of it, it’s not that hard to fit this medication into everyday life. "It can be a big change, but you'll soon realize that lots of people do this and it's not as big an inconvenience as you thought," says Erin Kelly, RN, a diabetes educator at Joslin Diabetes Center in Boston. Before you begin, sit down with a certified diabetes educator (your doctor can recommend one) to learn how to give yourself the shots and to figure out a routine that works for you. In the meantime, here’s a glimpse into how insulin injections might be part of your day-to-day life. A Day With Insulin If your doctor has prescribed insulin just once or twice a day -- which may be the case if you have type 2 diabetes -- then your diabetes care probably won't interfere with your daily life very much. In fact, you can probably leave your supplies at home while you're out and about for the day. Sometimes, the routine is more involved. If you have type 1 diabetes (or you have type 2 but it's not well-controlled), you may need three or four shots a day. Some of that insulin may be the "short-acting" type, which means you have to calculate how big your dose should be before you take it, usually before a meal. That means you’ll be testing your blood sugar with a glucose meter, doing some math, and then taking a shot. It can seem like a lot to learn at first, says Toby Smithson, a certified diabetes educator in Hilton Head, SC. *CGM-based treatment requires fingersticks for calibrat 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 Therapy

Insulin Therapy

Why do I need to take insulin? When you digest food, your body changes most of the food you eat into glucose (a form of sugar). Insulin allows this glucose to enter all the cells of your body and be used as energy. When you have diabetes, your body doesn’t make enough insulin or can’t use it properly, so the glucose builds up in your blood instead of moving into the cells. Too much glucose in the blood can lead to serious health problems. All people who have type 1 diabetes and some people who have type 2 diabetes need to take insulin to help control their blood sugar levels. The goal of taking insulin is to keep your blood sugar level in a normal range as much as possible so you’ll stay healthy. Insulin can’t be taken by mouth. It is usually taken with injections (shots). It can also be taken with an insulin pen or an insulin pump. How often will I need to take insulin? You and your doctor will develop a schedule that is right for you. Most people who have diabetes and take insulin need at least 2 insulin shots a day for good blood sugar control. Some people need 3 or 4 shots a day. Do I need to monitor my blood sugar level? Yes. Monitoring and controlling your blood sugar is key to preventing the complications of diabetes. If you don’t already monitor your blood sugar level, you will need to learn how. Checking your blood sugar involves pricking your finger to get a small drop of blood that you put on a test strip. You can read the results yourself or insert the strip into a machine called an electronic glucose meter. The results will tell you whether or not your blood sugar is in a healthy range. Your doctor will give you additional information about monitoring your blood sugar. When should I take insulin? You and your doctor should discuss when and how you Continue reading >>

Treatment

Treatment

There's no cure for diabetes, so treatment aims to keep your blood glucose levels as normal as possible and to control your symptoms to prevent health problems developing later in life. If you've been diagnosed with diabetes, you'll be referred for specialist treatment from a diabetes care team. They'll be able to help you understand your treatment and closely monitor your condition to identify any health problems that may occur. Type 1 diabetes occurs because your body doesn't produce any insulin. This means you'll need regular insulin treatment to keep your glucose levels normal. Insulin comes in several different preparations, each of which works slightly differently. For example, some last up to a whole day (long-acting), some last up to eight hours (short-acting) and some work quickly but don't last very long (rapid-acting). Your treatment is likely to include a combination of different insulin preparations. Insulin Insulin injections If you have type 1 diabetes, you'll probably need insulin injections. Insulin must be injected, because if it were taken as a tablet, it would be broken down in your stomach (like food) and would be unable to enter your bloodstream. When you're first diagnosed, your diabetes care team will help you with your insulin injections, before showing you how and when to do it yourself. They'll also show you how to store your insulin and dispose of your needles properly. Insulin injections are usually given by an injection pen, which is also known as an insulin pen or auto-injector. Sometimes, injections are given using a syringe. Most people need two to four injections a day. Your GP or diabetes nurse may also teach one of your close friends or relatives how to inject the insulin properly. Insulin pump therapy Insulin pump therapy is an alter 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 >>

Insulin Treatment

Insulin Treatment

Insulin is a hormone made in your pancreas, which lies just behind your stomach. It helps our bodies use glucose for energy. Everyone with Type 1 diabetes and some people with Type 2 diabetes need to take insulin – either by injection or a pump – to control their blood glucose levels (also called blood sugar levels). Injecting insulin Insulin is injected using a syringe and needle, or an insulin pen or needle. The needles used are very small as the insulin only needs to be injected under the skin (subcutaneously) – not into a muscle or vein. Once it's been injected, it soaks into small blood vessels and is taken into the bloodstream. As your confidence grows and you become more relaxed, injections will get easier and soon become second nature. The most frequently used injection sites are the thighs, buttocks and abdomen. You may be able to inject into your upper arms, but check with your diabetes team first as this isn't always suitable. As all these areas cover a wide skin area, you should inject at different sites within each of them. It is important to rotate injection sites, as injecting into the same place can cause a build up of lumps under the skin (also known as lipohypertrophy), which make it harder for your body to absorb and use the insulin properly. The three groups of insulin There are three groups of insulin – animal, human (not from humans but produced synthetically to match human insulin) and analogues (the insulin molecule is like a string of beads; scientists have managed to alter the position of some of these beads to create 'analogues' of insulin). Nowadays, most people use human insulin and insulin analogues, although a small number of people still use animal insulin because they have some evidence that they otherwise lose their awareness of 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 >>

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 >>

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 >>

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