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Why Insulin For Type 2 Diabetes

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 >>

So Which Is It, With Type 2 Diabetes? Do You Make Too Much Insulin Or Not Enough?

So Which Is It, With Type 2 Diabetes? Do You Make Too Much Insulin Or Not Enough?

When you have Type 2 diabetes and you have been told that you have it because your pancreas either fails to make enough insulin or that the insulin that it makes is not able to be used properly (that’s a mouthful), have you ever thought to yourself, “Huh?” Has this information been filed away in the part of your brain labeled, “Information I don’t understand and sounds too confusing to learn,” just waiting to be purged when possible? Whenever I hear a patient being told this I often wonder if they’re going to ask, “Well, which is it, do I make too much insulin or not enough, and why does this happen?” I think if I had diabetes I would want to know. Let me see if I can explain it here. I will start off by reminding you that it takes approximately 10 years to go from completely normal to actually having diabetes. I am sure this varies somewhat from person to person, however on average it takes 10 years. After you eat a meal that has sugar in it, the sugar will enter the blood stream. In response to sugar entering the blood the beta cells, located throughout the pancreas, start making insulin. Typically, the greater the amount of sugar that enters the blood, the greater the amount of insulin produced by the beta cells in the pancreas. At least, this is the way it is supposed to work. The insulin produced in the beta cells then enters the blood stream and looks for some sugar. Once it finds a sugar molecule it swims over and grabs a hold of it. (A little-known fact is that insulin only has one arm, so it can only grab ahold of one sugar.) The insulin then takes the sugar out of the blood vessel and over to a muscle, fat or liver cell. Once close to the cell the insulin starts heading over to one of the cell’s many doors. The insulin then opens the door t 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 >>

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 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 >>

Combating Insulin Resistance In Type 2 Diabetes

Combating Insulin Resistance In Type 2 Diabetes

While diabetes is not a disease that you can see on the outside of those that have it, inside their bodies they are silently fighting a war against one of their own. This battle is known as insulin resistance. Insulin resistance is one of the telltale signs of prediabetes and type 2 diabetes. Why the bodies of some are unable to respond to insulin properly, is still a bit of a mystery. But there are some ways to enable the body to become more receptive to the insulin being produced. Building up Resistance For those without diabetes or even insulin resistance, when they eat their typical meal, their blood sugar levels will begin to rise. This process then signals the pancreas to begin producing insulin. Insulin then travels in the body and works to induce the muscle cells and fat to absorb any extra glucose from the bloodstream, to be used as energy. When the cells take in the glucose, the blood sugar levels will begin to lower and eventually balance out to a normal level. Insulin also sends a signal to the liver, which works as the glucose repository in the body to store glucose for use later. But those with insulin resistance have a tolerance built up to insulin, which makes it less effective when released. This means that more insulin is required to take induce the muscle and fat cells to take in the glucose and to signal the liver to store some for later. I recommend reading the following articles: Because of an insulin resistance in the body, the pancreas begins to produce much larger amounts of insulin to help energize the cells and return blood sugar levels to normal. This is the reason why those with type 2 diabetes have much higher levels of insulin in their body. Because the pancreas has the ability to increase insulin production, the beginning stage of insulin 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 >>

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 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 >>

Get Unlimited Access On Medscape.

Get Unlimited Access On Medscape.

You’ve become the New York Times and the Wall Street Journal of medicine. A must-read every morning. ” 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 >>

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 >>

Why Insulin Can Become Necessary For A Person With Type 2 Diabetes

Why Insulin Can Become Necessary For A Person With Type 2 Diabetes

People with type 2 diabetes may require insulin when their meal plan, weight loss, exercise and antidiabetic drugs do not achieve targeted blood glucose (sugar) levels. Diabetes is a progressive disease and the body may require insulin injections to compensate for declining insulin production by the pancreas. That is why starting insulin treatment should never be seen as a failure. Starting insulin treatment should never be seen as a failure. Treatment with insulin may be added to an antidiabetic medication or completely replace it. Regardless of the treatment, lifestyle habits (diet, exercise, stress management) are essential to managing diabetes. Many people are reluctant to inject insulin for various reasons: Fear of pain or needles Guilt Impression that this is the “last resort” Fear of hypoglycemic attacks Fear of weight gain Memories of loved one who had to take insulin If this is the case, do not hesitate to discuss your concerns with a health care professional. Some of your fears may be due to false beliefs. Learning more about today’s insulin treatment will probably allay your fears. For many people, insulin is an effective way to achieve good blood-sugar control, which can prevent or delay certain diabetes complications over the long term. Every person with diabetes being treated with insulin should be trained by a health care professional. This training should include the different injection steps, as well as the treatment and prevention of hypoglycemia, which can occur in anyone on insulin. Research and text: Cynthia Chaput, Dietitian Scientific review: Louise Tremblay, Nurse. M. Ed. June 2014 - Revised May 2016 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 >>

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