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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 >>

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 >>

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 >>

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 >>

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 >>

The Introduction Of Insulin In Type 2 Diabetes Mellitus

The Introduction Of Insulin In Type 2 Diabetes Mellitus

Eddy Tabet Background Conservatively, over 1 million people have been diagnosed with diabetes mellitus in Australia, the majority with type 2 diabetes mellitus (T2DM). Until the progressive decline in pancreatic beta cell function, which characterises T2DM, can be meaningfully halted, most of these patients will require insulin therapy to maintain optimal glycaemic control over time. Objective/s The aim of this article is to provide a pragmatic overview of when and how to initiate insulin therapy for T2DM in a primary care setting. Discussion Current Australian guidelines recommend initiating insulin therapy as once daily basal therapy or as premixed insulin. Com-mencement and titration of either insulin in T2DM can be conducted safely in an ambulatory care setting and it is ideal that gen-eral practitioners become familiar with this, particularly in the context of the number of people affected. For the majority with type 2 diabetes mellitus (T2DM), insulin therapy will be required to maintain optimal glycaemic control over time.1 The general practitioner (GP) plays a vital part in the care of patients with T2DM using insulin. This article provides a pragmatic overview of introducing insulin therapy in T2DM. The pathophysiology of T2DM The core pathophysiological defects leading to the development of T2DM are insulin resistance in muscle and liver cells, resulting in decreased glucose uptake and increased hepatic glucose output, coupled with failure of pancreatic beta cells to produce sufficient insulin to maintain normoglycaemia and to prevent adipose fatty acid release. This ‘glucolipotoxicity’ leads to further impairment of the beta cells, and a progressive cycle of beta cell dysfunction and metabolic decline. Although these processes are not necessarily the only 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 >>

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 >>

Insulin For Type 2 Diabetes

Insulin For Type 2 Diabetes

Considering insulin? What you should know. By the dLife Editors Many people with type 2 diabetes will eventually require insulin to keep their diabetes in control. In fact, most experts believe we wait too long in the progression of type 2 diabetes before starting people on insulin. Progressing to insulin does not mean you are failing, but just that your body needs a little more help to keep your blood sugar in range. How much insulin you need, and when you take it, depends on several factors: the type of insulin your doctor has prescribed, your nutrition and exercise habits, and other co-existing medical conditions, and medications you may be taking. Types of Insulin Insulin can be divided into three main categories. The first is long-acting, also known as basal or background insulin. It is usually given once (or sometimes twice) daily, and is intended to help control blood sugar over a twenty-four-hour period. The second category is shorter-acting insulins. These are used to help control blood sugar spikes after eating, and also to “correct” an unusually high blood sugar reading. Depending on the type, they start to work within fifteen to thirty minutes, and last for three to six hours. Many people with type 2 diabetes do well with just a long-acting insulin combined with oral medicines, while others will need to add a mealtime dose of shorter-acting insulin to control after-meal blood sugar spikes. The third category is made up of combinations of long- and shorter-acting insulin. These insulin mixtures are usually given twice daily. The long-acting insulins now approved for use in the United States are Lantus, Levemir, Toujeo, Tresiba, and Basaglar. Novolin N and Humulin N are older forms of insulin that are not as long-acting as the newer ones, and their activit Continue reading >>

Diabetes Mellitus Type 2

Diabetes Mellitus Type 2

Diabetes mellitus type 2 (also known as type 2 diabetes) is a long-term metabolic disorder that is characterized by high blood sugar, insulin resistance, and relative lack of insulin.[6] Common symptoms include increased thirst, frequent urination, and unexplained weight loss.[3] Symptoms may also include increased hunger, feeling tired, and sores that do not heal.[3] Often symptoms come on slowly.[6] Long-term complications from high blood sugar include heart disease, strokes, diabetic retinopathy which can result in blindness, kidney failure, and poor blood flow in the limbs which may lead to amputations.[1] The sudden onset of hyperosmolar hyperglycemic state may occur; however, ketoacidosis is uncommon.[4][5] Type 2 diabetes primarily occurs as a result of obesity and lack of exercise.[1] Some people are more genetically at risk than others.[6] Type 2 diabetes makes up about 90% of cases of diabetes, with the other 10% due primarily to diabetes mellitus type 1 and gestational diabetes.[1] In diabetes mellitus type 1 there is a lower total level of insulin to control blood glucose, due to an autoimmune induced loss of insulin-producing beta cells in the pancreas.[12][13] Diagnosis of diabetes is by blood tests such as fasting plasma glucose, oral glucose tolerance test, or glycated hemoglobin (A1C).[3] Type 2 diabetes is partly preventable by staying a normal weight, exercising regularly, and eating properly.[1] Treatment involves exercise and dietary changes.[1] If blood sugar levels are not adequately lowered, the medication metformin is typically recommended.[7][14] Many people may eventually also require insulin injections.[9] In those on insulin, routinely checking blood sugar levels is advised; however, this may not be needed in those taking pills.[15] Bariatri 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 >>

Going On Insulin With Type 2 Diabetes

Going On Insulin With Type 2 Diabetes

Receiving a diagnosis of diabetes can be scary. There are so many things to think about and so many things that will eventually need to be changed in our lives. We often hear those awful stories from well-meaning friends and family about complications etc. One aspect of living with type 2 diabetes that definitely gets a bad rap is the need to go on insulin. For some reason most people believe that injecting insulin is a painful process that completely disrupts your life. Needle-phobia is a real thing for many people. Being “tied down” to giving yourself shots sounds like such a hassle. Possible weight-gain and scary lows seem to find their way into any discussion about using insulin. Insulin use means I’ve failed. Well, let’s talk about some of those issues and see if we can’t dispel the myths. Pain from injections: My one and only experience with injecting insulin happened when I was in the hospital for surgery. My post-surgery glucose readings were high (due to the stress) so I needed some insulin. I can say without hesitation that I didn’t feel the injections. Today’s needles are tiny compared to needles of the past. Fear of pain is no excuse these days. Needle-phobia/hassle: I can understand having some trepidation surrounding the idea of filling a syringe and poking yourself with a needle. Mastering this process is very doable but for those who are squeamish or just plain scared, there are insulin pens! Insulin pens make injecting insulin simple and easy. Possible weight-gain: Yes, injecting insulin can cause weight-gain but it doesn’t have to. This article on the Mayo Clinic website contains some examples of ways you can keep from gaining weight while injecting insulin. The bottom line is that if you pay attention and adjust your food intake and ex Continue reading >>

Indications For Insulin In Type 2 Diabetes Mellitus

Indications For Insulin In Type 2 Diabetes Mellitus

Ensure that existing treatment is taken properly. Insulin treatment should be considered in patients with inadequately controlled blood glucose levels - which is considered as a glycated haemoglobin (HbA1c) level of 7.5% or more (or a other higher level agreed with the individual) (1) Other indications include: continued weight loss (even if insidious), persistent symptoms or both. The introduction of insulin therapy in these patients almost always results in substantial improvement in well-being in non-obese patients with poor diabetic control but without symptoms, whose weight is stable and who are conscientious with existing therapy obese patients without symptoms but whose weight is stable present a management dilemma: the correct therapy is intensification of diet - however a few of these patients will benefit from treatment with insulin. A three month trial of therapy with insulin can be a method of determining the efficacy of insulin in the individual patient often insulin therapy is required in patients with intercurrent illness. After recovery from the illness insulin therapy is withdrawn provided adequate control is achieved and maintained the development of hyperlipidaemia or early diabetic complications strengthens the decision to tighter control by starting insulin therapy if pregnancy is planned, patients are generally switched to insulin therapy Reference: 1. National Institute for Health and Clinical Excellence (NICE) 2009. Type 2 diabetes: newer agents for blood glucose control in type 2 diabetes 2. Prescribers' Journal (2000); 40 (1):38-48. Continue reading >>

Insulin In Type 2 Diabetes Mellitus

Insulin In Type 2 Diabetes Mellitus

the United Kingdom Prospective Diabetes Study Group (UKPDS) has pointed out that majority of type 2 diabetes patients will experience progressive pancreatic beta cell dysfunction even when their diabetes control is excellent (1) so type 2 diabetics may eventually require treatment with insulin when oral hypoglycaemic medication is no longer effective a straight swap to insulin treatment is usual if the maximal therapy with non-insulin treatments have been reached according to estimations in UK general practice, only 50% of patients who require insulin due to failure of oral medication will receive it within 5 years o the average time taken from beginning treatment with the last oral agent to beginning insulin therapy is around 8 years (2) in the case of overweight patients taking metformin, then treatment with metformin may be continued - this is because metformin may attenuate weight gain resulting from the introduction of insulin therapy insulin therapy and a sulphonylurea may decrease the amount of insulin actually required and enhance the use of a single night-time dose but overall the clinical advantages of this combination are small (3) the average weight gain resulting from introduction of insulin therapy is 4 kg - however some patients may have a marked increase in weight after onset of insulin therapy in a comprehensive review of combination therapies with insulin in type 2 diabetes Yki-Jarvinen suggests an algorithm for starting insulin in an insulin naive type 2 diabetic patient who is on maximal oral hypoglycaemic therapy. In this algorithm she suggests stopping sulphonylurea treatment and continuation of metformin at a dose of 2g per day in combination with insulin treatment (4). If the patient is not on a dose of 2g per day when conversion to insulin occur Continue reading >>

Starting On Insulin In Type 2 Diabetes

Starting On Insulin In Type 2 Diabetes

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

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