Diabetes Doctor Answers – Do I Really Need Insulin?

Insulin, this word creates panic among almost all diabetic patients (whether Type 1 or Type 2 Diabetes). We all know that type 1 diabetics need insulin but here I explain why sometimes type 2 diabetics require insulin. As a Diabetes doctor (diabetologist), I see many Diabetic patients coming to me, Controlled or Uncontrolled. Most of them have these questions in mind:

Do I need Insulin?

Will my insulin be started?

Can my insulin be stopped?

Can I switch back to oral medications?

How long will my insulin continue?

TO ANSWER THESE QUESTIONS, LET US FIRST KNOW WHAT IS DIABETES

Diabetes mellitus, commonly known as Diabetes, is a metabolic disease that causes high blood sugar. The hormone insulin moves sugar from the blood into your cells to be stored or used for energy. With diabetes, your body either doesn’t make enough insulin or can’t effectively use the insulin it does make.

So, broadly Diabetes can be divided into:

Type 1 Diabetes (Earlier known as Insulin Dependent Diabetes)  and

Type 2 Diabetes (Earlier known as Non-Insulin Dependent Diabetes)

As the earlier name suggests, in Type 1 Diabetes, the body is unable to produce insulin and thus one needs to consult a diabetes doctor to obtain an external source of Insulin to combat high sugars. Unfortunately, insulin from an external source can only be given through injections; thus, Type 1 Diabetic needs multiple shots of Insulin to control sugars.

In contrast, Type 2 Diabetics have adequate insulin production or rather high insulin production at the start of the disease but the insulin produced is not effectively utilized by the body. 

So, the question comes why Type 2 Diabetics need Insulin

Type 2 diabetics may need insulin as when the body senses high sugars (ineffective insulin, unable to control it), it tries to bring it back to normal range by producing more and more insulin, thus exhausting the production hub of insulin (known as Beta Cells), which over time is depleted. 

Hence, in Type 2 diabetes, over a period of time, Insulin production starts declining and the pathology of INEFFECTIVE INSULIN ALSO MOVES TO INSUFFICIENT INSULIN thus, Type 2 Diabetics eventually might need Insulin and patient must consult their diabetes doctor.

But fortunately, with a wide variety of oral drugs for Type 2 Diabetics, Insulin initiation can be delayed but unnecessary delay even after your diabetes doctor’s advice should be avoided.

SO COMING BACK TO ANSWER TO QUESTIONS BY DIABETES DOCTOR – 

Do I need Insulin? 

Type 1 Diabetes – Yes, only treatment modality available as of now.

Type 2 Diabetes – Considering the nature of the disease, you might need it over some time.

Will my insulin be started? 

Type 1 Diabetes – Yes, at the time of Diagnosis

Type 2 Diabetes – Not necessarily (Some Type 2 Diabetics can maintain healthy sugar levels even without insulin throughout their life)

Can my insulin be stopped? 

Type 1 Diabetes – No (Only treatment option available right now)

Type 2 Diabetes – Can be stopped, if started for acute control of sugars, or if you have worked on your weight, your diet, and your activity levels (Don’t push your Diabetes doctor for the same, let them take the call)

Can I switch back to oral medications? 

Type 1 Diabetes – No (Not possible till oral insulin is available)

Type 2 Diabetes – Already explained (Depends upon many factors as described above)

How long will my insulin continue? 

Type 1 Diabetes – Lifelong (With newer insulins, fluctuations, weight gain and other complications related to conventional insulins have been overcome)

Type 2 Diabetes – Variable answer, but usually once started it really helps in better management of sugars, thus should be continued.

TALK TO YOUR DIABETES DOCTOR AND DISCUSS INSULIN.

RUNNING AWAY FROM IT WILL ONLY HELP THE DISEASE.