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What Type Of Diabetes Requires Insulin


When Dietary Changes Exercise And Medications Don’t Work

Session 39. Should Type 2 Diabetics Take Insulin? – Dr. Bernstein’s Diabetes University.
  • 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 levelin a way thats much faster than diet and exercise.Insulin will give your body a respite; it has been working overtime to try to bring down your blood glucose level.In this scenario, youd 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 , especially if the doctor wants you to take multiple medications.

Talk to your doctor and diabetes treatment team.Types of InsulinHow Much Insulin Should You Take?Where Should You Inject the Insulin?

  • Abdomen

Newer, Easier Ways to Inject InsulinA Final Note about Insulin

What Are The Symptoms Of Diabetes

Symptoms of diabetes include:

Type 1 diabetes symptoms: Symptoms can develop quickly over a few weeks or months. Symptoms begin when youre young as a child, teen or young adult. Additional symptoms include nausea, vomiting or stomach pains and yeast infections or urinary tract infections.


Type 2 diabetes and prediabetes symptoms: You may not have any symptoms at all or may not notice them since they develop slowly over several years. Symptoms usually begin to develop when youre an adult, but prediabetes and Type 2 diabetes is on the rise in all age groups.

Gestational diabetes: You typically will not notice symptoms. Your obstetrician will test you for gestational diabetes between 24 and 28 weeks of your pregnancy.

How To Know When You’ll Need Insulin

Injecting insulin above and to the side of the belly button can result in more consistent results.

There’s no simple way to tell when a patient with type 2 would do best on insulin, says Richard Hellman, MD, former president of the American Association of Clinical Endocrinologists. But there are guidelines.

“In general if a patient has a hemoglobin A1C that is higher than the agreed upon goal and they are not on insulin, we recommend insulin therapy,” Dr. Hellman says. The American Diabetes Association recommends an A1C of 7% or below, and the American College of Endocrinology and the American Association of Clinical Endocrinologists recommend an A1C of 6.5% or below.


If you can’t lower your A1C with diet, exercise, or other medications, you may need insulin to do the job.

Exceptions to the insulin ruleThere are exceptions, of course. Someone who otherwise seems to be a good candidate for insulin may not be able to manage such a regimen if he or she has limited vision and dexterity and no family support. Good News About Today’s Improved Insulins

If you do need insulin in the short- or long-term, your doctor may prescribe one of four different types. These vary by how quickly or slowly they reach the bloodstream , the amount of time they work at maximum strength , and how long they continue to be effective .

According to the American Diabetes Association , your need for insulin is based on several factors.

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

Starting insulin treatment should not be seen as a setback.

People with type 2 diabetes may require insulin when their meal plan, weight loss, exercise and antidiabetic drugs do not achieve targeted blood glucose 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 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 todays 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.

Types Of Insulin Treatments

Insulin treatment indications n type 1 diabetes requires

All types of insulin produce the same effect. They mimic the natural increases and decreases of insulin levels in the body during the day. The makeup of different types of insulin affects how fast and for how long they work.

  • Rapid-acting insulin: This type of insulin begins working approximately 15 minutes after injection. Its effects can last between three and four hours. Its often used before a meal.
  • Short-acting insulin: You inject this insulin before a meal. It starts working 30 to 60 minutes after you inject it and lasts five to eight hours.
  • Intermediate-acting insulin: This type of insulin starts working in one to two hours after injection, and its effects may last 14 to 16 hours.
  • Long-acting insulin: This insulin may not start working until about two hours after you inject it. Its effects can last up to 24 hours or longer.

Also Check: Diabetic Eating Too Much Sugar

What Does It Mean If Test Results Show I Have Protein In My Urine

This means your kidneys are allowing protein to be filtered through and now appear in your urine. This condition is called proteinuria. The continued presence of protein in your urine is a sign of kidney damage.


A note from Cleveland Clinic

Theres much you can do to prevent the development of diabetes . However, if you or your child or adolescent develop symptoms of diabetes, see your healthcare provider. The earlier diabetes is diagnosed, the sooner steps can be taken to treat and control it. The better you are able to control your blood sugar level, the more likely you are to live a long, healthy life.

Last reviewed by a Cleveland Clinic medical professional on 03/28/2021.

References

How Does Diabetes Affect Your Heart Eyes Feet Nerves And Kidneys

Blood vessels are located throughout our bodys tissues and organs. They surround our bodys cells, providing a transfer of oxygen, nutrients and other substances, using blood as the exchange vehicle. In simple terms, diabetes doesnt allow glucose to get into cells and it damages blood vessels in/near these organs and those that nourish nerves. If organs, nerves and tissues cant get the essentials they need to properly function, they can begin to fail.Proper function means that your hearts blood vessels, including arteries, are not damaged . In your kidneys, this means that waste products can be filtered out of your blood. In your eyes, this means that the blood vessels in your retina remain intact. In your feet and nerves, this means that nerves are nourished and that theres blood flow to your feet. Diabetes causes damage that prevents proper function.

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Glycemic Control During Pregnancy

Because pregnant patients with type 1 DM are at risk for multiple poor maternal and fetal outcomes, it is essential to provide these patients with prepregnancy counseling, good glycemic control before and during pregnancy, and a complete medical evaluation. High-risk possibilities include exacerbation of existing hypertension, renal insufficiency, retinopathy, and more frequent congenital anomalies. These patients should be referred to obstetricians specializing in high-risk pregnancies.

Despite advanced age, multiparity, obesity, and social disadvantage, patients with type 2 DM were found to have better glycemic control, fewer large-for-gestational-age infants, fewer preterm deliveries, and fewer neonatal care admissions than patients with type 1 DM. This finding suggests that better tools are needed to improve glycemic control in patients with type 1 DM.

A Guide For The Decision To Start Insulin

Type 1 Diabetes

Most clinicians do not think algorithmically when managing clinical conditions and advising people with diabetes. They often prefer to follow a patient-led agenda, and individuals will highlight their problems and preferences for solutions in quite different ways. As a result, a simple algorithm for starting insulin is not feasible. However, it is possible to provide a checklist that may help to guide the clinician-patient interaction to ensure that decisions occur in a logical way, and importantly without missing the opportunity to obtain relevant information .

The first consideration might be to assess whether an acute need is present, although usually that will be obvious. At diagnosis, other referral, or when admitted for whatever reason as an in-patient, the presence or absence of marked hyperglycemia, weight loss, ketones, ketoacidosis, or dehydration must be ascertained. If marked hyperglycemia alone is present, is there an acute precipitating factor, and if not, is there any prospect that glycemic control can be restored by lifestyle change? Is the patient in a risky or uncertain environment? In these cases, there may be a strong, immediate need, and persuasive advice to consider insulin may be appropriate .

Recommended Reading: Normal A1c Range


What Is Diabetes Mellitus

Diabetes mellitus, also called diabetes, is a term for several conditions involving how your body turns food into energy.

When you eat a carbohydrate, your body turns it into a sugar called glucose and sends that to your bloodstream. Your pancreas releases insulin, a hormone that helps move glucose from your blood into your cells, which use it for energy.

When you have diabetes and donât get treatment, your body doesnât use insulin like it should. Too much glucose stays in your blood, a condition usually called high blood sugar. This can cause health problems that may be serious or even life-threatening.

Thereâs no cure for diabetes. But with treatment and lifestyle changes, you can live a long, healthy life.

Diabetes comes in different forms, depending on the cause.


How Do I Check My Blood Glucose Level Why Is This Important

Checking your blood glucose level is important because the results help guide decisions about what to eat, your physical activity and any needed medication and insulin adjustments or additions.

The most common way to check your blood glucose level is with a blood glucose meter. With this test, you prick the side of your finger, apply the drop of blood to a test strip, insert the strip into the meter and the meter will show your glucose level at that moment in time. Your healthcare provider will tell you how often youll need to check your glucose level.

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When Should Insulin Therapy Be Started

Indications for insulin therapy and when to begin it are poorly defined in guidelines and still subject to individual judgment based on a wide range of opinion . Personal beliefs and experience, familiarity with the use of the different insulin preparations and delivery systems, individual preference, patient needle phobia, concern about chronic hyperinsulinemia, risk of hypoglycemia, and difficulties in controlling body weight are some of the many considerations regarding insulin therapy . Each one of these factors can be weighted differently between doctors and between people with diabetes. The expert group proposed that one way to rationalize the approach to insulin treatment could be to consider some clinical scenarios. These could be as follows: 1) the time of diagnosis or early thereafter; 2) in the presence of other emerging medical conditions; and 3) in the course of routine ambulatory diabetes management.

Different Methods Of Delivering Insulin

Insulin treatment indications n type 1 diabetes requires

Not only is the variety of insulin preparations growing, so are the methods for administering insulin.


Pre-filled insulin pens

In the twentieth century, insulin was available only in an injectable form that required carrying syringes, needles, vials of insulin, and alcohol swabs. Clearly, patients found it difficult to take multiple shots each day; as a result, good blood sugar control was often difficult. Many pharmaceutical companies now offer discreet and convenient methods for delivering insulin.

Many manufacturers offer pen delivery systems. Such systems resemble the ink cartridge in a fountain pen. A small, pen-sized device holds an insulin cartridge . Cartridges are available for the most widely used insulin formulations. The amount of insulin to be injected is dialed in, by turning the bottom of the pen until the required number of units is seen in the dose-viewing window. The tip of the pen consists of a needle that is replaced with each injection. A release mechanism allows the needle to penetrate just under the skin and deliver the required amount of insulin.

Insulin pumps

The most exciting innovation in pump technology has been the ability to combine the pump in tandem with newer glucose sensing technology. This is called sensor-augmented insulin pump therapy.

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Insulin Needs In The Two Types Of Diabetes

Even though patients with both type 1 and type 2 diabetes need insulin, as that is the main cause behind the condition, their individual need for insulin varies.


While people living with type 1 diabetes need to supplement their body with insulin due to the inability of their body to make enough, the case is a bit different with type 2 diabetes.

Although a type 2 diabetes patient may be prescribed insulin, doctors will most likely recommend you first start out on a healthy diet and a more active life through regular exercise to see if it will help.

Even if at the end, you will need to take medications and/or insulin, exercising and eating right may help you require less than you expected.

A significant factor that determines whether or not a person with type 2 diabetes will need insulin is your individual circumstance.

Insulin Can Cause Dangerously Low Blood Sugar

Okay this one is possible, but not likely. People with type 2 diabetes tend to be at lower risk of hypoglycemia than those with type 1. A prolonged episode of low blood sugar could cause a loss of consciousness or coma. Still, most people with type 2 can easily recognize the symptoms, which include anxiety, shaky hands, sweating, and an urge to eat. Consuming a bit of sugara few Life Savers, diluted juice, or glucose tabletsquickly reverses the low blood sugar.


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Situations When Type 2 Diabetics Must Go On Insulin

Few things are more worrisome for diabetics than when type 2diabetes needs insulin. Some doctors even use insulin as a scare tactic.

But the truth is, sometimes insulin therapy is really theonly way to go. Most of the time insulin is associated with worsened diabetesor the end of the road. But hopefully after you finish reading, youll feelmore confident that insulin is not the end and you can still regain yourhealth.

Insulin is indicated when blood sugar control cant beachieved with diet, exercise, and oral drugs for people with type 2 diabetes.

There are 3 main situations when insulin is usually used forpeople with type 2 diabetes. They are as follows:


  • Early in the disease to help get blood sugarlevels within normal ranges and to prevent complications of diabetes fromdeveloping.
  • Later in the disease when oral drugs start tolose their ability to control blood sugar levels and fail.
  • When needed in medical situations.
  • Early Initiation ofInsulin in Type 2 Diabetes

    For most newly diagnosed or people who havent had diabetesfor very long, their doctor will put them on oral medications and a diet andexercise regimen. The goal is to get these three to work in getting blood sugarlevels under control.

    But when a type 2 diabetic presents with weight loss, moresevere symptoms and blood sugar levels greater than 250 mg/dL patients arestarted early on insulin therapy.

    Late-Stage InsulinTherapy in Type 2 Diabetes

    When MedicalSituations in Type 2 Diabetes Require Insulin

    Insulin Therapy In People With Type 2 Diabetes: Opportunities And Challenges

    Insulin and Type 2 Diabetes (Conditions A-Z)
  • 1Newcastle University, Newcastle upon Tyne, U.K.
  • 2Oregon Health & Science University, Portland, OR
  • 3Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, LA
  • 4FRCPath, Aston University, Birmingham, U.K.
  • 5Justus Liebeg University, Giessen, Germany
  • 6Department of Clinical and Experimental Medicine, University of Pisa School of Medicine, Pisa, Italy
  • 7Mount Sinai Medical School, New York, NY
  • 8Rambam Technion Hospital, Haifa, Israel
  • 9Department of Medicine I, Rudolfstiftung Hospital, Vienna, Austria
  • 10Antwerp University Hospital, Antwerp, Belgium
  • 11Diabetes Unit, Department of Internal Medicine, Hadassah Hebrew University Hospital, Jerusalem, Israel
  • Corresponding author: William T. Cefalu, william.cefalupbrc.edu.
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      What Are The Complications Of Diabetes

      If your blood glucose level remains high over a long period of time, your bodys tissues and organs can be seriously damaged. Some complications can be life-threatening over time.

      Complications include:

      • Dental problems.

      Complications of gestational diabetes:

      In the mother:Preeclampsia , risk of gestational diabetes during future pregnancies and risk of diabetes later in life.

      In the newborn: Higher-than-normal birth weight, low blood sugar , higher risk of developing Type 2 diabetes over time and death shortly after birth.

      Can Diabetes Kill You

      Yes, its possible that if diabetes remains undiagnosed and uncontrolled it can cause devastating harm to your body. Diabetes can cause heart attack, heart failure, stroke, kidney failure and coma. These complications can lead to your death. Cardiovascular disease in particular is the leading cause of death in adults with diabetes.

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