Type 2 Diabetes: When to Consider Using Insulin

Post Date: April 2015

If you have type 2 diabetes, you may be taking medicine and watching what you eat to help manage your blood sugar. Even if you have been working hard to manage your blood sugar, your condition may have progressed and now your doctor wants you to consider using insulin. Here’s what you need to know.

What is insulin?

Insulin is a hormone that helps the body move sugar into cells. The sugar is then stored in these cells to be used later for energy. In people with type 2 diabetes, there is a problem with how their body makes or uses insulin. As a result, their blood sugar doesn’t get absorbed into the cells for storage and the sugar can build up in their bloodstream.

Insulin is also made in a laboratory. This type of insulin is usually injected into the fat under the skin so it can enter the bloodstream.

Why is insulin recommended for some people?

Keeping blood sugar at a healthy level can lower the risk of diabetes complications. Usually, doctors and other healthcare providers recommend that people with type 2 diabetes control their blood sugar through a combination of managing diet, getting physical activity, and losing or maintaining weight. If doing all of those does not keep blood sugar at a healthy level, doctors may prescribe one or two oral diabetes medicines. If a person’s blood sugar is still higher than what is best for them, then the doctor may recommend adding insulin.

If I take insulin, can I stop taking my other diabetes medicines?

Most people use insulin in addition to taking oral diabetes medicines, and the insulin helps the medicine work more effectively. However, it is possible you may discontinue some oral medicines when insulin is added. Talk to your doctor about your specific situation.

If I take insulin, can I eat what I want and be more relaxed about exercising?

No! Even though taking insulin is a very effective way to manage blood sugar, you still need to watch what you eat and get regular physical activity.  A nutritious diet and regular physical activity are important to your overall health and well-being and can reduce your risk for diabetes-related complications.  

Does it mean I’ve been unsuccessful in treating my diabetes if I have to go on insulin?

No! Don’t be hard on yourself if your doctor recommends that you take insulin. Even if you are doing everything right, diabetes can progress, which makes it more difficult to manage blood sugar levels. Many people with type 2 diabetes eventually need to go on insulin, so you are not alone. The sooner you can get your blood sugar under control, the better chance you have of preventing complications.

If I start taking insulin, will I have to take it forever?

Most people continue taking insulin because it is so effective in controlling blood sugar. There are a small number of people who take insulin because of a temporary situation—such as having an injury and not being able to exercise—and they usually stop taking insulin when their situation resolves.

What can I do if I don’t like needles?

Tell your doctor or diabetes educator if you have a fear or dislike of needles. They can help you by providing reassurance and education about the process of insulin injection or can teach a friend or caregiver to give you injections. The needles that are used for insulin injections are smaller than what you might think.  Relaxation techniques may also help. If you have a severe needle phobia, you may benefit from speaking to a counselor.  You may want to ask your doctor about a new rapid-acting inhaled insulin that became available last year.  It is not recommended for smokers or people who have asthma or COPD, and some people who use it might need to also use injectable, longer-acting insulin.   

What are the options for taking insulin?

There are different types of insulin. They vary in how quickly they work, when they peak, and how long they last. Also, insulin is available as insulin pens, however, using a syringe or an insulin pump may be an option for you. Your healthcare provider will work with you on what type of insulin is right for you.

What can I expect if I go on insulin?

When your blood sugar is better controlled you may feel much better.  You will need to learn how to make taking your insulin and checking your blood sugar part of your daily routine. A diabetes educator or other healthcare provider can help you figure out your daily routine and explain ways you can stay healthy and avoid problems. Because insulin can increase the chance of having low blood sugar (hypoglycemia), you will need to know the signs of low blood sugar. Some people gain weight when they go on insulin, but having good blood sugar control is more important than avoiding weight gain.

Your Rite Aid Pharmacist can help answer your questions about managing diabetes and using insulin.

These articles are not a substitute for medical advice, and are not intended to treat or cure any disease.  Advances in medicine may cause this information to become outdated, invalid, or subject to debate. Professional opinions and interpretations of scientific literature may vary.  Consult your healthcare professional before making changes to your diet, exercise, or medication regimen.

Sources:

American Diabetes Association Standards of Medical Care in Diabetes - 2015. Diabetes Care. 2015; vol 38 supp 1:S1-S94. http://professional.diabetes.org/admin/UserFiles/0%20-%20Sean/Documents/January%20Supplement%20Combined_Final.pdf

Insulin and Other Injectables, American Diabetes Association: Living with Diabetes

http://www.diabetes.org/living-with-diabetes/treatment-and-care/medication/insulin/

McCulloch, D. “Insulin therapy in type 2 diabetes mellitis”. UpToDate. Nov 24, 2014.

http://www.uptodate.com/contents/insulin-therapy-in-type-2-diabetes-mellitus?source=search_result&search=insulin+type+2+diabetes&selectedTitle=1~150

McCulloch, D. “Management of persistent hyperglycemia in type 2 diabetes mellitus”. UpToDate. Oct 29, 2014. http://www.uptodate.com/contents/management-of-persistent-hyperglycemia-in-type-2-diabetes-mellitus?source=see_link&anchor=H3#H3

Type 2 Diabetes, Medline Plus, National Library of Medicine:

http://www.nlm.nih.gov/medlineplus/ency/article/000313.htm


These articles are not a substitute for medical advice, and are not intended to treat or cure any disease. Advances in medicine may cause this information to become outdated, invalid, or subject to debate. Professional opinions and interpretations of scientific literature may vary. Consult your healthcare professional before making changes to your diet, exercise, or medication regime.