Insulin: A sound choice, not a last resort

Everybody with type 1 diabetes must start using insulin from the moment they are diagnosed. But in many cases, type 2 diabetes can be handled with a change in diet, more regular exercise, other lifestyle changes, and diabetes pills. Until fairly recently, insulin was not usually a regular part of the type 2 program.  But current treatment guidelines recommend that people with type 2 diabetes start insulin therapy early on.

Many people with type 2 diabetes who could benefit from insulin use, however, have trouble crossing that line. They may worry about the risk of side effects or complications of insulin, or the injection process. Or they may have the mistaken idea that needing insulin means they haven’t done a good job managing diabetes. In fact, insulin may simply be the next logical step in their diabetes treatment plan.

The truth about insulin
Body cells use glucose (sugar) to produce energy, but it is insulin that enables glucose to enter cells. Many people may think of diabetes as a “sugar-related” disease, but it’s an insulin-related disease first and foremost.

In general, in type 1 diabetes the pancreas produces no insulin, and the person needs to inject it. In type 2 diabetes the pancreas does produce insulin—at least at first—but the cells resist its action. The diet, exercise, and pills prescribed are designed to help reduce resistance and to keep glucose levels healthy in other ways.

But even if you follow your treatment instructions, the insulin-
producing cells in the pancreas (the beta cells) may eventually give out as type 2 diabetes advances. Insulin injections can help your body regulate sugar levels. The better your insulin and sugar control, the greater your chances of preventing or delaying diabetes complications. Many experts believe that the earlier a person begins insulin therapy, the lower the risk of these problems.

If it’s the needle that concerns you, keep in mind that the needle and syringe used in insulin therapy are small and thin. And, if you’re worried about injecting yourself in public, an insulin pen may be a less noticeable and more convenient method for using insulin.

A few drawbacks . . . and solutions
Insulin is a safe therapy. It’s true, however, that it may have some unwanted side effects.

In some cases, insulin can work too well, causing abnormally low blood sugar (hypoglycemia). The newer insulin preparations make low blood levels of glucose less likely, but it’s a good idea to know what the symptoms are and how to treat the condition.

As insulin helps your body process food and nutrients better, it may cause weight gain. A dietitian can work with you to develop a diabetes-friendly meal plan that will help control your weight.