Usually, Type 2 diabetes is treated with oral medications that stimulate insulin production in the pancreas, and type 2 diabetics only need to take insulin if these medications don’t work. According to Gerald Bernstein, MD, associate professor of medicine at Albert Einstein College of Medicine in Bronx, N.Y., and a past president of the American Diabetes Association, the idea of going on to insulin is often seen as a threat: ‘If you don’t lose weight, you’ll wind up on insulin.’ However, experts are now realising that the time for insulin may be sooner rather than later.
The overall goal of diabetes management is to slow the progression of the disease and, therefore, delay or prevent complications, and Dr Bernstein says ‘The reality is that all of the new data and the goals of glucose control suggest that insulin would actually be better used if it were started very early in type 2 diabetes’ and new guidelines have been given which ‘suggest that insulin should be the earliest medication intervention after the patient is taught lifestyle changes and is placed on metformin’.
Diabetes is a complicated illness, and while many people with type 2 diabetes do quite well with oral medications, when your body get stressed your diabetes gets worse. This could be caused by a serious illness or surgery, or even small stresses like an infection, or good stresses like pregnancy. You may need insulin to boost your wellness because of this, no matter what caused it, because your body needs help whilst it heals itself from the stress. If all goes well, the insulin may be reduced or eliminated once the stressor is gone. Depending on what your body needs, these could be short-acting or longer-acting insulins, or both, but the hope and the aim of these treatments is that this will be a temporary measure to get you back on track with your usual diabetes management plan.