May 4, 2015

Type 2, Use Insulin as Another Medication Tool

When I wrote this blog, I knew then that more would be said on the topic. Insulin for most doctors is not a word they want to hear. They threaten patients with it to convince patients to stay on oral medications. Then they stack oral medication on top of oral medication. This causes many patients to conclude that when they are required to use insulin that they have failed and this is their punishment.

And many people listen to these inept doctors when they should know better. Insulin is just another tool in the arsenal for managing diabetes. Many people with type 2 diabetes do use insulin. Others feel that using insulin makes them a failure. This should never be the case, but our doctors have been behind promoting this to keep patients on oral medications and because of the fact that doctors fear hypoglycemia to the point it clouds their thinking.

Insulin is simply a necessary and beneficial addition to diabetes management. There are a few reasons why people that have not needed insulin to require it (and possibly on a temporary basis). Gestational diabetes, surgery, broken bones, cancer, and taking steroidal medicines (prednisone for example) can require some people to take insulin for a temporary period. Then some people end up needing insulin on a permanent basis as they age because the pancreas becomes unable to produce enough insulin. Sometimes they have been on oral medications that force the pancreas to produce insulin and the pancreas can no longer produce sufficient insulin.

Now back to feeling as a failure because of needing insulin. When we age, the functioning of our pancreas often decreases and becomes unable to produce the quantity of insulin necessary for our cells to function and provide the energy we need. Because we are human, we don't always maintain a healthy food plan and exercise regimen and our blood glucose levels rise dramatically to a level only insulin can control.

When the dose of insulin is discussed, I urge you to read this about the three methods of dosing. It has been the experience of our support group that most doctors, CDEs, and dietitians all prefer the fixed dose of insulin. This in turn forces us, as patients, to eat a fixed number of carbs which may not be the best solution.

Yes, we need to learn how to count carbs and know what foods are safe in a food plan. This we can use when we are not feeling like eating but a snack, are under stress, have an infection, cannot exercise, or need to avoid food. This will help in managing our blood glucose levels and prevent having an episode of hypoglycemia. The amount of insulin needed will also depend on a patient’s weight, eating habits, exercise levels, other illnesses, and level of insulin resistance.

I prefer the third dosing method and use it because I have learned how with a little help from the endocrinologist. Having insulin resistance does make the adjusting more complicated at times as the level of insulin resistance has varied for me. Just when I think I have it down, it changes. I would encourage you to read this on blood glucose variables and this on more variables.

I am happy that I am on insulin and one 500 mg dose of metformin ER. I am better able to manage my diabetes, even with all the variables. I moved from oral medications to insulin about 3 months after diagnosis. Therefore, I had none of the feelings of failure, as I was able to embrace insulin and a better tool for the management of my diabetes.

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