Type 2 diabetes is a chronic, progressive disease. As time goes on, the pancreas becomes less able to make insulin. The body may also resist the action of any insulin that is made. As your diabetes changes, so must the tools used to control your blood glucose. Lowering blood glucose prevents or delays some complications of diabetes. Kidney problems, numbness and tingling in the arms, hands, legs and feet, eye problems, and problems with erections in men are all examples.
Throughout your journey with type 2 diabetes, the goals of treatment remain the same. It's up to you to decide how to enjoy a healthy and active lifestyle. Healthy living also lowers fasting and after meal blood glucose. Insulin (both what your pancreas is able to make and what is injected) is one of your primary tools. It is safe, readily available, given easily, acts quickly, and the dose can increase as needed.
Using insulin at different times during your life has many advantages. For instance, you may use insulin for a short time when first diagnosed. Depending on your fasting blood glucose levels, A1C, and other symptoms at the time, the Canadian Diabetes Association's (CDA) guidelines include the use of insulin. Especially if your A1C is over nine per cent, using insulin can actually rescue the ability of your pancreas to make insulin. Having your blood glucose over 14 mmol/L can be toxic to your pancreas. Insulin lowers your blood glucose quickly and efficiently, restoring some function to your pancreas. Adding insulin gives the pancreas a rest.
Insulin may also be temporarily needed if certain health concerns arise. For instance, using prednisone (a steroid medication) to treat an asthma attack can make blood glucose rise. Steroids, and illness in general, all increase blood glucose levels and so affect insulin needs. If your oral medications are already at maximum doses or would take too long to become effective, insulin can help you meet your targets and goals.
Insulin can also help those who have had type 2 diabetes for years. This is a progressive disease. Perhaps at first you reached your goals with lifestyle changes alone. Next, you might need to add pills — and more pills. Finally, even all of those pills may not work. It can also be hard to remember to take them, and they can get expensive.
Once again, adding insulin to your treatment may be helpful. Depending on which medications you take orally or by injection, some may be reduced or eliminated. This can simplify your routine and lower the cost of managing your diabetes. Better blood glucose control can lessen complications, leading to a better quality of life.
Expect to continue using metformin, an inexpensive drug. It is one of the first tools recommended by the CDA to treat type 2 diabetes. It can help reduce weight gain that sometimes occurs with insulin use. As well, it lowers the amount of glucose released by the liver, which is especially useful overnight. Some sulfonylurea medications, which 'squeeze' the pancreas to release more insulin, may absorb better once your blood glucose levels are brought back down to normal.
Insulin may not only lower the number and cost of pills you take, but offers greater flexibility in when and how much you can eat. Usually, a long-acting insulin is taken at bedtime. It acts as the background or basal insulin that your pancreas would normally make around the clock. Basal insulin allows the body to get and use the energy it needs for basic functions. When you take basal insulin, your pancreas is relieved of this task. The pancreas can use what insulin-making ability it has left to produce insulin for mealtime needs. This can allow daytime sulfonylurea medications to better cover your meals and reduce your after meal blood glucose once again. You may be able to eat regular-sized meals without worrying so much about blood glucose spikes afterward.
In addition, basal insulin brings down your fasting or morning blood glucose levels. By starting the day with blood glucose within target range, it is easier to maintain and achieve your desired numbers. Symptoms of high blood glucose may be reduced or eliminated. The constant thirst and associated trips to the bathroom may be lessened. Consider the luxury of a good night's sleep without all the interruptions to get up and go! You may even have more daytime energy if your blood glucose is lower.
Best of all, your feelings of frustration or hopelessness may be reduced. No longer will you find that no matter what you do, your numbers are always high. Now, you are in control and can do something. You are taking advantage of a powerful tool.
Say yes to insulin and all of its benefits. Begin by talking with your doctor or certified diabetes educator.