You were diagnosed with type 2 diabetes 5 years ago. You have been taking different combinations of pills, but your doctor has recently told you that you may need to start insulin to get better control of your blood glucose levels. You are not sure how to manage injections and wish you had a better understanding of why you may have to change your treatment plan.
Insulin and type 1 diabetes (T1D)1
If you have type 1 diabetes (T1D), you must be treated with insulin because your pancreas is not able to make insulin. Insulin is necessary to keep your blood glucose levels controlled, which prevents long-term diabetes-related complications such as damage to your kidneys, heart, blood vessels, nerves, and eyes. Insulin can be taken by injection or through an insulin pump.
Insulin and type 2 diabetes (T2D)2
You can develop type 2 diabetes (T2D) if your body does not respond well to insulin and/or when your pancreas does not produce enough insulin. Both of these conditions make it difficult to keep your blood glucose levels within a normal range and, consequently, your blood glucose levels rise.
Metformin is an oral medication that is usually the preferred treatment to start with if you have T2DM, assuming that it is well tolerated and you have no other medical condition that would prevent its use. 1 Medication to treat diabetes is always used in combination with lifestyle changes such as meal planning for a healthy diet, weight loss if necessary, and increased physical activity.
Here are some situations when your healthcare provider may consider adding insulin to your therapy: 1
- If your A1C is equal to or greater than 10% or your blood glucose level is greater than 16.7 mmol/L. (A1C is a blood test that measures glucose control over the previous 3 months)
- If you have symptoms from high blood glucose levels such as increased thirst and urinating frequently
- If you have not reached your target A1C after 3 months of treatment with a noninsulin drug
There are many different types and combinations of medications that can be used to treat T2DM. The choice of medication or combinations should be tailored to meet your individual needs. Your healthcare provider will consider factors such as how well the medications are working to control your glucose levels, the side effects, the risk of hypoglycemia, whether the medications cause weight gain, their cost and your personal preferences. 1
As you work with your healthcare provider to find the optimal therapy for controlling your blood glucose levels, your active involvement is critical to a successful outcome. So, plan healthy meals and snacks and take your medications as prescribed. Also, keep a diary of your blood glucose levels with the frequency recommended by your healthcare provider and use an accurate and reliable blood glucose meter, such as the OneTouch Verio Flex® meter, that can help you understand when you are in or out of range.
- American Diabetes Association. Classification and diagnosis of diabetes. Sec. 2. In Standards of Medical Care in Diabetes 2017. Diabetes Care 2017;40(Suppl. 1):S11–S24. Last accessed Feb 16th, 2018
- https://www.webmd.com/diabetes/tc/type-2-diabetes-topic-overview - 1. Last accessed Jan 20th, 2018