When should you take insulin shots for type 2 diabetes?

We normally associate insulin with type 1 diabetes and oral  medications with type 2. We all know that the symptoms of type 2 diabetes are slow and the disease gradual in onset and that type 1 is rather sudden in onset. So, no need for a type 2 patient to take insulin?

You may have to reconsider this notion! Did you know that some patients of type 2 diabetes are prescribed insulin?

Type 2 Diabetes and General Treatment

Type 2 diabetes is a much more common type of diabetes with higher incidence rates. It can be caused due to a variety of reasons including family history, obesity, lifestyle factors like sedentary life and others.

As the patient experiences symptoms of diabetes type 2, he/she is advised to undergo diagnostic tests like HbA1c, fasting plasma glucose test, Lipid profile, and others. Later, the  patient is given  some education regarding diabetes and the need to modify lifestyle in order to maintain normal blood glucose levels.

The patient then is put on a prescription consisting Metformin and other medications in case the patient has hypertension, high cholesterol, or any other medical condition.

All patients are not the same

Though what we have mentioned above is a general scenario, not all patients are the same. For some patients, oral medications, dietary modifications, exercise, and weight loss suffice to keep blood glucose levels in range.

However, there are other patients who have severe hyperglycemia and their blood glucose levels wouldn’t come down with oral medications. Such patients run a risk of having complications like diabetic ketoacidosis, which is a life threatening condition.

Symptoms of Diabetic Ketoacidosis

  • General weakness and fatigue.
  • Abdominal pain.
  • Nausea/vomiting.
  • Severe dehydration and inability to perspire.
  • Altered consciousness.
  • Hypotension.
  • Increased heart rate.

This condition is the result of the body not having enough insulin. It is for this reason some patients with type 2 diabetes and poor glycemic control are put on an insulin therapy for a short time period. In some cases, insulin therapy might be permanent.

Short Term Insulin Therapy

When type 2 diabetes symptoms are not under control, a patient may be put on a short term insulin therapy. Usually, a patient with an HbA1c level more than 9% is put on short term insulin therapy. These patients continue the short but intensive insulin therapy for about two to five weeks.  

There are other cases where a patient is put on short term insulin therapy. In cases of the patient being pregnant, has cancer, surgery or is on steroidal medications this therapy is opted for.

Long Term Insulin Therapy

In the case of elderly patients, the symptoms of type 2 diabetes are not in control as the pancreas is unable to produce enough insulin.

In most of these patients, there is significant cell damage in the pancreas and no amount of oral medication works. Such patients achieve better control with long term insulin therapy. Most patients experience a reduction in the symptoms of type 2 diabetes after the insulin therapy.

The transition from oral medications to insulin is quite comfortable for most patients without any pain.

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