Jewels Doskicz is a registered nurse, freelance writer, patient advocate, health coach, and long-distance cyclist. Jewels is the moderator of Diabetic Connect’s weekly #DCDE Twitter chat, and she and her daughter both live healthfully with type 1 diabetes.
Disease management is always weaved into a diabetics thoughts, plans, and actions — but what if the medicine you're prescribed isn't really what you need or the most helpful for that matter Thankfully, researchers have been wondering about this as well.
Positive research results on insulin use in type 2 diabetics
An overwhelming percentage of people with type 2 diabetes (T2D) will be placed on insulin therapy in their lifetime. It clearly is the best idea to get T2D under control as quickly as possible and to avoid future health issues from the disease.
Cutting edge research at Mt. Sinai Hospital found that using insulin early on can stop dramatic glucose swings, giving new life to overworked insulin producing beta-cells in the pancreas according to Diabetes in Control. Their study focused on newer diagnosed patients (an average of 3 years) that were then treated with fast and long-acting insulin for four weeks.
When people are first diagnosed with type 2 diabetes, most have already "lost over fifty percent of their beta cell function," according to Diabetes Health. Focused studies such as this are important in preserving the life of the remaining 50 percent.
Could insulin be a top shelf med for T2D's in the future? According to this research, it may be in a diabetics' best interest.
Benefits of starting insulin therapy early in T2D
"Early on" is actually a very vague term when it comes to T2D. Many people are unfortunately diagnosed late in the game. T2D is different from type 1 diabetes (T1D) in the respect that it usually doesn't cause an acute illness needing immediate medical attention like T1D does.
Therefore, some patients have complications on diagnosis after walking around undiagnosed for a number of years. The goal is always for an early diagnosis; we do have measurable drivers pointing providers towards high-risk patients — it's just not always a successful process.
The first issue is at hand is a lack of insulin. With half of the beta cells in the pancreas pumping out insulin the writing is on the wall — these cells will experience burnout. The second issue is insulin resistance. Beta cells must produce extra insulin to keep sugars within range but the body can only do this for so long.
Pills To Shots
This is a problematic process at best. Type 2 diabetes is a progressive disease; what works at the get-go is sure to putter out over time. Research shows that it takes prodding on the patients' part to get the ball rolling. According to Diabetes Health, "Patients' misguided fears about needles, hypoglycemia, and weight gain often lead to reluctance and physician inertia."
There's a tipping point when therapies are not effective enough to keep blood sugars within a normal range. The process can be accelerated when patients aren't embracing diet and exercise recommendations.
At some point, pills step to the side as the big hitter insulin steps up to the plate.
Misconceptions Of Insulin Therapy
Why, you might ask, does it take so darn long for primary care providers to start their patients on insulin when they clearly need it?
Sad but true, according to a study in Diabetes Journals type 2 diabetes treatments begin to fail after a few years; this includes diet, exercise and medications.
Dr. Brown and his associates found two interesting statistics on insulin initiation:
- The average patient had HbA1c levels 8.0 percent for five years prior to starting on insulin.
- The average patient had HbA1c levels 7.0 percent for 10 years prior to starting on insulin. Imagine the decreases in diabetes complications if insulin was simply started when it was needed or at diagnosis.
Track your Hemoglobin A1cs
It's always important to be an active player in your health. Hanging up your jersey and handing the ball to your primary care provider may not be in your best interest. Try tracking your own results a home. This can be as simple as pencil and paper, a graph, or using a free app such as Diabetes Pal.