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Ask the Expert: What steps do we have to take to get off all insulin and get back on oral medications again?
By Jessica Gibbons, Certified Diabetes Educator and Registered Dietitian
September 22, 2009
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“What steps do we have to take to get off all insulin and get back on oral medications again? I want to feel the way I used to with this disease and still keep the numbers down as well as the weight.”
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Answer:
One of the hardest things to come to grips with when dealing with diabetes, is the fact that it is a progressive disease. For persons with Type 2, diet and exercise alone will work to keep blood sugars in control for a period of time. Then for awhile one medication will work. Then two or three medications will work. Finally a point is reached where insulin is necessary and there is almost no way to “reverse” that need. One can do only so much with diet and exercise. That being said, however, if you can exercise and lose 5-10% of your current weight (assuming you are overweight), you may decrease your insulin needs a bit (or even go off it again for a bit) but it won’t last forever. You can certainly make good meal choices, and eat the right amount of carbohydrate, but again, you may still need insulin. It is always better for us to be on insulin with good blood sugars, than to avoid insulin and run high blood sugars which can lead to complications. This may be frustrating to hear, but taking your insulin now will be so beneficial in the long run!
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Comments (7 comments)
Add your commentWhen it comes to diet and exercise, I have followed my routines religiously. So far and within the last 4 years, I have had to change or increase my meds three times. During the first 12 years of diabetes I went from no meds, to a minute dose of glimepiride( 1mg) and then 1 1/2 - 2mg. With the exception of 1 or 2 very short intervals, my a1c has always been 6.0 to 6.2 since my diagnosis. I have never really had a weight problem. Within the last year my blood sugar began to rise and get harder to control. My choice at this point was more medication, or more exercise. I chose to do substantially more exercise and actually managed to cut my medication dosage in half instead of increasing it. At this stage of my diabetes, if I cut the exercise my blood sugar increases to uncomfortably high levels and I would be forced to take higher doses of meds than ever before. My diabetes has obviously progressed inspite of my best efforts. The positive part of all this is that I have no complications from this disease so far. I attribute this to catching this disease early, and managing and contolling my BS ( a1c) for the entire 16 years!
This some way alters what I would like to see in the future for me cause I want so bad to be the weight I was. But after being misdiagnoised for over 13 years, thinking my problems were from my hypothyroidism. Assuming the weight gain was from that. I don't eat junk food, always to eat the good stuff homemade. On insulin now, but I'm a workaholic and I have little time for exercise. Now that the economy has put a dent on my second job, I have some time to do things with my now big kids, youngest is 17. I've suggested walking with my girls. Hope this works somehow.
Thanks for your article. You described my steps toward insulin use to a T. When I went on it, I asked the Dr. if I really worked hard, could I get off insulin. His answer was "oh sure". I now know that at my age, and the progression and damage done, that I will never be off insulin. It's just a fact, and the sooner you come to grips about it, and do your best, then you will feel better about yourself. Thanks again.
This was a very comforting article for me. I am like so many other people thinking that getting off insulin was the way to go. However, this article helped me to put that in perspective. Thank you
I agree that insulin is the best way. I started with oral medications and eventually ended up on insulin but I do both. My neighbor is the same a me Type 2 but just takes insulin low dose. He was on the pump for about six months. He thought that since he was on the pump, he could eat and drink whatever he wanted. Wrong answer. He ended up having a heart attack with a mild stroke. His doctor took him off the pump immediately and put him back on regular shots. He recovered but his wife keeps him in line.
Good article. It made me realize that I'll probably never be off insulin, permanently. It made good sense to me the statement of being on insulin with a good blood sugar rather off with a bad, only makes sense. .
Jessica Gibbons, a very well written and informative article. I am Type 1 (for 64 years) and I have several Type 2 friends who have gone through every stage you mentioned. Eventually they started pumping their insulin for much better control. There are more and more Type 2 diabetics switching from injections to pumping.