Type 2 diabetes and insulin treatment are not often associated, but many people with type 2 diabetes use injected insulin because diabetes can get harder to treat over time. In fact, the majority of people who have type 2 diabetes may have to use insulin at some point in their life for many reasons, including increased insulin resistance and pancreatic beta-cell burnout. It does not necessarily mean that you have failed or did not take care of yourself properly if you find your doctor prescribing insulin.
There are also special situations where insulin is preferred, such as during pregnancy, before major surgery, with certain health conditions or because of other drugs.
Common Treatment Progression
Diabetes is a complicated disease and we are all different. Blood sugar levels, age, fitness, compliance, medical history, lifestyle and existing complications are taken into consideration when treatment regimens are designed. Below is a common diabetes treatment progression over time for someone with type 2 diabetes with increasing insulin needs. Your own treatment plan may vary.
- Diet and Exercise
- Oral Medication
- Multiple Therapies
- Long-acting Insulin
- Short-acting Insulin
What Is Insulin?
Insulin is a hormone created in the pancreas and secreted by pancreatic beta-cells. One of its functions is to help move glucose from the blood into cells for future energy needs—thereby lowering blood sugar levels.
People with type 2 diabetes may experience insulin resistance, pancreatic beta-cell burnout or both. These conditions make it hard to move blood sugar out of the bloodstream and to maintain healthy blood sugar levels.
When diet, exercise and other lifestyle changes are no longer effective to lower blood sugar levels, injected insulin is considered.
About Injected Insulin
There are over 20 different kinds of insulin with varying action times. In simple terms, there are longer-acting and shorter-acting insulins.
Long-acting insulin is used to lower your blood sugar levels over a longer period of time. Long acting insulin is also called background insulin or basal insulin.
Short-acting insulin is used to lower after-meal blood sugar levels. It has a much shorter duration than long-acting insulin. It is also called bolus insulin.
Insulin can be injected from a syringe or pre-filled injectable insulin pens, or delivered via an insulin pump. In addition, long-acting and short-acting insulin can come pre-mixed. Ask your doctor what types of insulin and delivery systems are right for you.
How to Give an Insulin Injection
Type of Insulin Delivery Video
Sources:
Ilkova, H; Glaser B; Tunçkale, A; Bagriaçik, N; and Cerasi E. "Induction of Long-term Glycemic Control in Newly Diagnosed Type 2 Diabetic Patients by Transient Intensive Insulin Treatment." Diabetes Care 1997 20(9):1353-1356
Raskin MD, Philip; Allen MD, Elsie; Hollander MD; Priscilla; Lewin MD, Andrew Lewin; Gabbay MD PhD, Robert A; Hu PhD, Peter; Bode MD, Bruce; Garber MD, Alan. "Initiating Insulin Therapy in Type 2 Diabetes." Diabetes Care 2005 28(2):260-265
Turner FRCP, Robert C; Cull PhD, Carole A; Frighi MD, Valeria; Holman FRCP, Rury R. "Glycemic Control with Diet, Sulfonylurea, Metformin, or Insulin in Patients with Type 2 Diabetes Mellitus" JAMA 1999 281(21):2005-2012
