Going Off Insulin
| Author: Judy Kohn, RN, BSN, CDE |
| Last Updated: Friday, September 14, 2007 |
Q: "What is your opinion on going off insulin? I have been on insulin for over ten years, but knew in the beginning that my body was still producing its own. Now that I lost weight, I hardly need any insulin, but I am a little leery to try other meds. Some of the new meds that I have heard about cause weight gain, which I really don't need."
A: When you started insulin 10 years ago, there was only one category of oral agents available (sulfonylureas) which stimulates the pancreas to produce more insulin. Now we have so many more choices, with drugs in 6 different categories.
Keep in mind that type 2 diabetes is a progressive disease, and over time, many people will require insulin. In other words, the oral agents work for a while, but eventually, the pancreas just doesn't produce adequate amounts of insulin, and approximately 50% to 60% of people with type 2 will need to take insulin for the rest of their life.
It is possible you may be able to get off insulin
Of course, each person is different. I have seen people who were overweight when they started insulin (because the oral agents weren't able to adequately control their diabetes). Several years later, after they followed a careful diet and exercise regimen and lost their weight, they were able to go off insulin. In these cases, their initial need for insulin was due to insulin resistance caused by the excess weight; so the weight loss and exercise reversed the insulin resistance, and they no longer required injected insulin to manage their diabetes. Needless to say, you must first discuss this thoroughly with your doctor.
You may still require insulin
However, there are also many people who lost all their excess weight and adhered to a careful diet and exercise plan, yet despite all their success in lifestyle management, they still had elevated blood sugars and continued to require insulin, due to the basic fact mentioned earlier-that diabetes progresses over time.
New variables, new medications
What is different now is that not only are there more categories of oral agents, but also there are two newer categories of drugs, called incretin mimetics and DPP-4 inhibitors, that target specific problem areas in type 2 diabetes. Please be sure to read all the related questions to learn about the various options to consider.
Related Questions
Insulin Resistance
Q:
"Could you explain insulin resistance so that I can understand it? This
term seems confusing to me."
Type 2 and Diabetes Medication
Q:
"As a person with type 2 diabetes, I have worked hard to bring down my
weight and I also exercise regularly, so why are my blood sugars rising? Does
this mean I will need to start taking medication?"
Long-Term Effects of Oral Agents
Q:
"I currently take Avandia® 4mg twice daily and Glucophage® 850mg twice
daily. My typical fasting is 120. My question is: What are the long-term
effects of the two drugs I am taking versus if I take the old and proven meds
like Glucotrol® or Amaryl®."
Sulfonylureas and Meglitinides
Q:
"I am only on Glucophage® but my blood glucose is not in target range and
my doctor said he plans to add a sulfonylurea. Would you explain more about
sulfonylureas?"
Alpha Glucosidase Inhibitors
Q:
"How do Glyset® and Precose® work?"
Thiazolidinediones
Q:
"How do Actos® and Avandia® work?"
Related Links
Joslin Diabetes Center
http://www.joslin.org/
Important Notice: The responses provided by the team of Diabetes Educators are based on their personal experiences and expertise as practicing diabetes healthcare professionals, and are not to be considered diabetes management advice from Abbott Laboratories. Remember that information provided by the team of Diabetes Educators is for general background purposes and is not intended as a substitute for medical diagnosis or treatment by a trained professional. You should always consult your physician about any healthcare questions you may have, especially before trying a new medication, diet, fitness program, or approach to healthcare issues.
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