Insulin - Treatment For Type 2 Diabetes: Diabetes A Plan For Living

Content provided by the Faculty of the Harvard Medical School

Insulin

Insulin is the only drug made from a naturally occurring glucose-lowering hormone, and it is the most potent and effective of the available diabetes medications. Early treatment with insulin may result in a "remission" period, a time during which you can stop taking all blood-sugar-lowering medications. What's more, by some estimates as many as 65% of all people with type 2 diabetes may eventually need to use insulin. Yet insulin therapy is usually not initiated in people who have type 2 diabetes until they've had the disease for more than 10 years. This reluctance, on the part of both patients and doctors, most certainly reflects the fact that it has to be administered by injection. This situation may change if inhaled insulin gains in popularity.

Insulin therapy is simpler for type 2 diabetes than for type 1. Usually, only one or two doses per day are necessary. However, larger doses (generally more than 50 units per day and often much more) are required to override insulin resistance. For instance, you may take one shot of intermediate- or long-acting insulin or one shot of 70/30 insulin — which is 70% intermediate NPH and 30% regular (see "Types of insulin") — in the morning to keep blood glucose levels in check the entire day. Or a single injection of NPH, Lente, or glargine (Lantus) at bedtime might suffice. You might also have a two-shot regimen, a mixture of rapid-acting and longer-acting insulin (usually NPH) taken in the morning and again before dinner. It may turn out that some people with type 2 diabetes need only inhaled insulin to adequately control their blood sugar.

Once you develop a sound insulin program, you can often manage your blood sugars with less-frequent monitoring (once or twice a day to adjust your insulin dose) than is needed for type 1 diabetes.

Last updated:	January 23, 2007