When someone is diagnosed with diabetes, they typically ask if they will have to take insulin shots.  The answer depends on what type of diabetes they have and how high blood sugar levels are at the time of diagnosis. There are two main types of diabetes, Type 1 and Type 2. More than 90% of those diagnosed with diabetes have Type 2.
     What’s the difference in the two types?
     Everyone needs the hormone called insulin to help the body use the food we eat.  Insulin is made by the pancreas and is usually pumped out each time food is consumed. In Type 1 diabetes, the pancreas stops making any insulin. Researchers think the body’s own immune system attacks the pancreas and kills the cells that make insulin or that a virus damages these cells.
     Type 1 diabetes usually comes on suddenly with symptoms that resemble a bad stomach bug.  It is frequently diagnosed in children and young adults who are not overweight. Symptoms may include thirst, frequent urination, weight loss, hunger and fatigue. These individuals have to take insulin to stay alive and they will always need insulin. Unfortunately, the children don’t outgrow their diabetes.
     Type 2 diabetes is a more difficult to diagnose because the symptoms can be mild for many years. Blurry vision, numbness or tingling in the hands and feet, night time trips to the bathroom, infections that are difficult to clear up, dry itchy skin or sores that heal slowly can all be signs of diabetes in addition to those mentioned above for Type 1.
     Type 2 diabetes is more commonly seen in those who are overweight and very inactive with a family history of diabetes. In a previous article I discussed prevention of Type 2 diabetes with healthy eating and more physical activity. Weight loss of only 20 pounds can usually get blood sugars much closer to the normal range.
Some patients with Type 2 diabetes have very high blood sugars by the time the diagnosis is made. Physicians will treat these blood sugars with insulin shots for a short period of time and then change to pills for long term control.  I have heard the statement “I have the mild type of diabetes because I don’t have to take shots.” Type 2 diabetes can cause heart attacks, strokes, kidney failure, amputations, and is the leading cause of blindness.  Just because people with Type 2 diabetes can control the disease with pills, doesn’t mean it is “mild” or harmless. The key to preventing these complications is good control of blood sugars, blood pressure and cholesterol levels. In some patients with Type 2 diabetes, the pancreas wears out and it no longer produces enough insulin for blood sugars to stay in control. These people with Type 2 will need insulin to treat their diabetes.
     Insulin is a wonderful drug and really should not be feared by those with diabetes. Those with Type 1 would die without it and many with Type 2 will eventually need it.