question: what is the cause for T2's to go on medication/insulin?

[Carina1962]

I have a question - what actually causes Type 2's to go on medication? especially insulin? i know that it is when BS levels get too high despite effort with diet/excercise but is it something to do with beta cells in the pancreas? do they die off in time and how can we 'preserve' them if this is the case? hope it's not too much of an indepth question but i still don't fully understand what diabetes is all about

 

[Caroline Wilson]

Types 2s go on tablets to help improve insulin use or stimulate more insulin productio. Type 2s still have a functional pancreas, so we just need a little help.

My understanding is insulin is given when the pancreas slows down and stops producing quite so much insulin.

 

[Northerner]

I think Peter C can probably help out with this one. My rather basic understanding is pretty much as you have said - insulin resistance causes the pancreas to work hard to try and produce enough insulin to reduce blood glucose levels, but in time this can cause it to fail. Often following a healthy diet and having regular exercise will make a person more sensitive to insulin so this can delay the failure of the pancreas.

 

[ukjohn]

If the above statements are correct, then why was I put on insulin from day 1 in hospital and not tablets, I am type 2. Perhaps my pancreas was shot to hell anyway.

 

[Northerner]

If the above statements are correct, then why was I put on insulin from day 1 in hospital and not tablets, I am type 2. Perhaps my pancreas was shot to hell anyway.

I think the problem with Type 2 is that it can go undiagnosed for a long time so people can be at different stages of beta cell function when diagnosed. Plus, no doubt individual doctors probably have different views on treatment regimes.

 

[RachelT]

As far as i can see you do/take whatever you need to in order to get your Hba1c in an acceptable range. Diabetes is a description of the symptoms rather than what's actually wrong with you. People's actual needs vary considerably from person to person. If you can control your diabetes through diet and excercise that's great.
Metformin makes it easier for the body to take up sugar from the blood so if your diabetes is caused by a sugar transport type problem then it's probably the treatment for you.
If your pancreas doesn't make quite enough insulin to be effective, then you might need Gliclazide or another sulphonlyurea.
Arcabose makes it harder for the body to digest glucose and starch, so less suagr goes into the blood in the first place.
The Glitasones work like metformin.
The Gliptins increase insulin production and decrease the ammount of glucgon the liver produces.
Byetta and Victoza work like the gliptins and slow down erm...the speed at which you digest food.
If your pancreas doesn't produce enough insulin when stimulated or the above drugs don't work or suit you, then insulin can be the answer.
My DSN tells me diabetes is a degenerative disease so it can be a case that your pancreas gets less effective in insulin production over time. But not always, two of my grandparents are diabetic, my Gran is diet controlled beacuse she can't tollerate metformin and my Granddad was on Metformin for years and years and has recently swapped to Gliclazide because of his kidney function.
Your pancreas isn't nessasarily shot John, it's just that your diabetes is subtilely different to mine.

Thus ends my rough guide to diabetes meds....
Rachel

 

[Irisdove]

I have a question - what actually causes Type 2's to go on medication? especially insulin? i know that it is when BS levels get too high despite effort with diet/excercise but is it something to do with beta cells in the pancreas? do they die off in time and how can we 'preserve' them if this is the case? hope it's not too much of an indepth question but i still don't fully understand what diabetes is all about

By reducing the amount of carbohydrate in the diet, you can help reduce the need for the beta cells to produce insulin. This rests them and also helps reduce insulin resistance in the cells.
Beta cells will die off if over used, as in the over production of insulin. The use of the Sulphonylureas which stimulate the beta cells to produce insulin can actually in some cases hasten the demise of the said beta cells.

(Uk John) If the above statements are correct, then why was I put on insulin from day 1 in hospital and not tablets, I am type 2. Perhaps my pancreas was shot to hell anyway.

I?m afraid hospitals often just take the ?easy? option and use insulin first! I know of several people diagnosed in hospital who were placed on insulin but, once they came out, are now on oral medication which quite successfully controls their diabetes. Of course it all depends on how high your initial blood sugars were in the first place.

 

[sofaraway]

I?m afraid hospitals often just take the ?easy? option and use insulin first! I know of several people diagnosed in hospital who were placed on insulin but, once they came out, are now on oral medication which quite successfully controls their diabetes. Of course it all depends on how high your initial blood sugars were in the first place.

Having very high levels can increase insulin resistance in themselves. Even people who wouldn't normally be very insulin resistant will build some resistance with high levels, thats why it can often take higher amounts of insulin to correct a high high.

So sometimes initially tablets will not be enough to control the blood sugars but once insulin has been able to bring the blood sugars down, some people can then trial tablets. Also some people it isn't clear cut if they have type 1 or 2 so may be placed straight to insulin and then things are thought about later when it might be more clear.