Can Diabetes Kill You
Yes, its possible that if diabetes remains undiagnosed and uncontrolled it can cause devastating harm to your body. Diabetes can cause heart attack, heart failure, stroke, kidney failure and coma. These complications can lead to your death. Cardiovascular disease in particular is the leading cause of death in adults with diabetes.
Insulin And Type 2 Diabetes
If your health care provider offered you a medication to help you feel better and get your blood sugar under control, would you try it? If so, you might be ready to start taking insulin.
Does insulin immediately make you think of type 1 diabetes? Think again. Between 30 and 40 percent of people with type 2 diabetes take insulin. In fact, there are more people with type 2 diabetes who take insulin than type 1 because of the much larger number of people with type 2. Experts believe even more people with type 2 should be taking insulin to control blood sugar — and the earlier, the better. With an increase in people developing type 2 at a younger age and living longer, more and more people with type 2 will likely be taking insulin.;
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“If you live long enough with type 2 diabetes, odds are good you’ll eventually need insulin,” says William Polonsky, Ph.D., CDE, associate clinical professor of psychiatry at the University of California, San Diego; founder and president of the Behavioral Diabetes Institute; and author of Diabetes Burnout: What to Do When You Can’t Take It Anymore .
When To Contact A Medical Professional
- Chest pain or pressure
- Shortness of breath
- Red, painful skin that is spreading quickly
These symptoms can quickly get worse and become emergency conditions .
Also call your provider if you have:
- Numbness, tingling, or pain in your feet or legs
- Problems with your eyesight
- Sores or infections on your feet
- Symptoms of high blood sugar
- Symptoms of low blood sugar
- Frequent feelings of depression or anxiety
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Insulin Will Make You Gain Weight
Theres some truth to this one. Some people with type 2 diabetes may gain weight after starting insulin therapy. However, the insulin therapy itself does not induce weight gain. Its because if a diabetes treatment is working, the body begins to process blood glucose more normally, and the result can be weight gain. The good news is that this tends to level out as insulin therapy continues, and the weight gain may be transient, explains Dr. Crandall.
The Future Of Insulin
More insulin advances are percolating. There will be new insulins that act even faster. Improvements will be made in the open-loop pumps currently on the market, and efforts continue to develop the so-called artificial pancreas, or closed-loop system that promises, with several different models, to control blood sugar without the person having to do all the thinking.
Work also progresses on alternate ways to take insulin. The second generation of inhaled insulin is on the way with the FDA’s approval of Afrezza in 2014. Investigation is ongoing for delivering insulin buccally — via the tongue, throat, and cheeks — or through a skin patch.
While the progress on new insulin products and delivery systems is encouraging, don’t delay starting insulin if your health care provider and your diabetes health status indicate you need it now. The insulin available today is safe and relatively easy to take, and injections are nearly painless. Plus, starting to take insulin sooner rather than later may improve your health quickly and make your life better for many years to come.
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A Guide For The Decision To Start Insulin
Most clinicians do not think algorithmically when managing clinical conditions and advising people with diabetes. They often prefer to follow a patient-led agenda, and individuals will highlight their problems and preferences for solutions in quite different ways. As a result, a simple algorithm for starting insulin is not feasible. However, it is possible to provide a checklist that may help to guide the clinician-patient interaction to ensure that decisions occur in a logical way, and importantly without missing the opportunity to obtain relevant information .
The first consideration might be to assess whether an acute need is present, although usually that will be obvious. At diagnosis, other referral, or when admitted for whatever reason as an in-patient, the presence or absence of marked hyperglycemia, weight loss, ketones, ketoacidosis, or dehydration must be ascertained. If marked hyperglycemia alone is present, is there an acute precipitating factor, and if not, is there any prospect that glycemic control can be restored by lifestyle change? Is the patient in a risky or uncertain environment? In these cases, there may be a strong, immediate need, and persuasive advice to consider insulin may be appropriate .
What Is Hyperglycemic Hyperosmolar Nonketotic Syndrome
Hyperglycemic hyperosmolar nonketotic syndrome develops more slowly than diabetic ketoacidosis. It occurs in patients with Type 2 diabetes, especially the elderly and usually occurs when patients are ill or stressed.If you have HHNS, you blood glucose level is typically greater than 600 mg/dL. Symptoms include frequent urination, drowsiness, lack of energy and dehydration. HHNS is not associated with ketones in the blood. It can cause coma or death. Youll need to be treated in the hospital.
Can Diabetes Cause Headaches Or Dizziness
Yes, its possible to develop headaches or dizziness if your blood glucose level is too low usually below 70 mg/dL. This condition is called hypoglycemia. You can read about the other symptoms hypoglycemia causes in this article.Hypoglycemia is common in people with Type 1 diabetes and can happen in some people with Type 2 diabetes who take insulin or medications such as sulfonylureas.
Factors That Speed Insulin Absorption
Variation in insulin absorption can cause changes in blood glucose levels. Insulin absorption is increased by:
- injecting into an exercised area such as the thighs or arms
- high temperatures due to a hot shower, bath, hot water bottle, spa or sauna
- massaging the area around the injection site
- injecting into muscle this causes the insulin to be absorbed more quickly and could cause blood glucose levels to drop too low.
Initiation Titration And Follow
The initial dosage of insulin is individualized based on the patient’s insulin sensitivity. Insulin therapy may be started with a set dosage, such as 10 units of glargine daily, or by using weight-based equations. Equations to estimate augmentation, replacement, carbohydrate ratio, and correction therapy are listed in Table 2. When using replacement therapy, 50 percent of the total daily insulin dose is given as basal and 50 percent as bolus, divided up before breakfast, lunch, and dinner. For example, a 120-kg patient requiring basal-bolus and correction insulin would need 36 units of basal insulin ; 12 units of short-acting insulin before each meal ; and, for correction, 1 unit of a short-acting insulin for every 25 mg per dL above the set glucose target.
American Diabetes Association Blood Glucose and A1C Goals for Patients with Diabetes Mellitus
90 to 130 mg per dL
60 to 100 mg per dL
Postprandial blood glucose
< 180 mg per dL
100 to 130 mg per dL
< 7.0 percent
< 6.0 percent
note: Recent studies have found no cardiovascular benefit with A1C targets of 6.0 or 6.5 percent compared with targets between 7.0 and 8.0 percent. Some microvascular benefit has been associated with A1C targets of 6.0 or 6.5 percent.
Adapted with permission from American Diabetes Association. Standards of medical care in diabetes2010 . Diabetes Care. 2010;33:S11S61.
American Diabetes Association Blood Glucose and A1C Goals for Patients with Diabetes Mellitus
When Should Insulin Therapy Be Started
Indications for insulin therapy and when to begin it are poorly defined in guidelines and still subject to individual judgment based on a wide range of opinion . Personal beliefs and experience, familiarity with the use of the different insulin preparations and delivery systems, individual preference, patient needle phobia, concern about chronic hyperinsulinemia, risk of hypoglycemia, and difficulties in controlling body weight are some of the many considerations regarding insulin therapy . Each one of these factors can be weighted differently between doctors and between people with diabetes. The expert group proposed that one way to rationalize the approach to insulin treatment could be to consider some clinical scenarios. These could be as follows: 1) the time of diagnosis or early thereafter; 2) in the presence of other emerging medical conditions; and 3) in the course of routine ambulatory diabetes management.
Can Type 2 Diabetes Be Cured
There is no cure for type 2 diabetes, but some people are able to put their diabetes into remission. This means that your blood sugar levels are healthy and you dont need to take diabetes medication any more. Remission can be life-changing, but its not possible for everyone.
Learn more about diabetes remission.;
How To Get Free Prescriptions For Diabetes Medicine
You’re entitled to free prescriptions for your diabetes medicine.
To claim your free prescriptions, you’ll need to apply for an exemption certificate. This is known as a PF57 form. To do this:
- fill in a form at your GP surgery
- you should get the certificate in the post about a week later it’ll last for 5 years
- take it to your pharmacy with your prescriptions
Save your receipts if you have to pay for diabetes medicine before you receive your exemption certificate. You can claim the money back if you include the receipts along with your completed PF57 form.
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How Does Diabetes Affect Your Heart Eyes Feet Nerves And Kidneys
Blood vessels are located throughout our bodys tissues and organs. They surround our bodys cells, providing a transfer of oxygen, nutrients and other substances, using blood as the exchange vehicle. In simple terms, diabetes doesnt allow glucose to get into cells and it damages blood vessels in/near these organs and those that nourish nerves. If organs, nerves and tissues cant get the essentials they need to properly function, they can begin to fail.Proper function means that your hearts blood vessels, including arteries, are not damaged . In your kidneys, this means that waste products can be filtered out of your blood. In your eyes, this means that the blood vessels in your retina remain intact. In your feet and nerves, this means that nerves are nourished and that theres blood flow to your feet. Diabetes causes damage that prevents proper function.
What Does It Mean If Test Results Show I Have Protein In My Urine
This means your kidneys are allowing protein to be filtered through and now appear in your urine. This condition is called proteinuria. The continued presence of protein in your urine is a sign of kidney damage.
A note from Cleveland Clinic
Theres much you can do to prevent the development of diabetes . However, if you or your child or adolescent develop symptoms of diabetes, see your healthcare provider. The earlier diabetes is diagnosed, the sooner steps can be taken to treat and control it. The better you are able to control your blood sugar level, the more likely you are to live a long, healthy life.
Last reviewed by a Cleveland Clinic medical professional on 03/28/2021.
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Guidelines For Starting Insulin
Know your health care provider’s plan up front. Ask what A1C and blood glucose measures are used and how you will start taking insulin.
Think short-term, not long-term. Start taking insulin when your health care provider recommends it, and notice if you feel better and have more energy. Don’t try to put it off from appointment to appointment.
Ask to be referred to a diabetes education program to learn the ins and outs of taking insulin and get the support you need.
Have a plan with your health care provider to be in touch regularly to increase your dose until you hit your blood glucose targets.
Get the inside scoop from people who have successfully transitioned to insulin. Try attending a support group or connecting with people willing to support you in one or more of the diabetes online communities.
Explore your options for insulin delivery — using the traditional vial and syringe, or using the more contemporary and convenient pens or possibly an insulin pump. Check your health insurance plan to see what it covers.
Continue to eat well and exercise regularly.
Strive for consistency. Take your insulin and eat at similar times every day when possible.
Store insulin properly. Keep the pen or vial of insulin at room temperature , and store extras in the refrigerator.
Carry a source of carbohydrate to treat low blood sugar, such as glucose tablets or hard candy. Start by using 15 grams of carbohydrate.
When Should Insulin Therapy Be Initiated
Type 2 diabetes is a progressive disease, and thus, ultimately this question will arise for many of our patients. Unfortunately, there is no unequivocal answer, which was nicely illustrated by a recent interactive case vignette. The polling results demonstrated once again that the management of patients with type 2 diabetes uncontrolled by two oral glucose-lowering agents is controversial. Furthermore, the preferred treatment option was found to be related to the respondents’ locations and self-reported specialties .
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Heres How You Can Get Started:
- Work with your doctor to determine what level of physical activity you should engage in
- Figure out how much time per day you can devote to exercise
- Set fitness goalshaving clear goals can help you stay motivated
- Consider where youll start working outthe gym, in your neighborhood, in a park?
- Build different activities;into your daily routine
- Start slowly and allow for recovery time
- Keep track of what you do and stay focused on your goals
- Listen to your body
How Is Diabetes Diagnosed
Diabetes is diagnosed and managed by checking your glucose level in a blood test. There are three tests that can measure your blood glucose level: fasting glucose test, random glucose test and A1c test.
- Fasting plasma glucose test: This test is best done in the morning after an eight hour fast .
- Random plasma glucose test: This test can be done any time without the need to fast.
- A1c test: This test, also called HbA1C or glycated hemoglobin test, provides your average blood glucose level over the past two to three months. This test measures the amount of glucose attached to hemoglobin, the protein in your red blood cells that carries oxygen. You dont need to fast before this test.
- Oral glucose tolerance test: In this test, blood glucose level is first measured after an overnight fast. Then you drink a sugary drink. Your blood glucose level is then checked at hours one, two and three.
|Type of test|
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How Can Therapeutic Approaches Be Revised
Even when individuals with conditions or circumstances allowing exemption from specific glycemic targets are removed from discussion, a sizable group of people who have no apparent reason not to attain HbA1c in the 5364 mmol/mol range remains. Insulin therapy is often said to be unlimited in its capacity to lower glucose levels, but in practice, even very high prescribed doses sometimes yield results that fall short of expectations . The underlying causes of failure of usual treatments are undoubtedly numerous, and to understand them calls for further effort to identify the personal characteristics of each person that may prove relevant . In many cases, progressive obesity, as a marker for high calorie intake and insulin resistance, identifies a metabolic challenge that resists success even when ample insulin is delivered to tissues. Other medical conditions may be important. Examples include unrecognized Cushing syndrome or a genetic or acquired disorder of extreme insulin resistance.
Dealing with problems when on insulin therapy
Exploring individual factors and their interactions lies at the center of personalized treatment and poses a more difficult challenge in this setting than at the time of starting standard treatments for an unselected population of patients . Personalized use of insulin and other therapies by people who have already demonstrated little success with a more generic approach requires time, expertise, and motivation.
Risk Factors Of Type 2 Diabetes
There are several factors that can affect your risk of developing type 2 diabetes. Because the symptoms of type 2 diabetes are not always obvious, its really important to be aware of these risk factors. They can include:;
- your age
- if you have a parent, brother, sister or child with diabetes
- your ethnicity
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How To Know When You’ll Need Insulin
Injecting insulin above and to the side of the belly button can result in more consistent results.
There’s no simple way to tell when a patient with type 2 would do best on insulin, says Richard Hellman, MD, former president of the American Association of Clinical Endocrinologists. But there are guidelines.
“In general if a patient has a hemoglobin A1C that is higher than the agreed upon goal and they are not on insulin, we recommend insulin therapy,” Dr. Hellman says. The American Diabetes Association recommends an A1C of 7% or below, and the American College of Endocrinology and the American Association of Clinical Endocrinologists recommend an A1C of 6.5% or below.
If you can’t lower your A1C with diet, exercise, or other medications, you may need insulin to do the job.
Exceptions to the insulin ruleThere are exceptions, of course. Someone who otherwise seems to be a good candidate for insulin may not be able to manage such a regimen if he or she has limited vision and dexterity and no family support. Good News About Today’s Improved Insulins
If you do need insulin in the short- or long-term, your doctor may prescribe one of four different types. These vary by how quickly or slowly they reach the bloodstream , the amount of time they work at maximum strength , and how long they continue to be effective .
According to the American Diabetes Association , your need for insulin is based on several factors.