What is type 2 diabetes?
Type 2 diabetes is classified as insulin resistance with an inadequate response in insulin secretion. Although there initially may be some insulin deficiency, unlike in type 1 diabetes people with type 2 diabetes (T2DM) still have a pancreas that makes insulin. In fact, after the initial stage of insulin deficiency, many people with T2DM end up making more insulin than people without diabetes. This is the pancreas’ way of trying to compensate for the present insulin resistance. The body believes that because the person’s glucose levels are elevated there is not enough insulin available; however, there is actually plenty of insulin available, the cells are just not responding to it. Because of this, the pancreas begins working extra hard to pump insulin. Think of it like a sprint. Can you sprint forever? Neither can your pancreas.
Without acceptable BG control the person with T2DM will suffer from “pancreas burnout” and eventually will stop producing insulin entirely. When this happens the person with T2DM will end up needing insulin to replace the insulin they are not making (similar to someone with type 1). But, good news! There are a lot of ways to prevent “pancreas burnout”. There are many drugs available that help with the “insulin resistance” aspect of the disease and can even help your pancreas to make more insulin! I will discuss these options in a future post. Also; a low-carb diet, exercise, and weight-loss are the keys to success in managing T2DM.
Lastly, I want to highlight something that I deal with daily in my practice. Many patients who come to me with T2DM are very scared of adding medications to their regimen. People tend to fear the side effects of the medications more than they fear the possible complications of the disease itself (blindness, kidney failure, heart failure, loss of sensation in lower limbs). This is not a good approach to type 2 management and many of these people end up on insulin with some, if not all, of these complications.
Because of this, insulin gets a “bad rap”. Many people tell me stories about their brother or aunt who was diagnosed with a complication and was then started on insulin. In their mind insulin=complication. I cannot stress this enough…it was not the insulin that caused the complication, it was the lack of insulin and the lack of glucose control. Please do not wait until you develop a complication to be open to treatment. This is the biggest mistake a person with diabetes can make.
That being said, someone with diabetes should not be blindly taking treatment. Make sure you know what you are taking and why. Ask about side effects. Make sure you are comfortable with what you put in your body. You are in charge of your health and your future. Work collaboratively with your clinician. We are on your team!