What Causes Type 2 Diabetes
Insulin is a hormone made by your pancreas that acts like a key to let blood sugar into the cells in your body for use as energy. If you have type 2 diabetes, cells dont respond normally to insulin this is called insulin resistance. Your pancreas makes more insulin to try to get cells to respond. Eventually your pancreas cant keep up, and your blood sugar rises, setting the stage for prediabetes and type 2 diabetes. High blood sugar is damaging to the body and can cause other serious health problems, such as heart disease, vision loss, and kidney disease.
Diabetes And Brain Insulin Resistance
Insulin is a hormone produced by the pancreas that helps the body regulate blood sugar levels.
Although insulin resistance is an element of prediabetes and type 2 diabetes, brain insulin resistance is not quite the same thing.
Brain insulin insensitivity can be correlated to diabetes and obesity, but more so has to do with brain metabolism and the efficiency therein, Glatt explained.
Dr. Ahmet Ergin, an endocrinologist with SugarMD told MNT agreed, noting that insulin affects brain function.
Studies have shown that insulin plays a role in neurotransmission, which means it can influence our mood, behavior, and cognition, Dr. Ergin said. One theory is that brain insulin insensitivity directly causes diabetes by preventing the body from properly processing glucose.
Dr. Kausel described insulin resistance as a vicious cycle, noting that the process begins in the liver before it starts affecting different organs, such as the brain.
When we have brain insulin resistance, the important connection between the brain and gut for hunger satiety signals and metabolism gets impaired, making the problem even worse, Dr. Kausel said.
Symptoms of brain insulin resistance to look out for include:
- chronic fatigue
- long-term memory problems
- constant hunger
The Goal Of Insulin Is To Mimic The Pancreas
If you do need insulin, your healthcare provider may prescribe one of five primary typesrapid-acting, regular or short-acting, intermediate-acting, long-acting, or ultra long-acting. These vary in 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 .
The different types of insulin work to mimic the natural rhythm of a healthy pancreas, which produces a consistently low level of insulin as well as occasional bursts to cope with post-meal surges in blood sugar.
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How Do I Take Insulin
Insulin is normally injected under the skin with a very small needle. It can also be taken with an insulin pen. Your doctor will teach you exactly how to inject insulin, but here are the basics:
Wash your hands.
Take the plastic cover off the insulin bottle and wipe the top of the bottle with a cotton swab dipped in alcohol.
Pull back the plunger of the syringe, drawing air into the syringe equal to the dose of insulin that you are taking . Put the syringe needle through the rubber top of the insulin bottle. Inject air into the bottle by pushing the syringe plunger forward. Turn the bottle upside down.
Make sure that the tip of the needle is in the insulin. Pull back on the syringe plunger to draw the correct dose of insulin into the syringe .
Make sure there are no air bubbles in the syringe before you take the needle out of the insulin bottle. If there are air bubbles, hold the syringe and the bottle straight up, tap the syringe with your finger and let the air bubbles float to the top. Push on the plunger of the syringe to move the air bubbles back into the insulin bottle. Then withdraw the correct insulin dose by pulling back on the plunger.
Clean your skin with cotton dipped in alcohol . Grab a fold of skin and inject the insulin under the skin at a 90-degree angle . PICTURE 2.
Insulin In The Future
People with diabetes now depend on getting insulin by injection or pump. Someday there might be more options. Scientists are working hard to find new ways to give insulin. For example, an inhaled version of insulin is available for adults, but not yet for kids. Your childs care team can help keep you updated on the newest treatments for diabetes.
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How Do I Take And Adjust My Insulin Doses
It is important to learn the different methods of taking insulin and what kinds of insulin can be delivered through each method. There are several ways to take insulin syringe, pen, pump, or inhalation though injection with a syringe is currently the most common for people with type 2 diabetes. There are many apps that can help you calculate your insulin doses.
Your insulin regimen should be tailored to fit your needs and lifestyle. Adjusting your basal insulin dosage and timing will require conversations and frequent follow-up with your healthcare team. When initiating insulin therapy, you may be advised to start with a low dose and increase the dose in small amounts once or twice a week, based on your fasting glucose levels. People with diabetes should aim to spend as much time as possible with glucose levels between 70-180 mg/dl. Insulin may be used alone or in combination with oral glucose-lowering medications, such as metformin, SGLT-2 inhibitors, or GLP-1 agonists.
One of the most important things to consider is the characteristics of different insulin types. To learn more, read Introducing the Many Types of Insulin Is There a Better Option for You? and discuss with your healthcare team.
In order to dose insulin to cover meals or snacks, you have to take a few factors into consideration. Your healthcare team should help you determine what to consider when calculating an insulin dose. Prandial insulin doses will usually be adjusted based on:
How To Titrate Insulin Dosage And Monitor Progress
A major feature of this regimen is that insulin is added to existing treatment. Glycaemic control should therefore improve immediately and for practical purposes, should not deteriorate. This means that the dose of insulin can be increased relatively slowly, minimising the risk of hypoglycaemia. As described originally, the regimen2 increased the insulin dosage by 4 units a day if the fasting blood glucose exceeded 8 mmol/L on three consecutive days and by 2 units a day if it exceeded 6 mmol/L. We tend to do it slightly slower and adjust insulin dosage according to these glucose thresholds every 1-2 weeks. The slower pace helps to gain the patients confidence and reduces the risk of hypoglycaemia. This titration regimen is of course not cast in stone and there are ongoing trials that are exploring the best options.
After 2-3 months, the patient is likely to be on about 30 units of insulin each day and maximum oral drug therapy. Measuring the HbA1c concentration after this interval helps to quantify the new level of glycaemic control and further increases in insulin dosage can be made accordingly. There is generally a reduction in HbA1c of about 2% and an increase in body weight of several kilograms. If these changes are not evident, one should consider the possibility that the patient has not been taking the insulin regularly or someone unfamiliar with the regimen has reduced or stopped one or more of the oral hypoglycaemic drugs.
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About Type 2 Diabetes
Diabetes is usually a lifelong condition that causes a person’s blood glucose level to become too high.
The hormone insulin produced by the pancreas is responsible for controlling the amount of glucose in the blood
There are two main types of diabetes:
- type 1 where the pancreas doesn’t produce any insulin
- type 2 where the pancreas doesn’t produce enough insulin or the body’s cells don’t react to insulin
This topic is about type 2 diabetes.
Read more about type 1 diabetes
Another type of diabetes, known as gestational diabetes, occurs in some pregnant women and tends to disappear after birth.
Making The Switch To Insulin
Making the transition is much easier than it used to be because most patients are started on a long-acting insulin that does not need to be matched with food intake.
Insulin pens that are preloaded are replacing insulin that needs to be drawn up into a syringe. Patients may still be worried about giving themselves injections, but because the needle is so tiny the adjustment is often quick.
Toujeo and Lantus are long-acting forms of insulin that are available in a prefilled injectable pen.
And a new class of medication called sodium-glucose cotransporter 2 inhibitors is also available now, according to Mazhari. It works via a different pathway thats not pancreas-dependent, offering another medical therapy option for patients with type 2 diabetes.
The key to an easy transition to insulin is education.
Patients need to know how to take their insulin properly since there are many formulations on the market, including short- and long-acting insulin and premixed, Mazhari said. Most can be started on a long-acting insulin once a day, though for some patients short-acting or mealtime insulin may be necessary as well. Insulin doses need to be further adjusted depending on blood sugar readings.
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Being Overweight Or Obese
You’re more likely to develop type 2 diabetes if you’re overweight or obese with a body mass index of 30 or more.
Fat around your tummy particularly increases your risk. This is because it releases chemicals that can upset the body’s cardiovascular and metabolic systems.
Measuring your waist is a quick way of assessing your diabetes risk. This is a measure of abdominal obesity, which is a particularly high-risk form of obesity.
Women have a higher risk of developing type 2 diabetes if their waist measures 80cm or more.
Asian men with a waist size of 89cm or more have a higher risk, as do white or black men with a waist size of 94cm or more.
Exercising regularly and reducing your body weight by about 5% could reduce your risk of getting diabetes by more than 50%.
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Treatment For Low Blood Glucose
If you have type 2 diabetes that’s controlled using insulin or certain types of tablets , you may experience episodes of hypoglycaemia.
Hypoglycaemia is where your blood glucose levels become very low.
Mild hypoglycaemia can make you feel shaky, weak and hungry, but it can usually be controlled by eating or drinking something sugary.
If you have a hypo, you should initially have a form of carbohydrate that will act quickly, such as a sugary drink or glucose tablets.
This should be followed by a longer-acting carbohydrate, such as a cereal bar, sandwich or piece of fruit.
In most cases, these measures will be enough to raise your blood glucose level to normal. You should aim for a hypo to be treated and to recheck your blood glucose level within 15 minutes.
If blood glucose still less than 4mmol/l then repeat the treatment using a fast acting carbohydrate. When your blood glucose returns to normal then have your longer acting carbohydrate.
If you develop severe hypoglycaemia, you may become drowsy and confused, and you may even lose consciousness.
If this occurs, you may need to have an injection of glucagon into your muscle or glucose into a vein. Glucagon is a hormone that quickly increases your blood glucose levels.
You may require input from a health care professional. If the glucagon is not successful, you may require an injection of dextrose into your vein.
Your diabetes care team can advise you on how to avoid a hypo and what to do if you have one.
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One Type Of Insulin Can Be Inhaled
In the United States, theres one brand of insulin that can be inhaled. Its a rapid-acting form of insulin. Its not suitable for everyone with type 2 diabetes.
If your doctor thinks you might benefit from rapid-acting insulin, consider asking them about the potential benefits and downsides of using an inhalable medication. With this type of insulin, lung function needs to be monitored.
Causes Of Type 2 Diabetes
Your pancreas makes a hormone called insulin. It helps your cells turn glucose, a type of sugar, from the food you eat into energy. People with type 2 diabetes make insulin, but their cells don’t use it as well as they should.
Usually, a combination of things causes type 2 diabetes. They might include:
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What Is Insulin And Why Do I Need It
Insulin is a hormone that controls the level of blood sugar in your body. People with diabetes may not have enough insulin or may not be able to use it properly. The sugar builds up in the blood and overflows into the urine, passing out of your body unused. Over time, high blood sugar levels can cause serious health problems.
All people with type 1 diabetes, and some people with type 2 diabetes, need to take insulin to help control their blood sugar levels. The goal in treating diabetes is to keep the blood sugar level within a normal range.
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Diabetes can be managed through oral medications. In addition to insulin, metformin, which is a sugar-reducing agent, is also a common treatment for diabetes. It is considered a first-line therapy for diabetes treatment and is often added to insulin. It is important to know the risks of taking diabetes medications. Some drugs can be addictive, so you must consult your doctor before taking any medication. Your physician can prescribe you an appropriate treatment plan based on your medical history.
Your doctor will prescribe medication and check your blood glucose levels on a regular basis. Your A1c level will be checked every six months and your cholesterol levels will be tested regularly. Your doctor will also look for any signs of retinopathy, which is damage to the nerves in the eye caused by diabetes. You will also be examined for any foot problems. It is important to see a foot specialist regularly. Your feet should be thoroughly inspected for damage to the nerves.
While the first two types of insulin are the most common treatments, diabetes can be treated in a variety of ways. Your doctor may prescribe medications to control high blood pressure, which can protect the kidneys. Other types of medication include aspirin and other types of anti-platelet drugs. If your doctor is concerned about your blood sugar level, you may need to try a different medication. Some medications can cause side effects. Your treatment will depend on what type of insulin you need.
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What Is Insulin Made Of
Insulin is made in different ways. You and your healthcare team will discuss which insulin you can take.
- Human insulin this is synthetic and made in a laboratory to be like insulin made in the body.
- Analogue insulin the insulin molecule is like a string of beads. Scientists have managed to alter the position of some of these beads to create genetically engineered insulin known as analogues.
- Animal insulin This isnt used much anymore, but some people find that insulin from animals works best for them. It is usually from a cow or pig.
Will I Need Medication Or Insulin For Type 2 Diabetes
Some people take medication to manage diabetes, along with diet and exercise. Your healthcare provider may recommend oral diabetes medications. These are pills or liquids that you take by mouth. For example, a medicine called metformin helps control the amount of glucose your liver produces.
You can also take insulin to help your body use sugar more efficiently. Insulin comes in the following forms:
- Injectable insulin is a shot you give yourself. Most people inject insulin into a fleshy part of their body such as their belly. Injectable insulin is available in a vial or an insulin pen.
- Inhaled insulin is inhaled through your mouth. It is only available in a rapid-acting form.
- Insulin pumps deliver insulin continuously, similar to how a healthy pancreas would. Pumps release insulin into your body through a tiny cannula . Pumps connect to a computerized device that lets you control the dose and frequency of insulin.
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Type 2 Diabetes Prevention
Adopting a healthy lifestyle can help you lower your risk of diabetes.
- Lose weight. Dropping just 7% to 10% of your weight can cut your risk of type 2 diabetes in half.
- Get active. Thirty minutes of brisk walking a day will cut your risk by almost a third.
- Eat right. Avoid highly processed carbs, sugary drinks, and trans and saturated fats. Limit red and processed meats.
- Quit smoking. Work with your doctor to keep from gaining weight after you quit, so you don’t create one problem by solving another.
Do Rotate The Place Where You Inject Insulin
Try not to inject your insulin in the same exact place on your body every time. This is to prevent a condition called lipodystrophy. In lipodystrophy, the fat under the skin either breaks down or builds up and forms lumps or indentations that can obstruct insulin absorption.
Instead, rotate injection sites. The best places for injecting insulin are your abdomen, front or side of thighs, upper buttocks, and upper arms due to their higher fat content. Each injection should be at least two inches from the previous site. Try not to inject too close to your belly button or into any moles or scars.
For mealtime insulin, its best to consistently use the same part of the body for each meal. For example, you can inject in your stomach prior to breakfast, your thigh prior to lunch, and your arm prior to dinner.
Clean your skin with cotton dipped in alcohol or an alcohol pad before you inject yourself. Wait 20 seconds for the area to dry before you inject. This helps avoid infections.
You should also wash your hands thoroughly with soap and warm water before you handle any needles.
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