What Happens When You Run Out Of Insulin
First, lets talk about the physical process that sets in when a person with diabetes does not get enough insulin into their body.
Very quickly, severe hyperglycemia sets in. That is high blood sugar that leads to a state called DKA, short for diabetic ketoacidosis, which untreated leads to death.
Basically whats doing on is this: insulin helps sugar enter the cells, which use it for fuel. Without insulin, the body cannot access enough sugar to function properly, so your liver begins to turns some of the body fat into acids called ketones. These build up in the bloodstream and spill over into the urine. When these excess ketones get into the blood, the blood becomes acidic, causing DKA: a combination of very high blood sugar, dehydration and shock, and exhaustion.
Symptoms are vomiting and hyperventilation, and eventually passing out and going into a coma. Without treatment, this leads to death.
Generally, the first signs of DKA show up once the blood glucose level has been north of 300 mg/dL for about four hours, but how quickly things get out of hand at that point is highly variable. Some people with diabetes feel ill immediately, while others can wander around in a daze for days.
If you have any residual insulin at all in your system, it can help hold off DKA even when your blood sugar level is high, according to Dr. Silvio Inzucchi, clinical director of the Yale Diabetes Center.
Hospitalizations for DKA are unfortunately on the rise in the United States.
Your Treatment Needs Can Change
Over time, your condition and treatment needs can change. If youve found it difficult to manage your blood sugar with lifestyle changes and other medications, your doctor might prescribe insulin. Following their recommended treatment plan can help you manage your condition and lower your risk of complications.
Incretin Mimetics And Non
These medications come in oral pill form, or in injectable form, and include the GLP-1 and DPP-4 inhibitors. They slow down digestion and signal the pancreas to make more insulin. These have a desired side effect of weight loss, and can lower A1C, while using the bodys natural blood glucose lowering mechanisms.
Injectables that are for diabetes, but are not insulin help the pancreas to produce more insulin. However, they may cause a side effect of nausea. Extended release injectable medications are given once weekly.
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Causes Of Type 1 Diabetes
Type 1 diabetes is an autoimmune condition, where the immune system mistakes the cells in your pancreas as harmful and attacks them.
Without insulin, your body will break down its own fat and muscle, resulting in weight loss. This can lead to a serious short-term condition called diabetic ketoacidosis. This is when the bloodstream becomes acidic, you develop dangerous levels of ketones in your blood stream and become severely dehydrated.
This results in the body being unable to produce insulin, which is required to move glucose out of the blood and into your cells to be used for energy. This is called Type 1 diabetes.
Read more about the causes of type 1 diabetes
Pramlintide Is An Injected Medicine For People With Diabetes
In type 1 diabetes, Pramlintide can be taken in addition to insulin to help control mealtime blood sugars.
If you have type 2 diabetes, and lifestyle changes are not enough to control your blood sugar, typically, your provider will first start you on a single medicine. For people who are overweight, metformin is usually the first medicine prescribed.
If the single therapy doesnt work, additional medicines can be added. Many people require treatment with 2, 3 or more different medicines. If pill combinations dont work, an injected medicine such as an incretin-based medicine, amylin analog or insulin may be prescribed. Medicine combinations are used because different drugs target different parts of your bodys sugar regulation system.
Rarely, and usually due to other medical conditions, it may be necessary to start medical treatment of type 2 diabetes with insulin therapy. Usually, however, insulin therapy is the last treatment prescribed and is added only after the oral medications or non-insulin injections dont work.
In this section, you will learn about the non-insulin treatment options for glucose control in type 2 diabetes including the different medicines, how they work, doses, and side effects.
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Managing Diabetes Without Insulin
Imagine life without insulin or pills, or being able to dramatically reduce your dosages. A pipe dream? For the great majority of Type 2 diabetics who come to the Pritikin Longevity Center, its exactly what happens.
Doris Drew is one stunning example. Fifteen years ago, the software programmer from Wichita, Kansas, suffered from diabetes, hypertension, high cholesterol, and obesity. Her blood sugar was alarmingly high. My mother died from complications related to diabetes. I saw myself going through the same agony she endured, and I was frightened.
So Doris came to the Pritikin Longevity Center. Today, shes off all diabetic medications, shes lostand kept off130 pounds, her blood pressure is normal, and her blood sugar readings indicate that shes essentially a nondiabetic, her physician proudly announces. Shes in state-of-the-art control.
Her life is in state-of-the-art control, too. I like to think of the Pritikin Program as my own personal hobby. I love the food, and Im always on the gowalking, strength training, ballroom dancing. The healthier Ive become, the more hopeful and rewarding my life is.
Getting Regular Physical Activity
Keeping active every day is a key part of diabetes treatment. Exercise strengthens your childs muscles and bones, helps them feel good, and controls blood sugar levels. In fact, exercise makes insulin work better. Kids with type 1 diabetes can and should exercise.
Encourage your child to stay active, and set a goal of 60 minutes each day. Let them choose what they enjoy whether thats walking the dog, riding a bike, or playing team sports. For some kids, starting a new exercise habit might be hard at first. But if they enjoy the activity and feel good when they do it, theyll find it easier to stick with it.
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Should I Sterilize The Skin With Alcohol Before Giving The Injection
No, do not swab the skin with alcohol to ‘sterilize’ it. There are four reasons:
- The smell of the alcohol can make your dog dislike the injections.
- Due to the nature of the thick hair coat and the type of bacteria that live near the skin of dogs, brief swabbing with alcohol or any other antiseptic is not effective.
- Because a small amount of alcohol can be carried through the skin by the needle, it may actually carry bacteria with it into the skin.
- If you have accidentally injected the insulin onto the surface of the skin, you will not know it. If you do not use alcohol and the skin or hair is wet following an injection, you will know that the injection was not done properly.
Although the above procedures may at first seem complicated and somewhat overwhelming, they will very quickly become second nature. Your dog will soon learn that once or twice each day it has to sit still for a few moments. In most cases, a reward of stroking results in a fully cooperative dog that eventually may not even need to be held.
Why Physical Activity Is A Key Tool For Diabetes Treatment
That includes 150 minutes per week of moderate-intensity aerobic activity, such as:
- Brisk walking
- Taking group fitness classes that involve using weights
- Using weight machines at the gym
- Heavy gardening or other activities that can help you build and maintain muscle
- Overhead arm stretches
- Torso twists
- Leg lifts or extensions
Before you start a formal exercise program or increase your level of physical activity, it’s important to get your doctor’s okay and to find out which activities you can do safely.
In general, though, exercise can provide people with diabetes with a lot of benefits. Exercise is critical for patients with diabetes to maintain heart health and maintain glucose control, Dungan says. She notes that its best to consult your doctor about the type and frequency of activity that is best for you, and find out whether you need additional testing to make sure that exercise is safe. Still, Dungan says, brisk walking nearly every day for at least 30 minutes is safe and beneficial for most people.
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Do I Have Other Treatment Options For My Diabetes
When medicines and lifestyle changes are not enough to manage your diabetes, a less common treatment may be an option. Other treatments include bariatric surgery for certain people with type 1 or type 2 diabetes, and an “artificial pancreas” and pancreatic islet transplantation for some people with type 1 diabetes.
Insulin Treatments: A Common Option
While lifestyle and dietary changes may assist a cat in managing diabetes, Koble notes that many cats will need to receive insulin shots before going into remission.
Insulin, as Koble explains, is a hormone that is made in the pancreas that regulates blood sugar levels. The more insulin secreted, the lower the blood sugar will drop. The less insulin that is secreted, the higher the blood sugar will remain. When there is not enough insulin, blood sugar remains high, resulting in diabetes.
For cats that do require insulin, most cats need a dose every 12 hours. Koble adds, All insulin is safe when used properly.
Any cat with diabetes will have to maintain visits with their vets based on their diagnosis. Some require frequent office visits for blood sugar measurements and some prefer to empower clients to do monitoring at home, Koble explains. If a cat is well regulated and doing well, there may be up to six months on average between recommended visits.
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Checking Blood Sugar Levels
Treating type 1 diabetes also includes checking blood sugar levels every day. There are two ways to do this:
The care team also will monitor your childs blood sugar using a blood test called glycosylated hemoglobin . The results will show how often your childs blood glucose was in and out of the healthy range in the 23 months before the test. This helps the care team know how well the care plan is working for your child.
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.
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How To Lower Blood Sugar Without Insulin
These days, there are so many ways to lower blood sugar without insulin. But for most people, insulin is one of the scariest things a doctor can say.
For starters, here are a couple of things to keep in mind.
Insulin only makes up a very small percentage of a doctors prescribing regimen when it comes to type 2 diabetes. Insulin is only used for a couple of main reasons.
Three of the biggest reasons why a doctor may put you on insulin have to do with one of the following:
Ive heard of many of the doctors that I work with threatening their patients with insulin. I think this is a bad approach. All it does is make people fear insulin even more.
I talk about how to get off of insulin if you are already on insulin in another article. But insulin therapy is a big issue with diabetes therapy.
Not to mention many associate insulin with worsened diabetes, amputations, and dialysis. And lets face it, insulin does come with side effects such as edema and weight gain to name a few.
But remember, as I mentioned already, insulin is usually a small part of most primary care doctors prescribing regimen.
Usually they will prescribe an oral drug for diabetes and after 2 or 3 different drug combinations and your blood sugar levels are still out of control, then most doctors will prescribe insulin.
What Do I Need To Know About Insulin Treatment For Diabetes Mellitus
In diabetic dogs, the main treatment for regulating blood glucose is giving insulin by injection. Dogs with diabetes mellitus typically require two daily insulin injections as well as a dietary change. Although a dog can go a day or so without insulin and not have a crisis, this should not be a regular occurrence treatment should be looked upon as part of the dog’s daily routine. This means that you, as the dog’s owner, must make both a financial commitment and a personal commitment to treat your dog. If you are out of town or go on vacation, your dog must receive proper treatment in your absence.
There is a newer glucose monitoring system that can measure glucose continuously over several days. Talk to your veterinarian to see if this is right for your dog.
Consistent treatment is a vital component of the proper management of the diabetic dog. Your dog needs consistent administration of insulin, consistent feeding, and a stable, stress-free lifestyle. Your dog should live indoors to minimize uncontrollable variables that can disrupt regulation. The most commonly used insulins are Vetsulin®, Caninsulin®, Humulin®N, and Detemir . Your veterinarian will determine the best insulin for your dog.
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Is Diet And Exercise Enough Or Do I Need Metformin
In the past few years, the American Diabetes Association has seen changes to its guidelines related to the effectiveness of diet and exercise in managing diabetes. It is current practice to start metformin early to protect beta cells from further damage.
Metformin can lower A1C by 1-2 percent. It should be used in the treatment of Type 2 diabetes for this reason, along with its protective mechanism related to beta cells in the pancreas. Most people with diabetes will want to achieve an A1C of less than 7 percent in order to avoid the long term complications of diabetes.
Your healthcare provider will look at your A1C numbers, and determine the need for interventions, including diet, exercise, oral medications, non-insulin injectable medications for diabetes, or insulin. Generally, what happens is that a person with diabetes will do well on metformin for a number of years, and then they tend to start seeing their A1C creep up.
It becomes more difficult to keep the A1C below 7 percent with diet, exercise, and metformin. At this point, your healthcare provider may be looking at adding in a number of different oral medications for diabetes, or adding a GLP-1 injectable, and eventually insulin if A1C goal is not achieved by other means.
Some important factors that should be taken into consideration when picking a diabetes medication are:
- the costs,
- side effects , and
- the risk of a low blood sugar.4
How To Tell If Your Cat Has Diabetes
While there are a few things to look out for, Dr. Erika Raines, DVM, CVA, CVSMT, of the Holistic Pet Vet Clinic in Tigard, Ore., says more frequent drinking and urination is the biggest sign of diabetes in cats. She notes that cats may also develop diabetic neuropathy, where they start to lose nerve function in their back legs and have weak hind legs as a result. Raines says that the most common sign of neuropathy is a cat who walks flat on his back legs with his hocks on the ground.
A change in eating and drinking routines may also signal the onset of diabetes in cats. Without insulin, body can’t use glucose. So in the beginning you notice your cat is really hungry and is still losing weight, says Koble. The body also tries to dilute the high sugar by increasing the thirst, so cats that are diabetic will drink and urinate much more than a healthy cat.
If you notice any of these signs, take your cat to the veterinarian immediately. If untreated, diabetes in cats can lead to severe issues, including weakness in the legs , diabetic ketoacidosis, infections, cataracts, nausea, kidney failure, severe dehydration, seizures, coma, and even death, explains Koble.
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Diabetes Type 1 And Type 2 Definition And Facts
- Controlling blood sugar levels is the major goal of diabetes treatment, in order to prevent complications of the disease.
- Type 1 diabetes is managed with insulin as well as dietary changes and exercise.
- Type 2 diabetes may be managed with non-insulin medications, insulin, weight reduction, or dietary changes.
- The choice of medications for type 2 diabetes is individualized, taking into account:
- the effectiveness and side effect profile of each medication,
- the patient’s underlying health status,
- any medication compliance issues, and
- cost to the patient or health-care system.