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Why do I need insulin to control my diabetes?

Q: I am a diabetic for the past 7 years. I have been taking regular treatment besides doing blood test. From the past two years, I get tired and sweat frequently. In the past 15 days, my sugar level has increased, though I have a controlled diet. Doctor has advised me to take insulin injection @ 18 units in the morning and 12 units in the night. I am very tensed due to this. How long do I have to take an injection? My recent blood test results are given below: Glycosylated haemoglobin (Hb1ac) - 12%; Method: latex agglutination inhibition assay; mean blood glucose (mbg) - 349.0 mg/dl; investigations: fbs – 221; pbs - 483; blu - 24.12; scr - 75 mg%; tchl kip - 223 mgs%; hdlc lip - 46.00 mgs%; trig lip - 793 mgs%; ldlc lip - 184.00 mgs%. Investigation: triodothyronine (t3) - 0.9 ng/ml; thyroxine (t4) - 6.> micro gm/dl; thyroid stimulating - 3.3; micro units/ml hormone (tsh).

A:Beta cells in pancreas make insulin which controls blood glucose levels. The defect in diabetes mellitus (DM) is both beta cell dysfunction and Insulin resistance i.e., ineffective insulin action. This means that amount of insulin secreted by pancreas is insufficient and there is defect in insulin action. As the diabtes progresses beta cells are unable to produce insulin and that stage patients will need insulin. Thats the reason thet 20-30% of Type 2 DM patients need insulin. In your case it seems that your pancreas is not making enough insulin so you need insulin. Insulin therapy is a important tool to control blood sugar levels. What matters is good control whether it is with insulin or medications so that the chances of complications can be minimised. Its also possible that once sugars are controlled with insulin you will be shifted back to oral tablets. Insulin should be given with oral tablets so let me know the medications you are taking. Its better to take Lantus insulin which is once a day and we can achieve better results. I hope this will allay your anxiety about insulin and you will start taking insulin to get a good metabolic control.


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