Many patients with type 2 diabetes respond with reservations, doubts and fears to their doctor's suggestion to start insulin therapy. Fear of the needle still poses a significant barrier to insulin treatment. If individual therapy goals can not be attained through weight loss, physical activity and oral antidiabetic drugs, insulin should be used. The sooner this happens, the lower the patient's risk for complications in the eyes, kidneys, and nervous system.
Civilization disease No. 1
In Germany there are about six million diabetics, about one million of which are treated with insulin. Diabetes is one of the most common metabolic disorders in humans. While in patients with type 1 diabetes mellitus, because of the lack of insulin production in the pancreas, the hormone must be supplied from the beginning, in patients with diabetes mellitus type-2, the blood sugar levels are first tried by a change in diet, increased physical activity and tablets to lower. If optimum blood glucose control can not be achieved in this way, combination therapy can be used to administer various oral antidiabetics or insulin. Well-trained and motivated patients with type 2 diabetes take part of the treatment in their own hands and, even in advanced age, are able to perform insulin treatment under the guidance of their doctor
Why is it?
In the treatment of type 2 diabetes, two problems have to be tackled: on the one hand, the insulin resistance (reduced insulin action on the cells) of the target organs and the resulting relative insulin deficiency. On the other hand, the delayed release of insulin from the pancreatic B cells after ingestion. Insulin has three target organs: the fatty tissue, the muscles and the liver. The hormone allows the absorption and storage of sugar from the blood into the cells and regulates the release from the liver. If insufficient insulin is available or if the effect of insulin on the target organs is impaired, the sugar level in the blood rises. The body is initially able to compensate for the diminished insulin action through increased insulin production of the pancreas. An appropriate nutritional plan, physical activity and insulin-producing medicines help to lower blood sugar. Over time, however, the target cells are less sensitive to the hormone and the production capacity of the pancreas gradually expires. At the latest now, the time has come for an insulin therapy to reach the therapy goal
With well-adjusted blood sugar right from the start, patients are much more likely to avoid dreaded diabetes episodes and maintain their performance and well-being. For this a regular control of the blood sugar is necessary. Furthermore, it is important to determine the value of glycated hemoglobin (HbA 1c) at regular intervals. In a healthy metabolite with a mean blood sugar level of 90 milligrams per deciliter (5 millimoles per liter), the HbA 1c value is about 5 percent. Control of HbA 1c should be done once a quarter. However, this does not replace regular blood glucose self-monitoring. The results should be entered by the patient in his diabetes health passport and in his blood sugar diary.
The results of the UKPDS study (U United Kingdom Prospective D Diabetes S Study), presented in the fall of 1998, show that permanent reduction of HbA 1c significantly reduces diabetic complications. If it is not possible to achieve a good blood sugar setting with tablets alone, this goal can usually be achieved with an additional dose of insulin. Likewise, in renal, hepatic and cardiac insufficiency certain oral antidiabetics are contraindicated and an insulin therapy is necessary. With a variety of modern aids, insulin therapy is nowadays no longer associated with the patient with any major burdens. After a certain period of practice, the handling of the syringe or the insulin pen becomes routine and the optimized metabolic control increases the well-being and thus the quality of life.