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When must we pump insulin instead of taking oral medication
- Thread starter hophx
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cugila
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Can't think of a single thing.
The longer anybody who can stays off Insulin, the better. I'd take a tab anyday.
Ken
The longer anybody who can stays off Insulin, the better. I'd take a tab anyday.
Ken
kegstore
Well-Known Member
Hop
I'll have a go at this... Essentially talking about two different treatments for two different conditions. T1 is the result of the body not producing insulin at all, hence injections or a pump are required. T2 is a consequence of the body's resistance to insulin that IS produced naturally, the pills simply stimulate insulin production to compensate. However, some T2s do eventually go on to insulin injections if for example, they are unable to maintain good control.
Pump therapy is normally only considered for T1 patients, when multiple daily injections or regular hypoglycaemia are a problem. Pump therapy for a T1 is still a relative novelty in the UK, and I think unheard of for a T2? I'm certain I'll be corrected if I'm wrong...
Pump advantages
Potential for better overall glycaemic control
Flexibility of treatment for varied lifestyle
Pump disadvantages
Attached to a little box all the time
MUST test blood sugar at least 5-6 times a day
Expensive for your local NHS Trust (admittedly their problem and not your's)
I must admit that having had a pump for 4 years, you'd have to wrestle me for it now, I think it's great.
I'll have a go at this... Essentially talking about two different treatments for two different conditions. T1 is the result of the body not producing insulin at all, hence injections or a pump are required. T2 is a consequence of the body's resistance to insulin that IS produced naturally, the pills simply stimulate insulin production to compensate. However, some T2s do eventually go on to insulin injections if for example, they are unable to maintain good control.
Pump therapy is normally only considered for T1 patients, when multiple daily injections or regular hypoglycaemia are a problem. Pump therapy for a T1 is still a relative novelty in the UK, and I think unheard of for a T2? I'm certain I'll be corrected if I'm wrong...
Pump advantages
Potential for better overall glycaemic control
Flexibility of treatment for varied lifestyle
Pump disadvantages
Attached to a little box all the time
MUST test blood sugar at least 5-6 times a day
Expensive for your local NHS Trust (admittedly their problem and not your's)
I must admit that having had a pump for 4 years, you'd have to wrestle me for it now, I think it's great.
Dennis
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Hi Hop,hophx said:
I think your question may have caused some misunderstanding. By the phrase "pumping insulin" did you actually mean injecting insulin or using an insulin pump? These are two somewhat different things.
hanadr
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Being a T2 married to a T1, I see the problems of using insulin and the definite advantages of using diet, exercise and Metformin to work on insulin resistance. T1 husband injured his foot during a hypo and ended up in hospital on IV antibiotics. I don't get hypo. I use pretty much the minimum dose of Metformin.
jopar
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Some T2's are lucky enough to find good control using the diet, exercise and/or medication appraoch, but there are some that will fall outside of this and require insulin, at what point is really a decission between the doctors and the individual as they would be the ones privy to the information required to make this choice..
Insulin does have a disadvantage as yes you are at risk of hypo's, but used correctly then hypo's and high should be limited risks, but still risks though... And there could be a time when injecting insulin and obtaining better control out wieghs the risk of trying to control with oral medication etc...
Sadly for T1's we don't get a choice we have no alternitives we've got to use insulin, it's only the delivey that some get the option with either inject or use a insulin pump!
And talking of insulin pumps, there's no clinical reason that a T2 who uses insulin can't use a insulin pump, in America T2 insulin users do have this option open to them..
Sadly here, pumps are difficult for T1's to extract out of the NHS, and almost impossible for T2's more so because it's not covered by the NICE guildelines, however saying that there are actually a couple of T2's using a insulin pump which are funded by the NHS, I think if I remember rightly that they are under one particular consultant though..
Insulin does have a disadvantage as yes you are at risk of hypo's, but used correctly then hypo's and high should be limited risks, but still risks though... And there could be a time when injecting insulin and obtaining better control out wieghs the risk of trying to control with oral medication etc...
Sadly for T1's we don't get a choice we have no alternitives we've got to use insulin, it's only the delivey that some get the option with either inject or use a insulin pump!
And talking of insulin pumps, there's no clinical reason that a T2 who uses insulin can't use a insulin pump, in America T2 insulin users do have this option open to them..
Sadly here, pumps are difficult for T1's to extract out of the NHS, and almost impossible for T2's more so because it's not covered by the NICE guildelines, however saying that there are actually a couple of T2's using a insulin pump which are funded by the NHS, I think if I remember rightly that they are under one particular consultant though..
Thank all of you for your reply.
Really ,I ask for my mother ,she's 70 years old, she has also had diabetes for 3 year ago.She's very lazy to do exercise.She is always use oral medication, I'm afaid her organs will be harmed by oral medication(Contra-indication of oral medication).I think, if we inject insulin (or pump) directly into our blood, that will help us to elude the effects unexpected of oral medication to our organs (stomach, liver...) . Is that right ?
Really ,I ask for my mother ,she's 70 years old, she has also had diabetes for 3 year ago.She's very lazy to do exercise.She is always use oral medication, I'm afaid her organs will be harmed by oral medication(Contra-indication of oral medication).I think, if we inject insulin (or pump) directly into our blood, that will help us to elude the effects unexpected of oral medication to our organs (stomach, liver...) . Is that right ?
diabetesmum
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Hi Hophx,
Not sure I can really answer your question but I can say that insulin is not injected or pumped directly into the blood stream but subcutaneously (ie just under the skin into the tissues). I would imagine that it does still have to be processed by the liver, though possibly not the stomach. I am not sure of this though, not being a scientist or doctor!
Sue
Not sure I can really answer your question but I can say that insulin is not injected or pumped directly into the blood stream but subcutaneously (ie just under the skin into the tissues). I would imagine that it does still have to be processed by the liver, though possibly not the stomach. I am not sure of this though, not being a scientist or doctor!
Sue
Trinkwasser
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Generally but not exclusively, Type 2 is caused by insulin resistance. Addressing that is #1 treatment, which normally means metformin and exercise, plus a diet which keeps BG levels low.
Without dealing with the IR Type 2s may require insulin doses which would kill a Type 1.
Having said which, some authorities (principally in the States) will use insulin much earlier than in the UK, and this does have some advantages since getting the BG into range will actually reduce IR.
In general though hyperinsulinemia is a direct cause of some of the "diabetic complications" and one of the reasons for disintegration in Type 2s is the pancreas' need to overproduce insulin to overcome the resistance.
IMO it depends very much on the individual and their specific type of diabetes. Sometimes adding a basal insulin reduces load on the pancreas and makes it more able to deal with mealtime carbs. In other cases adding a bolus insulin for meals when the pancreas is still capable of putting out a low (basal) level is a plan. In some cases Byetta, or a sulph, may cause the pancreas to stop misbehaving.
Without dealing with the IR Type 2s may require insulin doses which would kill a Type 1.
Having said which, some authorities (principally in the States) will use insulin much earlier than in the UK, and this does have some advantages since getting the BG into range will actually reduce IR.
In general though hyperinsulinemia is a direct cause of some of the "diabetic complications" and one of the reasons for disintegration in Type 2s is the pancreas' need to overproduce insulin to overcome the resistance.
IMO it depends very much on the individual and their specific type of diabetes. Sometimes adding a basal insulin reduces load on the pancreas and makes it more able to deal with mealtime carbs. In other cases adding a bolus insulin for meals when the pancreas is still capable of putting out a low (basal) level is a plan. In some cases Byetta, or a sulph, may cause the pancreas to stop misbehaving.
