Understanding Insulin: Who Needs It and Why

For many individuals diagnosed with diabetes, the prospect of insulin injections can evoke anxiety and uncertainty. A common misconception is that insulin treatment begins immediately upon diagnosis, leading to a fear of needles and the complexities of managing their condition. However, insulin is a critical treatment for some, particularly those with type 1 diabetes, and understanding who needs insulin can alleviate some of this anxiety.

Type 1 diabetes is a condition where the body cannot produce insulin, making its administration not just necessary but vital for survival. For individuals with this type, the absence of insulin can lead to life-threatening complications. In contrast, some individuals with type 2 diabetes may only need insulin if their blood sugar levels remain uncontrolled despite other non-insulin treatments. This distinction is important, as it underscores the varying needs of patients based on their specific circumstances.

Symptoms such as intense thirst and frequent urination can indicate a need for insulin, especially if they have emerged rapidly. In cases where these symptoms are accompanied by weight loss or ketosis, immediate insulin therapy is recommended to stabilize blood glucose levels. This initial approach not only alleviates distressing symptoms but can also provide insight into the long-term management required for patients.

Blood glucose targets for individuals on insulin therapy vary and must be tailored to each patient’s unique situation. For instance, guidelines suggest target blood glucose levels before meals should range from 4.0 to 7.0 mmol/l, while post-meal levels should remain below 8.9 mmol/l. It’s crucial to personalize these targets, especially considering factors such as age, overall health, and living situations. Older adults living alone, for instance, may require less stringent controls to avoid the risks associated with hypoglycemia.

In cases where blood glucose levels exceed 11 mmol/l, the presence of ketones can signal the need for insulin treatment. This is particularly critical in acute diabetic ketoacidosis (DKA), a severe and life-threatening condition. Patients with a history of DKA are often advised to remain on insulin therapy indefinitely, highlighting the critical role of insulin in managing diabetes complications effectively.

Managing diabetes can seem daunting, but understanding the necessity and application of insulin can significantly improve quality of life for those affected. As medical technology advances, options such as continuous subcutaneous insulin infusion pumps and potentially inhaled or oral insulin are being explored, offering more choices for individuals navigating diabetes management.