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Diabetes, Type 2: Should I Take Insulin?
You may want to have a say in this decision, or you may simply want to follow your doctor's recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them.
Diabetes, Type 2: Should I Take Insulin?
1Get the | 2Compare | 3Your | 4Your | 5Quiz | 6Your Summary |
Get the facts
Your options
- Take insulin to keep blood sugar levels under control.
- Don't take insulin. Try other methods to keep blood sugar levels under control.
Key points to remember
- The goal in treating type 2 diabetes is to keep blood sugar under control. When you control your blood sugar, you decrease your risk for other health problems caused by diabetes, such as eye problems, kidney disease, and nerve damage.
- Losing weight and increasing activity, along with taking diabetes medicine other than insulin, may be enough to keep blood sugar under control. Controlling blood sugar means staying in your target range.
- If your disease gets worse and your blood sugar can't be controlled, your doctor will likely suggest that you take insulin.
- Insulin is the most effective medicine for lowering blood sugar levels to meet target ranges and A1c goals.
- If you decide to use insulin, you'll learn what type is best for you and how much you'll need to take. And you'll need to know the signs of low blood sugar and what to do if you have a low blood sugar emergency.
- Starting insulin doesn't mean that you've failed to control diabetes. Type 2 diabetes is often a disease that gets worse over time. Insulin can help people with type 2 diabetes keep their blood sugar under control.
How is type 2 diabetes treated?
The goal in treating type 2 diabetes is to control blood sugar levels by keeping them in your target range. Lifestyle changes, such as losing weight and being more active, are the first steps to get blood sugar under control. But you may also need to take a diabetes medicine (such as metformin), which helps decrease the body's resistance to insulin and help insulin work better in the body.
Diabetes often gets worse over time. And when it does, diabetes medicines don't work as well. Insulin can help people with type 2 diabetes keep their blood sugar under control. Sometimes your doctor may recommend insulin because of other health problems, such as kidney complications.
What is insulin?
Insulin is a hormone that helps sugar enter your cells, where your body uses it for fuel. When your body doesn't make enough insulin or can't use it the way it's supposed to, your blood sugar gets too high. This can be serious or even life-threatening.
How is insulin used?
Most people use insulin as an injection, or shot. It is given into the fatty tissue just under the skin. Learning how to give yourself insulin may take some time. You'll also need to pay more attention to your blood sugar levels than you may be used to. But with practice, monitoring your levels and using insulin correctly can become a routine part of your day.
Some people can take insulin through an inhaler. Inhaled insulin works very fast, so it is usually taken right before eating. People who have lung problems or trouble breathing cannot take inhaled insulin.
What are the risks of using insulin?
Using insulin has few risks and side effects. You may gain weight, especially if you are already overweight. The biggest risk of insulin use is very low blood sugar (hypoglycemia), which can turn into an emergency if not managed right away.
Using inhaled insulin may reduce how well your lungs work. If you take inhaled insulin, your doctor will test your lungs every 6 to 12 months using a spirometer. This test is done in the doctor's office and is not painful.
About low blood sugar
Some common reasons for very low blood sugar include:
- Taking too much insulin.
- Skipping meals or not eating enough food.
- Exercising without eating enough, or being much more active than usual.
- Drinking too much alcohol (especially on an empty stomach).
By checking your blood sugar levels often, taking insulin on a schedule, and eating regular meals, you can avoid low blood sugar.
It's a good idea to know the signs of low blood sugar, which include feeling tired, weak, or shaky. If your blood sugar drops very low and you don't get help, you could get confused or drowsy or even lose consciousness and possibly die.
Most of the time, you can treat mild-and sometimes moderate-low blood sugar by eating something that contains sugar.
What are the benefits of using insulin?
Insulin is the most effective medicine for lowering blood sugar levels. Keeping blood sugar under control reduces your risk for other health problems caused by diabetes, such as eye problems, kidney disease, and nerve damage.
Why might your doctor recommend taking insulin?
If your blood sugar can't be controlled even if you lose weight and take other medicine for diabetes, your doctor is likely to recommend taking insulin.
Compare your options
Compare
What is usually involved? |
| |
|---|---|---|
What are the benefits? |
| |
What are the risks and side effects? |
|
- You give yourself insulin 1 to 4 times a day. Most people do this by giving themselves an injection, or shot. Some people may use an inhaler to take fast-acting insulin.
- You check your blood sugar levels several times a day to make sure that your levels are in your target range.
- You stay at a healthy weight and get regular exercise.
- You know the signs of low blood sugar, how to avoid low blood sugar, and what to do in case of a low blood sugar emergency.
- Insulin is the most effective medicine for lowering blood sugar levels.
- Keeping blood sugar under control decreases your risk for health problems caused by diabetes. These problems include eye problems, kidney disease, and nerve damage.
- Taking insulin increases your risk of very low blood sugar, which can be life-threatening if not managed right away.
- You may gain weight if you take insulin.
- You check your blood sugar to make sure that your levels are in your target range.
- You try losing weight and being more active to control your blood sugar.
- You take diabetes medicine to decrease your body's resistance to insulin. Or if you are already taking diabetes medicine, you may need to increase your dose.
- You don't have to give yourself a shot.
- You don't need to have inhaled-insulin-related lung tests.
- You don't have to worry as much about low blood sugar emergencies that can happen if you take insulin.
- If your diabetes gets worse, you may not be able to control your blood sugar.
- You may gain weight while taking some diabetes medicines.
- You are at risk for high blood sugar emergencies, which can be life-threatening.
- Uncontrolled blood sugar raises your risk for health problems such as eye problems, nerve damage, and kidney disease.
Personal stories about considering insulin
These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.
My mom had diabetes. She had to give herself insulin shots, and it looked so messy and painful. I swore that it would never happen to me. Well, for 8 years now I've had type 2 diabetes. I feel like I've done everything I can at this point. I don't really want to start insulin, but it's more important to me that I stay as healthy as I can. I am going to try the inhaled insulin.
Jeff, age 48
A few years ago my doctor said I had type 2 diabetes. But I didn't feel any different, so I didn't do anything. Then a few months ago, my doctor reminded me what could happen if we couldn't get my blood sugar under control. I got scared. So I've been eating better and checking my blood sugar, and so far, it's working. My numbers are holding. I'm going to keep it up and see what happens.
Maria, age 54
When I found out I had diabetes, I really got motivated. I started walking every day, tried eating better, and lost about 40 pounds. And I took a diabetes medicine. I was able to control my blood sugar for many years before it started creeping back up. Now I'm still pretty healthy, but my levels are out of control. Taking insulin is the next step.
Shannon, age 67
Take insulin? Not me. Not if I can help it. I'm going to lose some weight and exercise more. I've been keeping a blood sugar diary so I can track what makes it spike. I think I can beat this thing without insulin if I work really hard. I'm just not ready to take insulin now.
Mike, age 58
What matters most to you?
Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.
Reasons to take insulin
Reasons not to take insulin
I'd rather start insulin now than wait until my diabetes gets worse.
I want to avoid taking insulin as long as I can.
I can't control my blood sugar.
I think I can control my blood sugar without insulin.
I want to avoid other health problems from high blood sugar.
I'm less concerned about other health problems than I am about taking insulin.
I don't mind giving myself shots.
I don't want to give myself shots.
Gaining weight from taking insulin doesn't concern me.
I'm worried about gaining weight.
My other important reasons:
My other important reasons:
Where are you leaning now?
Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.
Taking insulin
NOT taking insulin
What else do you need to make your decision?
Check the facts
Decide what's next
Certainty
1. How sure do you feel right now about your decision?
Your Summary
Here's a record of your answers. You can use it to talk with your doctor or loved ones about your decision.
Your decision
Next steps
Which way you're leaning
How sure you are
Your comments
Your knowledge of the facts
Key concepts that you understood
Key concepts that may need review
Getting ready to act
Patient choices
Credits
| Author | Healthwise Staff |
|---|---|
| Primary Medical Reviewer | E. Gregory Thompson, MD - Internal Medicine |
| Primary Medical Reviewer | Kathleen Romito, MD - Family Medicine |
| Primary Medical Reviewer | Adam Husney, MD - Family Medicine |
| Specialist Medical Reviewer | David C.W. Lau, MD, PhD, FRCPC - Endocrinology |
Diabetes, Type 2: Should I Take Insulin?
- Get the facts
- Compare your options
- What matters most to you?
- Where are you leaning now?
- What else do you need to make your decision?
1. Get the Facts
Your options
- Take insulin to keep blood sugar levels under control.
- Don't take insulin. Try other methods to keep blood sugar levels under control.
Key points to remember
- The goal in treating type 2 diabetes is to keep blood sugar under control. When you control your blood sugar, you decrease your risk for other health problems caused by diabetes, such as eye problems, kidney disease, and nerve damage.
- Losing weight and increasing activity, along with taking diabetes medicine other than insulin, may be enough to keep blood sugar under control. Controlling blood sugar means staying in your target range.
- If your disease gets worse and your blood sugar can't be controlled, your doctor will likely suggest that you take insulin.
- Insulin is the most effective medicine for lowering blood sugar levels to meet target ranges and A1c goals.
- If you decide to use insulin, you'll learn what type is best for you and how much you'll need to take. And you'll need to know the signs of low blood sugar and what to do if you have a low blood sugar emergency.
- Starting insulin doesn't mean that you've failed to control diabetes. Type 2 diabetes is often a disease that gets worse over time. Insulin can help people with type 2 diabetes keep their blood sugar under control.
How is type 2 diabetes treated?
The goal in treating type 2 diabetes is to control blood sugar levels by keeping them in your target range. Lifestyle changes, such as losing weight and being more active, are the first steps to get blood sugar under control. But you may also need to take a diabetes medicine (such as metformin), which helps decrease the body's resistance to insulin and help insulin work better in the body.
Diabetes often gets worse over time. And when it does, diabetes medicines don't work as well. Insulin can help people with type 2 diabetes keep their blood sugar under control. Sometimes your doctor may recommend insulin because of other health problems, such as kidney complications.
What is insulin?
Insulin is a hormone that helps sugar enter your cells, where your body uses it for fuel. When your body doesn't make enough insulin or can't use it the way it's supposed to, your blood sugar gets too high. This can be serious or even life-threatening.
How is insulin used?
Most people use insulin as an injection, or shot. It is given into the fatty tissue just under the skin. Learning how to give yourself insulin may take some time. You'll also need to pay more attention to your blood sugar levels than you may be used to. But with practice, monitoring your levels and using insulin correctly can become a routine part of your day.
Some people can take insulin through an inhaler. Inhaled insulin works very fast, so it is usually taken right before eating. People who have lung problems or trouble breathing cannot take inhaled insulin.
What are the risks of using insulin?
Using insulin has few risks and side effects. You may gain weight, especially if you are already overweight. The biggest risk of insulin use is very low blood sugar (hypoglycemia), which can turn into an emergency if not managed right away.
Using inhaled insulin may reduce how well your lungs work. If you take inhaled insulin, your doctor will test your lungs every 6 to 12 months using a spirometer. This test is done in the doctor's office and is not painful.
About low blood sugar
Some common reasons for very low blood sugar include:
- Taking too much insulin.
- Skipping meals or not eating enough food.
- Exercising without eating enough, or being much more active than usual.
- Drinking too much alcohol (especially on an empty stomach).
By checking your blood sugar levels often, taking insulin on a schedule, and eating regular meals, you can avoid low blood sugar.
It's a good idea to know the signs of low blood sugar, which include feeling tired, weak, or shaky. If your blood sugar drops very low and you don't get help, you could get confused or drowsy or even lose consciousness and possibly die.
Most of the time, you can treat mild-and sometimes moderate-low blood sugar by eating something that contains sugar.
What are the benefits of using insulin?
Insulin is the most effective medicine for lowering blood sugar levels. Keeping blood sugar under control reduces your risk for other health problems caused by diabetes, such as eye problems, kidney disease, and nerve damage.
Why might your doctor recommend taking insulin?
If your blood sugar can't be controlled even if you lose weight and take other medicine for diabetes, your doctor is likely to recommend taking insulin.
2. Compare your options
| Take insulin | Don't take insulin | |
|---|---|---|
| What is usually involved? |
|
|
| What are the benefits? |
|
|
| What are the risks and side effects? |
|
|
Personal stories
Personal stories about considering insulin
These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.
"My mom had diabetes. She had to give herself insulin shots, and it looked so messy and painful. I swore that it would never happen to me. Well, for 8 years now I've had type 2 diabetes. I feel like I've done everything I can at this point. I don't really want to start insulin, but it's more important to me that I stay as healthy as I can. I am going to try the inhaled insulin."
— Jeff, age 48
"A few years ago my doctor said I had type 2 diabetes. But I didn't feel any different, so I didn't do anything. Then a few months ago, my doctor reminded me what could happen if we couldn't get my blood sugar under control. I got scared. So I've been eating better and checking my blood sugar, and so far, it's working. My numbers are holding. I'm going to keep it up and see what happens."
— Maria, age 54
"When I found out I had diabetes, I really got motivated. I started walking every day, tried eating better, and lost about 40 pounds. And I took a diabetes medicine. I was able to control my blood sugar for many years before it started creeping back up. Now I'm still pretty healthy, but my levels are out of control. Taking insulin is the next step."
— Shannon, age 67
"Take insulin? Not me. Not if I can help it. I'm going to lose some weight and exercise more. I've been keeping a blood sugar diary so I can track what makes it spike. I think I can beat this thing without insulin if I work really hard. I'm just not ready to take insulin now."
— Mike, age 58
3. What matters most to you?
Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.
Reasons to take insulin
Reasons not to take insulin
I'd rather start insulin now than wait until my diabetes gets worse.
I want to avoid taking insulin as long as I can.
I can't control my blood sugar.
I think I can control my blood sugar without insulin.
I want to avoid other health problems from high blood sugar.
I'm less concerned about other health problems than I am about taking insulin.
I don't mind giving myself shots.
I don't want to give myself shots.
Gaining weight from taking insulin doesn't concern me.
I'm worried about gaining weight.
My other important reasons:
My other important reasons:
4. Where are you leaning now?
Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.
Taking insulin
NOT taking insulin
5. What else do you need to make your decision?
Check the facts
1. The goal in treating my type 2 diabetes is to avoid taking insulin.
- True
- False
- I'm not sure
2. Insulin is an effective medicine for lowering my blood sugar levels.
- True
- False
- I'm not sure
3. Losing weight and increasing activity, along with taking a diabetes medicine (such as metformin), may be enough to keep my blood sugar under control.
- True
- False
- I'm not sure
Decide what's next
1. Do you understand the options available to you?
2. Are you clear about which benefits and side effects matter most to you?
3. Do you have enough support and advice from others to make a choice?
Certainty
1. How sure do you feel right now about your decision?
2. Check what you need to do before you make this decision.
- I'm ready to take action.
- I want to discuss the options with others.
- I want to learn more about my options.
| By | Healthwise Staff |
|---|---|
| Primary Medical Reviewer | E. Gregory Thompson, MD - Internal Medicine |
| Primary Medical Reviewer | Kathleen Romito, MD - Family Medicine |
| Primary Medical Reviewer | Adam Husney, MD - Family Medicine |
| Specialist Medical Reviewer | David C.W. Lau, MD, PhD, FRCPC - Endocrinology |
Note: The "printer friendly" document will not contain all the information available in the online document some Information (e.g. cross-references to other topics, definitions or medical illustrations) is only available in the online version.
Current as of: December 7, 2017
