Reasons For Temporary Insulin Use with Type 2 Diabetes

There are several reasons why people with type 2 diabetes might be put on insulin temporarily.

Short-term insulin is typically used during times of physical stress or change, and to help people establish, or reestablish, glucose control. It does not usually reflect poor diabetes management, or a worsening of the illness.

Grounds for temporary insulin use include:

• Pregnancy. Because there is concern about oral diabetes medications crossing the placental barrier, women planning to conceive who require medication for glucose control are typically switched to insulin for the duration of their pregnancy.
• Illness and Injury. Surgery, infections, broken bones, and other illnesses cause increased levels of stress, anxiety, periods of forced inactivity, and often unpredictable eating patterns. All these internal and external changes alter the body’s insulin production and ability to process glucose. Insulin may be recommended to regain and maintain stability until normal routines resume.
• Glucose Detox. Toxic, high blood sugar levels can eventually damage the pancreatic cells that manufacture insulin. This gluco-toxic state, or glucotoxicity, may be owed to a prolonged infection, or having undiagnosed, untreated diabetes. Short-term insulin therapy might be recommended to effectively get a patient's blood sugar under control.
• Med Side Effects. Steroid medications such as prednisone can cause extremely elevated blood sugar, so insulin may be prescribed to bring it down. Once steroid use is discontinued, most individuals no longer require insulin therapy.
• Kick Start. - To treat insulin resistance, people are usually asked to eat well, lose weight, exercise regularly, and maybe take an insulin sensitizing medication (e.g., Actos, Avandia Glucophage). Until those glucose lowering measures take effect, some individuals might be put on insulin.

The use of insulin with type 2 diabetes - even temporarily - sometimes triggers a sense of guilt in those with type 2 diabetes, but that feeling is generally unwarranted. Even people engaged in excellent diabetes management may at some point be asked to consider short-term insulin use for long-term benefit.

Sources: Joslin Center; Diabetes Self Mgmt; Diabetes New Zealand; Diabetes Self Mgmt
Photo credit: Nicu Buculei