How To Reduce—or Eliminate—the Need for Insulin in Type 2 Diabetes

For some people with the condition, lifestyle changes can help them come off insulin.

Individuals with diabetes have treatment options that will vary depending on the type of diabetes they have. Those who have been diagnosed with type 1 diabetes need insulin to survive because the beta cells in their pancreas don't produce insulin. People with type 2 diabetes use insulin as one more tool to control blood sugar.

However, if you have type 2 diabetes and your healthcare provider puts you on insulin, using this treatment method may not necessarily be a permanent one. Here's more about insulin and why someone with type 2 diabetes might need it, as well as how they may be able to stop using it.

What Is the Role of Natural Insulin in Type 2 Diabetes?

Your pancreas will release insulin when blood sugar, or glucose, is in your bloodstream—per the Centers for Disease Control and Prevention (CDC). As a hormone, insulin allows blood sugar to serve as an energy source for the body's cells in the moment or to be used for later.

However, when there are high levels of blood sugar in the body, the pancreas may try to keep up by producing more insulin. Over time, the cells that would normally be taking in the blood sugar ignore the insulin, which is known as insulin resistance. As a result, you body will eventually have an issue producing insulin, creating the basis for type 2 diabetes.

Why Might Taking Insulin Become Part of Type 2 Diabetes Treatment?

Even though there are insulin production problems for individuals who are diagnosed with type 2 diabetes, natural insulin is still present in some amount. Thus, staying on insulin may not always be necessary.

Instead, the treatment for people who have type 2 diabetes entails healthy eating, physical activity, and medications. However, if you are unable to manage your blood sugar levels with these methods, there would be a need to add insulin to your treatment plan.

The National Institutes of Diabetes, Digestive, and Kidney Diseases (NIDDK) also noted that you may have to take insulin under certain circumstances, like being treated in the hospital or during pregnancy. This could be the case even if you weren't currently prescribed insulin.

It's possible for insulin to be necessary if glucose toxicity is an issue, which is essentially an extension of insulin resistance. "When the sugar has been running high it creates in and of itself a resistance to other things to bring it down. It's a term we call glucose toxicity," said William Bornstein, MD, an endocrinologist at the Emory Clinic in Atlanta.

"So let's say that somebody comes in and their blood sugar is running pretty high and they want to try diet and exercise. It's less likely that the diet and exercise will work to bring it down," Dr. Bornstein explained. However, once your blood sugar is back under control, you may have the option to come off insulin.

What Can You Do To Reduce or Avoid the Need for Insulin

On a basic level, starting or returning to good workout and eating plans can make reducing the insulin dose that you take or removing insulin from your treatment plan possible on a basic level if insulin has been added to your treatment plan.

The American Diabetes Association (ADA) stated that when you exercise, your body becomes more sensitive to insulin, which in turn can lower your blood sugar—for up to 24 hours or more. You can start with as little as 5-10 minutes of exercise and gradually work your way up as you feel comfortable.

Additionally, you can also complement your exercise routine with a healthy diet. Foods you'll want to eat, according to MedlinePlus, might consist of:

  • Low or nonfat dairy
  • Produce (fruits and vegetables, with the exception of starchy vegetables)
  • Proteins (e.g., lean meats, nuts, beans)
  • Whole grains (e.g., quinoa, oats)

The ADA also has a great resource that talks about the Diabetes Plate Method, which can help you choose foods and portion sizes that are better for keeping your blood sugar in check.

Finally, "[a] person who is very, very obese or very heavy will find that if they lose a large amount of weight, their insulin requirements or their oral medication requirements may drop tremendously—even disappear," said Richard Hellman, MD, former president of the American Association of Clinical Endocrinologists. However, this amount of weight loss may not be possible without weight loss surgery, such as bariatric surgery.

For individuals with a body mass index (BMI) greater than 35, there is a 1% chance that they will be able to maintain a normal weight for a long time, according to the American Society for Metabolic and Bariatric Surgery (ASMBS). At that point, surgery may be the most effective way for weight loss to occur to help treat type 2 diabetes. The ASMBS said that the surgery has been shown to lower blood sugar levels and, in turn, potentially dial back how much you'll need diabetic medications. However, you would need to speak with your healthcare provider to determine your candidacy for this type of surgery.

Of note, you don't want to stop taking insulin or any medications for diabetes on your own without consulting your healthcare provider first. The ADA also suggested that you talk to your healthcare provider before beginning an exercise regimen. It's also a good idea to discuss any significant diet changes with them as well.

Furthermore, you'll want to make sure that you are taking any medications to manage your diabetes as prescribed. Checking your blood sugar regularly—for example, on a daily basis, after each meal, or according to your healthcare provider's instructions—is also important for knowing your blood sugar levels and ensuring that they are in a normal range.

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