Q: I have diabetes. I was able to keep my blood sugar under control without insulin. My doctor started prescribing insulin because I enrolled in a research program. Will the use of insulin actually stop my pancreas from working completely?
A: This is an important question and one a lot of people with diabetes wonder about.Â If youâ€™ve been wondering about this, hereâ€™s the scoop.Â For both type 1 and type 2 diabetes, it is usual for pancreas function to worsen over time. This is not caused by insulin treatment. In a person with type 1 diabetes, antibodies that attack this organ are the usual cause of damage to the pancreas. In a person with type 2 diabetes, the pancreas is overworked, since your body continues to signal that more insulin is needed. The damage that occurs in people with type 2 diabetes is therefore a form of â€œexhaustionâ€ or â€œburn-outâ€ of the pancreas. Pancreas â€œburn-outâ€ in type 2 diabetes is usually a very gradual process. Your doctors (who have included you in their study) may be hopeful that by giving you insulin early in the course of your diabetes, they may actually help your pancreas to keep functioning for a longer time.
Doctors prescribe low doses of insulin to people who have diabetes when they first start using insulin as a treatment. Your pancreas continues to work on its own, and the injected insulin helps to supplement the quantity that your pancreas is producing. It is usual for people with type 2 diabetes to require larger doses of insulin over time, because insulin resistance in the body increases as you age.
What are your questions about how you can best treat your diabetes?
Nearly 21 million Americans suffer from diabetes, and as anyone who has been affected by the disorder knows, it is about much more than a statistic: it means a new way of life. Diabetes: A plan for livingis a special report from Harvard Medical School that will help you learn how to better understand and manage your diabetes, including type 1 and type 2, as well as other variations of the disease. This report will show you that itâ€™s not just possible to live with diabetes; itâ€™s possible to live well.
Julie K. Silver, M.D., is an assistant professor in the Department of Physical Medicine and Rehabilitation at Harvard Medical School. She is also the Chief Editor of Books for Harvard Health Publications.