Can a diabetes patient ever stop taking insulin?
People with type 1 diabetes usually cannot stop insulin use once they have started. This is because of the very severe deficiency of insulin in this disorder.
However, there are a couple of exceptions of this general rule.
First, there is often a brief period of improvement in pancreas function after the initial diagnosis of type 1 diabetes.
This is so called “honeymoon period” can last for a few weeks to a couple of years. During this time, the amount of insulin needed to control the blood glucose is much lower and the occasional patient needs none at all.
Second, people who have received either a pancreas transplant or a pancreatic islet cell transplant can sometimes stop using insulin. The latter procedure is still considered an experimental therapy.
Although they can reduce or eliminate the need for insulin injections, these procedures should not be undertaken lightly.
This is because they are associated with a lifelong need for powerful immuno suppressive (antirejection) drugs that can cause serious side effects.
Type 2 diabetes can stop insulin
In principal, it is possible for a person with type 2 diabetes to discontinue insulin once he or she has started it, if the lifestyle factors that led to the worsening of the diabetes can be reversed.
Since the overwhelming majority of cases of type 2 diabetes are associated with overweight and lack of exercise, weight reduction and commencement of a regular exercise program will almost always result in significant improvement in glucose control.
This can lead a person on insulin, being able to discontinue it.
Unfortunately, in our society, it is very difficult for most people with type 2 diabetes to consistently pursue these goals and the majority will remain on insulin once it has been started.
Also, it is a normal part of aging for the insulin-secreting cells of the pancreas (beta cells) to show declining function.
The rate of this decline may be faster in people with type 2 diabetes.
This leads to a need to intensify treatment over time and may explain in part why the majority of those who start insulin treatment will not be able to discontinue it without significant deterioration in control of their diabetes.
Losing weight and stopping insulin
It is often a pleasant surprise to learn that you do not have to lose a dramatic amount of weight for this to occur.
Even a loss of between 5% and 10% in your weight can have remarkable benefits on your blood sugars.
Some patients often experience a significant reduction in the amount of insulin they need after only a modest weight reduction.
Lowering the insulin dosage helps to control appetite and further helps efforts at weight reduction.
Lowering the insulin dosage reduces appetite by reducing the likelihood of hypoglycemia, which must be treated by food intake, thus limiting the success of weight loss efforts.
Unfortunately, even with such an incentive, the majority of people with diabetes who start insulin will need to remain on it, due to the difficulty of achieving and sustaining successful weight reduction and also to the fact that the body’s own insulin production may by now be quite deficient.
Available approved medications for weight reduction are also seldom helpful long term, due to limiting side effects and lack of effectiveness.
However, patients who have undergone bariatric surgery are often able to achieve sustained weight loss and discontinue insulin for the medium to long term.
This approach is being increasingly used for people with severe degrees of obesity and serious health problems related to it, including diabetes.