Endocrinology-Diabetes Questions Insulin

Are my insulin injections permanent?

I am a 45 year old woman with diabetes. I have been recommended insulin injections twice a day. Are these injections permanent or will I ever be able to stop doing this eventually?

8 Answers

This is a very personal question and should be discussed with your treating physician since he or she know your case best. If you ask me, have there been any patients with diabetes mellitus type 2 who were able to come off insulin and remain controlled on oral medications, then the answer is yes.
It depends on how much insulin your body is still making. Have your doctor check a C-peptide level. If it is normal or high, then you may be able to stop insulin with strict diet and exercise. If your C-peptide is low, then it means your body has lost the ability to make insulin, so you will need insulin in some form forever.
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Answer: Starting on insulin does not have to be a one-way street. Patients can often work down and off of insulin, depending on the reason for starting insulin, how long the person has had diabetes, the type of diabetes, and how difficult it has been to control blood sugars. Individuals who cannot make insulin will not be able to stop insulin unless they receive and new pancreas. This group includes those individuals with established Type 1 diabetes, following pancreatic resection or destruction and many adults with latent autoimmune diabetes.

Stopping insulin is sometimes possible if an individual has not had diabetes for more than 10 years and blood sugars haven't been too high for too long. Taking strong measures to reduce insulin resistance, such as losing weight, increasing exercise, treating infections, addressing the causes of chronic stress and pain, treating sleep apnea and, if possible, getting off of medications such as steroids If a patient is on basal insulin and doesn't need mealtime coverage, taking these measures will reduce, and sometimes eliminate, the need for injecting insulin.
The answer requires knowing how much insulin your own body presently produces. This may be measured by checking fasting and post meal levels of c peptide or insulin. Once that is known your medication history, your weight, your dietary history would allow an accurate evaluation of your other alternatives. If you do not make adequate insulin you will need to remain on this essential hormone.
What an important question. Thank you for asking!

I suspect (assume) you have type 2 diabetes. In this case, the most common cause is underlying obesity (excess fat tissue). For many people with diabetes, weight loss can reduce their medication, including insulin dose. I have been surprised at how many people will make lifestyle changes and no longer require as much medication/insulin. The chances of making your diabetes / insulin "go away" are best if you lose weight (sometimes through bariatric surgery).

I would NOT recommend stopping medication outright. However, in reducing sugar intake and losing weight, you may notice day to day glucose checks getting lower and lower. Eventually, it may get to a point where you can move back to pills or nothing at all.

It is not 100% permanent depending on type of diabetes, duration of diabetes, quantity of insulin units / dose, family history, etc. Many factors contribute. Most important is to keep your sugars "out of the danger zone" to prevent complications like eye disease, kidney problems, and nerve issues. This is by average sugar less than 150 or hemoglobin A1c under 7% (in most cases).

Nothing is permanent. Nothing is permanent.

I hope you're able to find success! Great question!
It's documented that if you lose up to 10% of body weight and increase aerobic activity to 150 minutes a week, you will improve diabetes.
You may not need insulin injections forever. I assume you have type 2 diabetes and are not now taking insulin. With time though your pancreas loses its ability to make insulin in spite of what drugs you are taking to help. Insulin then may be needed. Blood sugar must be controlled to prevent serious complications. If that requires insulin, don't hesitate to take it. Its not so bad. I have taken it for 25 years. If you are overweight that creates insulin resistance and creates the need to take insulin. If you lose weight, your insulin resistance goes down and you might come off insulin. There are several insulin regimes you could tray y such as a very long acting insulin combined with a GLP1 RA in one shot/d instead of 2.
This is different for each person. Many people with type 2 diabetes can eventually stop injection therapy, if they make a big change in diet and exercise. Type 1 Diabetes is different and must always be treated with insulin.