By Dr. B Ramya , Diabetology
Insulin is a hormone that is secreted by the pancreas in our body. It is this Insulin that drives blood glucose into the cells of the body and keeps the blood sugar levels under control. Diabetes occurs when there is inadequacy in Insulin secretion, action or both. However, not all Diabetic patients require Insulin injections as there are oral medicines too.
1) Type 1 Diabetes Mellitus where there is absolutely no Insulin secretion in the body.
2) Diabetes in pregnancy , which does not come under control with diet.
3)Type 2 DM when the target HbA1c cannot be achieved in spite of multiple oral drugs.
4)Type 2 DM presenting with extremely high blood sugars ( HbA1c > 8 percent) at diagnosis. Such cases require a short course of Insulin, usually for a month only.
5)Long term Type 2 DM, where there is near total depletion of the Insulin-producing beta cells of the pancreas.
6)Significant Renal, Hepatic, Cardiac or Respiratory impairment where oral antidiabetic drugs become UNSAFE.
7)Severe infections or sepsis
8) Perioperative period, i.e, before, during and after surgery
9) Conditions like Diabetic ketoacidosis and Non-Ketotic Hyperosmolar state where the patent is comatose due to dangerously high blood sugars
10)Intolerance to oral drugs.
Hence we need to understand that not all Diabetics need Insulin but in the above-mentioned circumstances it becomes unavoidable.