When type 2 diabetes becomes severe , do patients need to inject insulin similar to patients with type 1 diabetes ?
Not all patients . With type 2 diabetes , there ’ s a tendency over time for those patients to need higher doses of medicines you have them on or different medicines entirely . There ’ s also a general tendency that , after a certain period of time , those patients also develop a degree of insulin deficiency as well as insulin resistance . At that point , they require insulin injections as part of their therapy . They are insulin requiring though , not insulin dependent . A lot of people with type 2 diabetes may need insulin as part of a broader regiment that may include pills as well . With type 1 diabetes , their whole treatment is very insulin centered .
Do you see gestational diabetes ( diabetes onset during pregnancy ) very often ?
We do see patients with gestational diabetes , but proportionally it isn ’ t as many as type 1 or type 2 . It ’ s still very important to recognize and treat for two reasons . Number one is the fact that untreated gestational diabetes can have really bad effects on the developing baby . The second is the fact that across the board any woman who develops gestational diabetes has a 50 percent chance of developing type 2 diabetes at some point in her life . If we start seeing a patient for gestational diabetes , often times they ’ re a patient of ours for life . They may develop type 2 diabetes or need to be screened periodically .
Due to the frequent hospital visits of an expecting mother , are the majority of cases noticed upon development ?
This is a standard of obstetric care nowadays . All pregnant women are screened for gestational diabetes . If they test positive , they ’ re taught how to manage their blood sugar , how to manage their diet . They may be put on oral medication or insulin .
Do patients ever self-diagnose their diabetes incorrectly ? If so , how ?
Many patients still think diabetes is directly related to eating sugar because their mother or grandmother told them that when they were little . That ’ s an old wives tale that needs to go away . Another thing we see commonly in patients who have diabetes : if we tell them they need insulin , it ’ s almost like a death sentence to them . ‘ If I need insulin , I must be a goner .’ That ’ s not the case . Insulin is just another tool . It doesn ’ t mean you ’ re at death ’ s door . You may live happily for a long time .
What are some good resources for people interested in the subject of diabetes ?
The American Diabetes Association website would probably be THE one place visit . A whole portion of their website is devoted to patients .
Visit the American Diabetes Association ’ s website at www . diabetes . org to learn more .
Thank you Dr . Williams
Dr . Fred Williams is a practicing endocrinologist with KentuckyOne Health Endocrinology and Diabetes Associates . Dr . Williams has practiced endocrinology since 1983 .
VITAL SIGNS Volume 11 • Issue 3 5