Vital Signs Volume 11, Issue 3 - Page 5

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
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 ƖfRFWFWfVGR"F&WFW2"VVBF&R67&VVVBW&F6ǒࠤFFVG2WfW"6VbFv6PFV"F&WFW26'&V7FǓb6svB&R6RvB&W6W&6W0f"VRFW&W7FVBFP7V&V7BbF&WFW3FVG27FFF&WFW20F&V7Fǒ&VFVBFVFr7Vv"&V6W6RFV"FW""w&FFW FBFVFBvVFWvW&RƗGFRFN( 2BvfW2FRF@VVG2FvvFW"FpvR6VR6ǒFVG2vfRF&WFW3bvRFVFVFWVVB7VƖN( 27BƖRFVF6VFV6RFFV( bVVB7VƖW7B&RvW"( FN( 2BFP66R7VƖ2W7BFW"FगBFW6( BV^( &RBFVF( 0F"RƗfRǒf"rFRࠥFRW&6F&WFW2766FvV'6FRvVB&&&ǒ&RDRP6Rf6BvR'FbFV vV'6FR2FWfFVBFFVG2ࠥdD4t2fVR( "77VR0f6BFRW&6F&WFW0766F( 2vV'6FR@wwrF&WFW2&pFV&&RࠤGVRFFRg&WVVB7Ff6G0bWV7FrFW"&RFP&Gb66W2F6VBWFWfVVCF227FF&Bb'7FWG&26&PvF2&VvBvV&P67&VVVBf"vW7FFF&WFW2खbFWFW7B6FfRFW( &RFVv@rFvRFV"&B7Vv"rFvRFV"FWBFW&RWB&VF6F 7VƖࠥFPG"vƖ0G"g&VBvƖ22&7F6rVF7&v7@vFVGV6RVFVF7&wBF&WFW0766FW2G"vƖ20&7F6VBVF7&w66P2ࠣP