Do people with type 1 diabetes always need insulin?
admin | May 16, 2011 | Comments 0
Yes. When you are first diagnosed with type 1 diabetes, your own pancreas is still able to make some insulin. But the islet cells in the pancreas are under attack by your own immune system. By the time you are diagnosed, you may already have destroyed three-quarters of your insulin-producing islet cells. The ones that remain are not
working very well. The high level of glucose in your blood drives your islet cells to push out as much insulin as they can, but all the time, they are being attacked by poisons made by the immune cells (lymphocytes) nearby.
Once you start taking insulin shots and your blood glucose comes down, this takes pressure off your struggling islet cells, so they recover for a while and are able to push out more insulin. Sometimes they recover so well that you can be taken off insulin again for several weeks or even for a few months. Doctors used to do this routinely. After you had just gotten used to the idea of having diabetes and taking insulin for the rest of your life, your diabetes appeared to go away and your insulin was stopped.
Instead of stopping insulin in the first few months, it is much smarter to keep taking insulin to get your blood glucose levels as close to normal as you can. By doing this, you are protecting yourself from getting damage to your body from a high blood glucose. You are also slowing down the rate at which the rest of your islet cells get destroyed. If you keep your diabetes well controlled from the start, you can continue making some insulin of your own for several years. You might think, “So what? Why should I care? I am taking insulin shots anyway.” But if your body can still make a little insulin of its own, it means that your blood glucose levels are easier to control and don’t swing about so unpredictably.
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