I often hear friends with diabetes tell me, “Shouldn’t I take insulin? So-and-so can now eat anything after taking insulin, and complications can be avoided after taking insulin, etc. In fact, this is not true.
First of all, let’s introduce the process of insulin secretion in our body. Insulin is secreted by the pancreatic beta cells in the pancreas after eating and absorbing glucose, and enters the liver together with the glucose absorbed in the intestine and digested by food, and nearly half of the insulin is degraded in the liver after the glucose-lowering effect. In contrast, after subcutaneous insulin injection, insulin enters all organs in the body evenly first, and the amount of insulin that acts in the liver is much smaller than that of the same amount of endogenous insulin. Firstly, the order of action is different from that of endogenous insulin, and the hypoglycemic effect of the liver is small and blood glucose fluctuates greatly.
Type 1 diabetic patients can only rely on exogenous insulin therapy due to the destruction of insulin-producing beta cells. In contrast, the initiating factor for the development of type 2 diabetes in the majority of patients is the weakened hypoglycemic effect of insulin due to excessive eating, lack of exercise and weight gain. Blood glucose control can only be ensured when the beta cells are able to secrete supraphysiologic doses of insulin, and when the pancreatic beta cells cannot produce sufficient insulin to counteract insulin resistance, blood glucose elevation will occur. However, this compensatory effect of beta cells is limited in terms of capacity and persistence, especially in individuals with a family history of diabetes, whose compensatory capacity for insulin resistance is worse and more prone to diabetes.
A study has been done that when a person gains 15 kg of weight from the age of 20 years and lasts for more than fifteen years he or she will develop disorders of glucose metabolism or diabetes mellitus. This suggests that weight gain is the main reason for the development of type 2 diabetes, and the reason for weight gain is a high-calorie diet and a reduction in physical activity. This shows how important the role of poor lifestyle habits is in the development of type 2 diabetes. If this is understood, it is easy to understand that for a fat diabetic, diet control and weight loss are far more important than insulin injections. Without diet control, the best treatments are useless. In addition, insulin therapy needs to be strictly matched with diet. After a certain amount of insulin injection, eating too much will lead to hyperglycemia, eating too little will lead to hypoglycemia, and in some cases there may even be irreversible and life-threatening conditions. Repeated hypoglycemia is not only unsafe, but can also aggravate the occurrence of chronic complications of diabetes. Therefore, insulin is not a panacea.