Why must some people take insulin as a medication on a regular basis?

Because the Beta cells in the islets of Langerhans of the pancreas no longer produces it. Insulin makes the glucose in food available as a fuel to muscles, nerve, and brain cells. Without insulin, the body falls back on second means of producing fuel by breaking down fat stores. If blood sugar is not controlled it can lead to future complications, such as......... kidney failure or damage, nerve damage, blindness, Heart disease, peripheral vascular disease, charcot foot, and even amputations. Short term complications, of extremely high blood sugar, can induce a life-threatening condition in Type 1 diabetics called Diabetic Ketoacidosis (DKA). Ketones are by-products of the body's use of fat broken down to use as a fuel when glucose is not available as a fuel because of a lack of insulin production from the pancreas. The Ketones are acidic and force the body to become extremely pH lowered. In an attempt to restore the normal level, the kidneys will excrete the ketones along with necessary potassium, magnesium, soidum, chloride, and phosphate. The acidosis will induce vomiting which will further deplete fluid and electrolytes (named above) and coma and death will ensue if the condition remains untreated.

Type 2 diabetics still produce some insulin but their cells are insulin resistant/and/or the pancreas is not producing sufficient quantities of insulin. Type 2 diabetics with extremely high glucose levels will develop what is known as Hyperosmolar Hyperglycemic Syndrome. Their bodies still produce some insulin and they will metabolize some glucose creating less ketone output in urine but they will still have the symptoms of excess urination, constant thirst, dehydration, sunken eyeballs, etc... present in diabetic ketoacidosis. They will not have the acetone (fruity breath) and high ketones in the urine as seen in DKA. This condition is still life threatening due to the dehydration and loss of necessary electrolytes for normal body function. Since Type 2 diabetics still produce some insulin, they can take oral medications that decrease their cell's resistance to the insulin they produce or increase the Beta cell's production of insulin.

In times of excess stress, disease, or illness, it is sometimes necessary to provide a Type 2 diabetic with insulin to accurately control the disease because of the stress put on the body.

Exercise and diet are key to controlling blood glucose levels and a diet mindful of glycemic index levels will help to control the minor spikes seen after a meal (post-prandial spike). Good Luck!!!