Managing type 2 diabetes without insulin

About one in 10 Americans are affected by diabetes, and the vast majority (90-95% according to the CDC) have type 2 diabetes. Priya S. Little, MD, Family Medicine Physician with GBMC Health Partners Primary Care—Jonestown, explains that both lifestyle choices and genetic components can play a role in a type 2 diabetes diagnosis.

“People who have a family history of diabetes, are overweight or obese, consume a diet high in sugar, or women who were diagnosed with gestational diabetes during pregnancy, have a much higher risk of developing diabetes in their lifetime,” Dr. Little says.

The easiest way to get ahead of a diagnosis, according to Dr. Little, is to have glucose levels screened during your annual physical exam.

“If you don’t have a doctor, get a doctor,” she advises. “If you can catch it early, or in the pre-diabetes stage, it can be totally reversible with simple lifestyle changes. If you catch it early and start treatment, your chances of having complications from the disease are greatly reduced.”

Type 2 diabetes is caused by insulin resistance of the cells, which causes blood sugar to rise and can lead to heart disease, vision loss, and kidney disease. Dr. Little emphasizes the importance of screening because symptoms of diabetes don’t become obvious until the disease has progressed significantly. Some of those symptoms include:

• Extreme thirst and a need to urinate frequently.
• Blurry vision (diabetic retinopathy affects the back of the eye).
• A tingling feeling in the feet.
• A dehydrated state characterized by dizziness and heart palpitations.

In terms of screening for diabetes, Dr. Little says, “Start with your annual exam, tell your doctor about your health history, assess your risk factors, and test as needed after that.”

Treatments for diabetes vary, but most health professionals are trying to get away from prescribing insulin for type 2 diabetics.

“A lot of people think you have to go on insulin immediately and inject yourself for the rest of your life, but these days that’s typically not the case,” Dr. Little says. “There are newer medications available that we’re recommending more frequently because they help with weight reduction and have a lot of cardiovascular benefits.”

Dr. Little emphasizes that early diagnosis improves chances for a less invasive treatment plan.

“Type 2 diabetes is a disease that’s really related to lifestyle,” she says. “I’ve had several patients who were on insulin at first and were able to get off it by changing their lifestyle.”

Those changes usually include weight management through diet and exercise, something Dr. Little says no patient should have to navigate on their own.

“Once a patient is diagnosed at GBMC, we stay on top of their treatment plan with monthly follow-ups. We make sure they’re able to see a nutritionist and address the whole picture of their health and continue to follow up until their blood sugars are stabilized and they’re comfortable with their new regimen,” she says.

Dr. Little encourages anyone who might be at risk of developing type 2 diabetes to get tested. She also advises patients to speak with their doctors about potential lifestyle changes that may lower the chance of a type 2 diabetes diagnosis.