The truth is we all take insulin. Every man, woman, child, chimpanzee, sea otter, and even fish. Insulin is a fundamental element that all critters on the planet share. Insulin the hormone that allows sugar to get from the blood into cells. An analogy that is often given is to picture every cell in your body as a little house with a locked door. Insulin is the key that opens the door so the pizza delivery guy can get it.
So in non-diabetic folks, when the cell orders a pizza the pancreas sends out the delivery guy with a set of keys for the cell’s front door. (Just set aside for the moment the notion of the pizza guy having keys to your house is a more than a little bit creepy.) The delivery guy arrives at the cell’s door step, unlocks the door, and delivers the pizza.
Now in Type-1 Diabetics, like myself, our immune system has killed off all of the cells in the pancreas that make insulin. So we’ve got a pizza chain with no drivers. Quite literally, we die if we do not inject. I guess you could compare injections to the pizza chain resorting to calling up a Temp Service and hiring some drivers for the day.
Type-2 Diabetes is a bit different. Lots and lots and lots of drivers, but they are morons and keep leaving the pizza shop with the wrong keys. They can’t open the doors at the cells, the cells are getting hungry and angry and are calling the pancreas and saying “hey, we ordered a pizza an hour ago and the #@$% driver hasn’t shown up yet!” And the pancreas is like, hey, we sent the guy out… we don’t know what happened, but we’ll send another driver pronto.
What’s happening in T-2s is called insulin resistance. For a time, the body makes lots and lots of insulin, but it just doesn’t work very well. To fight this resistance the body over produces insulin and eventually all of this overwork burns out the pancreas. In fact, as long as the body can keep up, most people are clueless that they have diabetes. It’s been estimated that by the time of diagnosis most T-2s only have about 10% of their insulin production capacity left. By 14 years post-diagnosis, it may be effectively gone. Once it is gone, it needs to be replaced to keep sugar levels safe. And that means injections. Bottom line: most diabetics will eventually need insulin. It is the nature of the disease, not a failure on the part of the person.
Last note: women with gestational diabetes will often be given insulin for the simple fact that as a natural hormone, it is safe for her baby for her to take it.