Dr. Paul Mason2 min read

Do you control your insulin, or does your insulin control you?

Injecting insulin into your body is a non-negotiable for those with type 1 diabetes, and it's sometimes necessary for those with type 2 diabetes.

But does it have to be this way? We look at whether insulin dependency can be reversed.

What is insulin-dependent diabetes?

Having insulin-dependent diabetes simply means your body's ability to release insulin is so impaired that you need to inject it. In the most extreme situation, your body literally cannot produce any insulin at all, and failure to inject insulin will result in death associated with a condition called ketoacidosis.

Is this common?

This is most common in type 1 diabetes. More common is type 2 diabetics who inject insulin with the goal of controlling excessive blood glucose levels.

And in both these groups, the philosophy of insulin dosing is most important. And by that, I mean do you control your insulin injections, or do your insulin injections control you?

When is insulin needed?

Every molecule of glucose consumed, in the form of carbohydrates or simple sugars, has the potential to raise blood glucose levels, and an insulin-dependent diabetic will require the injection of some amount of insulin to keep blood glucose levels stable.

This leads to the most logical way to dose insulin, based on how many carbs we eat. Eating more carbohydrates will require larger injections of insulin, while lower carbohydrate diets require less insulin injections.

How can we control the need for insulin?

Very simply, low carbohydrate diets in the management of diabetes has a very real impact on the need for insulin. Fewer carbohydrates means that blood sugars are more stable, and less insulin is needed for injection, further reducing the risk of complications like dangerously low sugar levels, known as hypoglycaemia.

There is another approach to insulin dosing which patients are sometimes recommended which defies all common sense. In this approach, patients are recommended to inject a specific amount of insulin, and then advised to consume enough carbohydrates to try and avoid dangerously low sugar levels.

This often requires both larger doses of insulin than would be otherwise needed, exposing patients to increased risk of complications, and higher intakes of carbohydrates.

The bottom line

Have no doubt, the combination of higher carbohydrate intakes and larger doses of injected insulin contribute to a worsening of metabolic sickness and the relentless progression of diabetes in these patients.

On the flip side, by eating a diet low in carbohydrates and then only injecting the required amount of insulin is very likely to lead to improvements, with studies demonstrating overall insulin requirements can be reduced by 90% on low carbohydrate diets.

In summary

At the end of the day, you should be in control of your medication.

Injecting a large amount of insulin and then having to consume more carbohydrates than you otherwise would or should means your insulin injections are controlling you.

If you find yourself in this situation, you should speak to your doctor about these two approaches, and explain that you would like to take control of your diabetes.

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