An awareness programme, held at the Peerless Hospital in Kolkata, addressed the benefits of early insulin therapy for effective diabetes management. The discussion was led by leading endocrinologists in the city — Dr KK Gangopadhyay, Consultant (Diabetes and Endocrinology), Peerless Hospital and Dr Sujoy Majumdar, Senior Visiting Consultant Endocrinologist, Peerless Hospital.
According to a 2017 study conducted by the International Diabetes Federation, nearly 73 million Indians are affected by diabetes. It is a chronic condition wherein the body produces little to no insulin, which leads to a rise in sugar levels in the blood. With a lack of proper management, diabetics are at risk of developing comorbidities, such as kidney failure, heart attack, nerve damage, liver damage and sometimes, even stroke.
Understanding the importance of insulin therapy
To avoid diabetes-related complications, it is necessary to ensure that the glucose levels in the blood are under control. The best option for controlling the glucose levels in the body is insulin therapy. Insulin is a hormone produced in the pancreas. For patients diagnosed with diabetes, the pancreas produces little or no insulin leading to Insulin deficiency, or the insulin produced by the pancreas fails to work which causes Insulin Resistance. This leads to glucose-toxicity. To stimulate the pancreas to release insulin, oral agents or injectables are recommended. This helps regulate blood sugar levels.
Elaborating further on insulin therapy, Dr KK Gangopadhyay, said, “In my practice, about 30% of my patients require a shift from oral therapy to Insulin injections/injectables. The advantage is that it aids in better control of the blood sugar levels, especially in cases where the patient has very high glycemic levels. We also recommend insulin injections in case of any existing infections or organ damage which limits the use of oral therapy or even in cases of pregnant women diagnosed with diabetes. Ensuring that the patients accept and adhere to this newer form of insulin therapy is a challenge that needs to be addressed.”
There are numerous barriers that patients face when they are put on insulin therapy, the first and foremost being the misconception that insulin is used as a last resort to treat diabetes. This stems from low awareness about insulin and its benefits. Other common misconceptions include the fear of weight gain, strict adherence in terms of when the therapy must be administered, the onset of low blood sugar (hypoglycemia) and rigid lifestyle in terms of diet.
Addressing the best means to alleviate these misconceptions, Dr Sujoy Majumdar said, “In order to sufficiently address patient misconceptions, doctors also need to put inappropriate efforts. A lot of physicians are apprehensive about patient acceptance to injectable insulin. They need to explain why a patient is put on insulin therapy and the related benefits — which include reduced burden on the pancreas and decreased pressure on the beta-cells. However, educating the patients on the National Guidelines for insulin therapy as well as proper administration techniques is also important. This can be done by providing them with dummy injections and advising them on the appropriate sites for administering the injectables. Care must also be taken to ensure that newer physicians also read through the same because administering insulin therapy requires significant expertise.”
Advancement in new Insulin therapy has made it convenient, safe and extremely effective, today. With the convenience of dosing, least risk of hypoglycemia and least weight gain, it can be initiated in any patient with diabetes. Insulin is also fairly easy to use, especially with the newer Insulin Pen Devices which are portable, discreet and come with small and thin needle sizes which reduce fear and pain.
Early use of insulin therapy significantly reduces the risk of developing comorbidities, such as kidney failure, heart attack, nerve damage and liver damage leading to a better quality of life. With the help of regular counselling and follow-ups, as well as addressing the myths around Insulin, effective diabetes management is now possible.