Educate to protect tomorrow

Education to protect tomorrow 

As part of this initiative  i will be sharing   different  post to educate about diabetes. The first one is insulin is not scam 

                              

 

 Insulin is not a scam

Year 2016 

The social media was flooded with deterogetoary post about  insulin. That year Dr Fiona Gottle editor of reputed journal made some nonscientific  comment about insulin during  her visit in India. She said pushing diabetes patient to insulin is the biggest scam. Later on many such post where insulin was humiliated were circulated. 

Insulin is the biggest discovery of the human being. 

It is the essential drug in diabetes management since 100 years. Over the years with lots of modifications it has proved to be the one of the best medicine in diabetes management.

Still many people have misconceptions about insulin. When we doctors ask patient to start insulin there is strong resistance from the patients. Some feel that use of insulin is unnatural way to treat diabetes. Some fear that it can cause damage to the kidney, heart. Some says no because they believe that insulin causes increased death. There are many quacks who encash these fears and misconceptions. There are many such centres and diabetes reversal  program run by these quacks. Patients in desperate move go to these places and loose health and money. Eventually delay in starting insulin results in increased complications in the patients with diabetes. Many type 1 diabetes patient develop diabetic ketoacidosis a deadly complication when they stop insulin. We as doctor commonly witness this sad reality. 

 

 For type 1 diabetes where pancreas doesn’t produce insulin  it is the only treatment available currently. Over period of time majority of type 2 diabetes patients require insulin. There is need to have legal actions on these quacks.But unfortunately all over the world they are increasing in the number. The social media is full of theirs badmouthing against insulin.There are few doctors who are also active participants in this rant against insulin. Those people call insulin as scam.  

Is Insulin scam?

Calling wonder drug like insulin a scam is totally ridiculous. Still let’s argue their arguments scientifically.

TYPE1 Diabetes is the autoimmune disease where there is destruction of insulin secreting beta cell of  pancreas. This results in insulin deficiency.So practically insulin is the only treatment available to this patients. 

Still there are many ads on YouTube and other social media platform which strongly advice to not take insulin in type 1 diabetes and promotes fancy treatment. People follow them blindly and come to us after stopping insulin. In majority of the patients blood glucose again goes high but in some patients blood glucose are under normal range. It is interesting that in some patients blood glucose remains under control while not on insulin. Does it mean that the fancy treatment offered by quacks is magical and can result in reversal of TYPE1 diabetes ? 

The answer is no. Currently no therapy can reverse type 1 diabetes. Blood glucose levels remaining near normal can happen in type 1 diabetes after achieving good control. This is known as honeymoon phase of diabetes or partial remission of diabetes.  During this phase the insulin requirements goes down and some patients can be managed without insulin for some duration.  During this phase if we continue previous dosages of insulin patients start getting Hypoglycemia i.e. low blood glucose levels. If this is not communicated prior to Patient’s family then they look after alternatives to insulin and land up in these quacks offices.These quacks will first talk to them in depth regarding how bad is insulin and will start their vague secret treatment and  shows that patient don’t need insulin. But eventually this phase gets over and these patients also need insulin. So practically  all type 1 diabetes still need insulin.

So if someone is saying type 1 diabetes can be treated without insulin then he or she is insane.

 

Now coming to other type of diabetes I.e. type 2 diabetes. Insulin was the first successful treatment available for patients with type 2 diabetes and it was the only treatment available for next 3 decade till sulphonylurea class of drug developed in 1950. Over period of time our understanding about how diabetes develops have improved. With current understanding we know that type 2 diabetes is not just about insulin resistance and multiple organs like pancreas, liver, kidney, brain, intestine, muscle, fat and hormones like glucagon, GLP1, GIP1 also play role in disease process. And now we know that there are multiple approaches where modifications in diet exercise and drugs used permutations and combination can keep blood glucose under control. That does not demean importance of insulin as eventually over period of time these patients lose ability to produce insulin and we need to give them insulin. There are some other type of diabetes like pancreatic diabetes, monogenic diabetes and LADA () which also requires insulin. Special situations like diabetes with pregnancy, diabetes in critically ill patients and patients who are waiting for surgery mandates use of insulin.

 

Since discovery of insulin millions of lives have been helped by insulin. There are landmark studies  in the field of diabetes like UKPDS, DCCT have clearly shown the beneficial effects of insulin.

Before glorifying the wonder drug insulin I must admit that there are limitations to insulin also. These limitations include Hypoglycemia, weight gain. 

Despite these limitations INSULIN IS PROBABLY THE SINGLE GREATEST DISCOVERY IN MEDICAL FIELD THAT HAS CHANGED THE LIVES OF MILLIONS OF PEOPLE OVER THE DECADE. We should treat insulin with respect bare minimum should not call this wonder drug as scam.<c> Dr Milind Patil Consultant Endocrinologist  share unedited

 #WorldDiabetesDay  #insulin  #endocrinologist