I Live with Type 2 Diabetes: Do I Need Insulin?

The amount of insulin your pancreas produces is limited if you live with type 2 diabetes (T2D). That means it’s still working a bit, but not as well as it should. When you live with T2D, you live with a little something called insulin resistance. Insulin resistance means your body doesn’t respond well to the insulin it produces. 

Why some people with type 2 and all people with type 1 diabetes need insulin

Let’s break it down even more—if you live with T2D, imagine a sponge full of water that slowly loses fluid over time. Eventually, you’ll have to “squeeze” that sponge to get the water you need. At some point, the sponge will dry. 

Now, imagine that the sponge is your pancreas and the water it contains is your insulin. That’s what’s happening inside of you! Pretty wild, right?

In type 1 diabetes (T1D), it’s as if this sponge were left in the summer sun for a long time. In a matter of a few hours, the sponge would be completely dry. In this condition, there is a total lack of insulin, which is why the use of insulin is necessary immediately after diagnosis to perform the body’s basic functions. 

In short, people with T1D need insulin to survive (insulin dependent), but that’s not always the case with T2D. 

In this guide, we break down when it’s beneficial for people with type 2 and when oral medications make the most sense to “squeeze” that sponge as much as possible to stimulate insulin production.

Why do some people with diabetes need insulin but others don’t?

Remember, not everyone with diabetes needs to take insulin. For people with T1D, it’s a non-negotiable. You have to take it, or you will not survive. For people with T2D, you might need insulin depending on your progression; however, latent autoimmune diabetes in adults (LADA)—an autoimmune form of diabetes where your body eventually stops making insulin—you will eventually require insulin depending on the severity or progression of your disease state. When you’re first diagnosed with T2D, metformin is almost always prescribed as the first line of treatment. 

 A C-peptide test can help your healthcare team tell the difference between T1D and T2D when the diagnosis is unclear. It may also provide clues about insulin resistance, which happens when your body does not respond to insulin as well as it should. Your results, along with your blood sugar levels and other tests, can help guide your treatment plan. 

What is C-peptide and how do you test it?

C-peptide is a substance made in the pancreas along with insulin and released at the same time. C-peptide tests help check how much insulin the body is making. If a test shows little or no C-peptides but blood sugar levels are high, it means the body isn’t making enough insulin or none at all.

This usually indicates a person has T1D. If C-peptide levels are high, it means the pancreas is making more insulin than usual to keep blood sugar levels steady, which can be a sign of T2D. 

When should I be tested?

If your blood sugar stays high even when you follow your diet, manage stress, exercise regularly and take medicine as prescribed, you should see your healthcare provider (HCP). This could mean you’ve been misdiagnosed with T2D but are actually living with T1D.

Before jumping to this conclusion, think about any changes in your life that might have affected your blood sugar. If needed, you might want to see an endocrinologist who specializes in metabolic disorders and can give you more information about your diabetes than your HCP.

Your HCP can help evaluate how serious your diabetes state is and can also check if you might have been diagnosed incorrectly. These factors will help determine whether you need insulin, should take oral blood-sugar-lowering medication or can manage your condition with diet and exercise alone.

Knowledge is power in life with diabetes

Knowing how well your diabetes plan works helps you and your HCP find problems early and fix them. Always go to your HCP with questions as you learn. You are the most important part of your healthcare team. Being an advocate for yourself is essential to living well with diabetes. Doing this can help you thrive with your disease, ensure you’re taking the best medications for your health and prevent serious health problems.

Living with T2D can carry a heavy burden of shame and stigma. Beyond Type 1 is changing what it means to live with T2D alongside a community of peers who truly understand. Join a community that’s been in your shoes. Explore our Community Apps.