April 21, 2005
Insulin, Type 2
Question from Buffalo, New York, USA:
If a person has type 2 diabetes, I have heard that their pancreas can eventually tire of producing so much insulin to overcome the resistance they are facing, and give up producing insulin so the person becomes insulin dependent. How common is that? At the point of being insulin dependent, are they now classified as type 1 or type 2?
The scenario you describe of “beta cell exhaustion” is common and can be looked at as the natural history of type 2 diabetes. The classification of the disease is still type 2 diabetes. When there was a more limited choice of early oral treatments for type 2 diabetes, up to 50% of patients with type 2 diabetes might be treated with insulin in their lifetime. The hope is that better control earlier in the course of diabetes may lower this percentage.