Diabetes Changes Over Time

If you start to feel like what you have always done to maintain your blood sugar is no longer enough, it’s probably not your imagination. But the mystery of why your diabetes seems to be getting harder to manage, even when you are trying to do everything “right”, is actually a normal part of type 2 diabetes. Type 2 diabetes is a progressive disease, meaning that it changes over time. There are many reasons for why this may happen. There are also many things you can do to help manage your diabetes.

As your diabetes changes, your pancreas may be making less insulin than it once did. Or, maybe it is releasing it too slowly. Or perhaps your body is no longer responding to the insulin it does make properly (called insulin resistance). In fact, all of these things could be happening.  


How to manage type 2 diabetes

There are some lifestyle changes that may be helpful. Becoming more physically active and watching what you eat may help you to control your blood sugar. Talk with your diabetes care team about ways you can be more physicially active. 

However, for many people with diabetes, the body becomes more insulin resistant over time. This is why medication changes may be an important part of managing your diabetes. For instance:

You may start out treating your diabetes with lifestyle changes (diet and physical activity) and pills (oral antidiabetic medications such as metformin). 

If at some point pills aren’t giving you enough control, your health care provider may add a long-acting (basal) insulin at night or in the morning (sometimes both) to help manage blood sugar between meals and while you sleep. 

If you are taking basal insulin and finding it harder to reach your A1C goal, your health care provider may add a fast-acting mealtime insulin, such as NovoLog®, to your diabetes care plan. Adding mealtime insulin to your care plan is a big step. Some people with type 2 diabetes feel that having to take insulin means that they have somehow failed in their diabetes care. However, this is not necessarily the case. In fact, about 40% of people with type 2 diabetes start insulin after 10 years of having diabetes. Starting insulin is not about failure. It’s about helping you better control your blood sugar, which is the goal of your diabetes care plan. And, remember that the longer you’ve had diabetes, the more likely it is that you may need to add insulin to your care plan.

Learn more about how and why diabetes changes over time with this helpful fact sheet. Download Now

Changes to your diabetes care plan can be overwhelming. If you need emotional support during this time, talk with the people who support you about how you feel. If you need more help than they can offer, talk to your health care team about getting additional support. There is help and support available; you just have to ask for it!

And, if you need help talking with your doctor about adding mealtime insulin to your care plan, you can use our Doctor Discussion Guide to organize your thoughts. 

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