by Rehana
(Karachi.Pakistan.)
Answer by Dr. Albana Greca, MD, MMedSc
Hello,
Feeling exhausted by glucose checks and injections is understandable. Ask whether newer technology or a simpler plan can reduce the burden safely.
Type 1 diabetes: The pancreas makes little or no insulin, so insulin cannot safely be replaced by herbs, tablets, water therapy or exercise. Stopping insulin can cause diabetic ketoacidosis.
Type 2 diabetes: Some people can control glucose with nutrition, activity, weight management and non-insulin medicines. Others need insulin temporarily or permanently because glucose is very high, they are ill, pregnant or no longer make enough insulin.
See type 1 diabetes and type 2 diabetes treatments.
Yes. A continuous glucose monitor, or CGM, uses a small sensor under the skin and displays readings on a receiver or phone. For people using insulin, it can replace most routine fingerstick checks and provide high- and low-glucose alarms.
A CGM is not completely needle-free. The sensor must be replaced periodically, and a fingerstick may still be needed if symptoms do not match the sensor.
An insulin pump delivers rapid-acting insulin through a small cannula. A tubeless patch pump attaches directly to the body. These devices can replace several daily injections, although the infusion site must still be changed every few days.
Automated insulin-delivery systems connect a CGM with a pump and adjust insulin from sensor readings. They still require training, meal dosing and a backup plan.
Our insulin treatment guide explains the main options.
Rapid-acting inhaled insulin is available in some countries and is taken at mealtimes. For type 1 diabetes, it must be used with basal insulin, so it does not eliminate injections completely.
It is unsuitable for people with asthma or chronic obstructive pulmonary disease, requires lung testing, and is not recommended for smokers or recent smokers. Availability outside the United States may be limited.
For type 2 diabetes, a clinician may consider metformin or other oral medicines, and sometimes non-insulin injections. The choice depends on HbA1c, health conditions, pregnancy, hypoglycemia risk and cost.
Sulfonylureas can stimulate insulin release but may cause low glucose and weight gain. They are not a simple substitute for insulin and do not work for type 1 diabetes. See diabetes medicine safety.
No herbal product has been proven reliable enough to replace insulin or prescribed medicine. Research on cinnamon, bitter melon, fenugreek, aloe and other supplements is limited or inconsistent. Products may interact with medicines or cause liver, kidney, digestive or low-glucose problems.
Vinegar is not a cure. “Salajeet” or shilajit products may also have contamination and quality concerns.
Read our review of herbs and supplements for diabetes.
Ask an endocrinologist or diabetes educator to review the whole routine. The plan may be simplified by using CGM, an insulin pen with a shorter needle, changing injection sites, using a pump, or selecting medicines with a lower risk of hypoglycemia.
Healthy eating and activity remain important, but exercise must match the person’s health and treatment. See diabetes and exercise.
Bring the glucose record, insulin names and doses, medicines and supplements to a diabetes review. Ask specifically about CGM, insulin pens, tubeless or standard pumps, automated insulin delivery and whether non-insulin treatment is medically appropriate.
Technology can reduce pricks, but it cannot make essential insulin optional.
Dr. Albana Greca
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