All about non-insulin injections for type 2 diabetes

Before insulin was discovered in 1921, people with diabetes had short life expectancies: there wasn’t much doctors could do for them except put them on super-strict diets, sometimes as low as 450 calories a day. They did not die from causes linked to diabetes, but from starvation.

Insulin revolutionized the therapeutics of this condition and now, a century later, a new generation of drugs without this vital component is being presented as an alternative for people to manage their type 2 diabetes. injections without insulin and who can benefit from them.

Secreted by the pancreas, the hormone insulin regulates many metabolic processes that provide cells with the energy they need to function.

Insulin production is regulated based on blood sugar levels and other hormones in the body. In a healthy person, the production and release of insulin is a tightly regulated process that allows the body to balance its metabolic needs.

As explained by the Endocrine Society, insulin allows the cells of the muscles, fat and liver to absorb glucose that is in the blood.

The most common problem associated with insulin is diabetes. Diabetes occurs when the body does not secrete enough insulin, or almost no insulin, or when it no longer uses the insulin it does secrete effectively.

Diabetes is divided into two categories:

Diabetes type 1. It occurs when the pancreas cannot produce insulin to support multiple body functions. It commonly occurs in children and, although an exact cause has not been found, many consider it to be an autoimmune disease. Some symptoms of type 1 diabetes include tiredness, increased urination and thirst, and vision problems.

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Type 2 diabetes. It is most commonly associated with adults and lifestyle choices. People with type 2 diabetes produce insulin, but often not enough for their body’s needs. They may also have difficulty using the insulin they produce effectively. Patients may not know they have type 2 diabetes until they have an annual checkup, as symptoms tend to be mild until the disease becomes severe.

In the United States alone there are 37 million people with diabetes, of which 90 to 95% have type 2.

Globally, cases of diabetes increased from 108 million in 1980 to 422 million in 2014. In 2019, there were more than 1.5 million deaths directly caused by diabetes.

The discovery of “synthetic” insulin changed the rules of the game, since it allowed millions of people to control the condition not only by changing lifestyles.

People with type 1 diabetes need to either take insulin through an insulin pump that releases amounts of the hormone at timed intervals, or inject it several times a day.

For people with type 2 diabetes, doctors generally recommend that they manage their condition with oral medications or the option of non-insulin injections, especially if sticking to a pill-taking routine is difficult.

What are injections without insulin?

Non-insulin injections or pens is a generic term used to define non-insulin injectable medicines to treat diabetes. They can be combined with oral medications or used alone. Some are disposable and used only once, and others contain multiple doses of medication.

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They include a family of six drugs, five of which are glucagon-like peptide (GLP-1) agonists, branded as Byetta, Bydureon, Tanzeum, Trulicity and Victoza; and one is an analog of amylin called Symlin.

They are useful for people who do not yet need to inject insulin, but require medication to control their diabetes. The patient, together with his medical team, must determine if it is the right medication for both his clinical needs and his daily reality (pills vs. injections, administration time, resources, etc.)

It is very important that the doctor indicates how to use it to release the medicine efficiently in the body, without hurting the skin.

One of the main recommendations is not to always inject the pen in the same place, but to rotate the injection in areas of the body that do not have bruises or wounds. There are areas of the body where an injection causes less discomfort, such as the abdomen or upper outer leg.

Injection pens that are recyclable should NEVER be shared.

These medicines, approved by the Food and Drug Administration (FDA) in 2005, stimulate the production of insulin and also have the effect of slowing down the production of insulin by the liver, which results in a decrease in blood sugar levels.

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Experts say non-insulin injections can work as a bridge from oral medications to insulin use. With luck, coupled with lifestyle changes, people living with type 2 diabetes may not need to use insulin for a long time, if not ever.

In addition to helping the body with its production and levels of insulin, some of the benefits of these injections include:

  • They help to lose weight, they are NOT weight loss medications, so they should only be used under a strict diabetes management strategy, but due to their form of action they promote weight loss.
  • The doses of injections are fixed, unless the doctor modifies them (this marks a difference with those of insulin that usually the same person must adjust)
  • They can help lower blood pressure slightly.
  • There are some versions of injections without insulin that are given once a week, which makes them very convenient.
  • They do not record serious side effects (nausea, body pain, among others), only some minor ones that usually disappear when the person has already adapted to the new treatment.

One of the disadvantages of these drugs is their cost, which can be up to 70% higher than regular drugs, even more so considering that it is a drug that will probably be used for life. Especially for people who don’t have health insurance. In general, diabetes drug prices have been rising steadily over the years.

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