One in 10 Taiwanese, or 2.2 million people, have diabetes, and some are in danger of being unable to manage their blood glucose level because they are unwilling to take insulin, a survey released yesterday by the Formosan Diabetes Care Foundation showed.
More than 30 percent of people in Taiwan with diabetes — those with a hemoglobin A1c (HbA1c) level of 7 percent or higher — cannot manage their blood sugar level, even though they are taking three or more oral medications, the survey showed.
A doctor should assess a diabetic’s condition when they do not respond to a combined drug treatment, then consider using insulin injections to mitigate the risk of them developing complications from the disease, said foundation director Li Hung-yuan (李弘元), who is a National Taiwan University Hospital doctor.
Photo: Lin Hui-chin, Taipei Times
The survey showed that among people with a HbA1c level of more than 9 percent, 54.4 percent were advised by doctors at least twice to take insulin, Li said.
“Most doctors and nurses will advise people to consider insulin treatment, which can benefit most diabetics,” he said.
Some people do not want to take insulin at first, even though diabetes causes cell production of insulin to decline 4 to 5 percent annually, but with early use of insulin injections, the rate can be reduced in pancreas cells, he said.
“Once cells stop producing insulin, it cannot be reversed,” Li said. “If the deterioration of pancreas cells goes unabated, then their bodies would be unable to control their blood sugar level in the long term. If insulin treatment is started early, it can relieve the burden on remaining pancreas cells that are still functioning.”
Many diabetics are afraid of needles, and therefore rely on oral medication, he said.
Thirty percent of people with diabetes are unwilling to take insulin injections, believing that other treatments are available, while another 30 percent say that insulin injections are inconvenient, he said, citing the survey.
“Insulin is a hormone, naturally produced by the human body. It does not interfere with the kidneys, nor will it cause other complications. Diabetes is caused by insufficient insulin not functioning to control blood sugar, or due to insulin resistance,” he said.
“Taking insulin injections can stabilize blood sugar levels, and mitigate the damage to pancreas cells from overproduction,” he added.
“Nowadays people can use insulin pens, which are much smaller with sharper needles, for more convenient use, and do not disrupt most people’s daily lives,” he said.
The foundation cited a case of a woman surnamed Chen (陳), 71, who has lived with diabetes for 12 years. For five years she took three oral medications to reduce her blood sugar level, but her HbA1C level still exceeded 8.5 percent.
She was therefore put on a rigorous diet, and had to give up many of her favorite dishes, it said.
After consulting medical experts for many years and with the onset of diabetic retinopathy — which can cause blindness if left untreated — she agreed to take insulin, and her HbA1C level fell to below 7 percent within three months, while also reducing her need for oral medicine, it said.
She also started to cook again with friends and was able to enjoy her favorite dishes, it said, adding that she said she regretted not taking insulin earlier, so that she could have avoided many years of discomfort.
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