Insulin is a life-saving hormone for people with diabetes. It helps the body cells take up glucose and use it as a source of energy or fuel. For people who are insulin-dependent, without the medication, a high amount of glucose is circulating the the blood which can result in more serious conditions such as diabetic ketoacidosis and coma.
Can diabetes be managed without insulin?
Now, several people with Type 1 and advanced stage of Type 2 diabetes are insulin dependent. For them, missing even a single dose of insulin can be a nightmare as it can lead to serious complications. Dr Mani Deepthi Dasari, Endocrinologist, Apollo Hospitals, Sheshadripuram, Bangalore, says, “It is not just with food, even normally, our liver produces glucose. That production cannot be stopped. So, missing even a single dose of insulin can lead to serious complications within a day for diabetic people who are insulin dependent.”
There are two types of insulin – basal (long-acting) insulin, which is taken once in 12 or 24 hours and bolus (short-acting) insulin which is taken at mealtimes. Currently, there are no alternatives to injectable insulin. However, they are usually available in every pharmacy. Dr Subrata Das, Senior Consultant – Internal Medicine and Diabetology, Sakra World Hospital, Bangalore adds there are different brands of insulin. There are insulin kits as well for travel which help people store the insulin pen kits for about two to three or four days outside the refrigerator.
Natural insulin substitute for diabetes
In dire situations or worst-case scenarios where one does not have access to insulin due to shortage or war situations like in Gaza, there are three things that one can do, say experts.
Staying well hydrated is very important to manage sugar levels. Dr Das says, “Without insulin, the sugar spike can lead to dehydration. So, keep yourself hydrated, drinking at least 3 liters of water.”
Reducing carb intake and including more protein and complex carbs in the form of vegetables in your diet can help manage sugar levels, say experts.
Continuing regular exercises can also help manage sugar fluctuations to some extent. Dr Das says daily exercise should include 30 to 40 minutes of walking and muscle strengthening exercises as they can help utilize glucose. “You can work with simple light weights and also do some yoga,” he adds.
The sugar levels in an insulin-dependent person with diabetes tend to fluctuate a lot without insulin. The sugars can get converted to ketones and lead to diabetic ketoacidosis (DKA), which can be life-threatening.
Diabetic ketoacidosis symptoms
The following are some of the symptoms of DKA which one can develop in a day or two without insulin:
- Excessive thirst, hunger and urination
- Abdominal pain
Dr Das says one can develop some or all the symptoms together. If left untreated, DKA develops into a more serious complication and can lead to diabetic coma which is life-threatening. “In the long-term, if diabetes remains uncontrolled with HbA1c of over seven percent, one can develop brain strokes, eye damage, heart attack, kidney issues and nerve damage,” he adds.
Dr Dasari says that for people with Type 1 diabetes (who have a complete deficiency of the hormone), there are no alternative medications to insulin. In the case of Type 2 diabetes, oral medications can help substitute for insulin in the short term. Hence, it is very important to keep at least a month’s stock of basal insulin in the refrigerator.
People with Type-1 diabetes are completely dependent on insulin and have no alternative medications presently. Hence, in scenarios where one cannot have continued access to or falls short of insulin, natural substitutes like staying well hydrated, low-carb diets and continuing with regular walks and muscle-strengthening exercises may help manage diabetes for some time.