Can Insulin-Dependent Diabetics Do Away With the Injections Completely?

With chants of ‘Kejriwal ko insulin do’, AAP leaders in Delhi protested outside the Tihar jail on Sunday, 21 April.

(Photo: Aroop Mishra/FIT)

With chants of ‘Kejriwal ko insulin do’, Aam Aadmi Party leaders (AAP) in Delhi protested, while carrying insulin, outside the Tihar jail on Sunday, 21 April.

In the past few days, party leaders have been alleging that there is a “conspiracy to kill” Delhi Chief Minister and AAP chief Arvind Kejriwal in jail by denying him access to insulin, even though he is diabetic.

The Tihar jail administration and the Enforcement Directorate (ED) have maintained in reports that Kejriwal had “stopped taking insulin months before his arrest and is on a basic anti-diabetes oral medicine.”

On the other hand, AAP has claimed that since February, Kejriwal had been on an “insulin reversal programme.” 

After he was arrested on 21 March, by the ED in the Delhi excise policy case, AAP leaders said that he has not been able to continue with the programme, and needs to be administered insulin again.

On Monday, 22 April, Atishi addressed a press conference, saying, "The ED lied in court and said specialists from AIIMS were consulted and they have said that no insulin is needed and have also formulated a diet chart for Kejriwal. However, the diet chart was not prepared by an endocrinologist or diabetologist, but by a dietician. We all know that dieticians are not MBBS doctors. On the basis of that diet chart, they have been saying in court that Kejriwal does not need insulin."

FIT spoke with endocrinologists to understand whether an insulin-dependent diabetes patient can completely let go of it.

If a Diabetes Patient Is off Insulin, Will They Never Need It Again?

Dr Richa Chatturvedi, Senior Consultant, Endocrinology, Indraprastha Apollo Hospitals, explains to FIT that type-2 diabetes occurs due to two reasons:

• Insulin resistance: Your body is not responding to whatever insulin is being produced. Leading a sedentary lifestyle or health conditions like obesity can increase insulin resistance. 

• Inadequate insulin formation: The beta cells in your pancreas are responsible for secreting insulin. If the amount of beta cells reduces, the insulin production goes down as well.

“While insulin resistance can be brought under control through lifestyle modification, the second scenario is a little tougher to deal with. Usually by the time diabetes is diagnosed, over 50 percent of the beta cells have already gone down. If diabetes is diagnosed at an early stage, medication and lifestyle changes are enough. But in the later stages, we have to supply insulin from outside – probably making the patient dependent on it lifelong.”

Dr Richa Chatturvedi

Dr Phulrenu Chauhan, Section Head, Endocrinology, PD Hinduja Hospital, agrees. She adds that while controlling glucose levels might be difficult, if insulin-dependent patients are able to moderate their sugar levels, then they can go off insulin.  

So, the only time that diabetes patients can go off insulin is when diabetes is still in the early stages and they are able to stabilise their sugar levels.

‘Take Precautions’: Going Off Insulin Doesn’t Mean Diabetes Is Cured

If a diabetes patient has been able to control their sugar levels and go off insulin, doctors still recommend that they take necessary precautions.

“Once a diabetic, always a diabetic,” says Dr Chauhan.

She emphasises that even if a patient has been told that they can discontinue insulin, that doesn’t mean they can go off medication. 

Dr Chatturvedi agrees. She tells FIT,

“If you are able to control your sugar levels and if the progression of the disease is slow, doctors might ask you to rely only on medication going forward. But you cannot function without medication.”

She goes on to add, “Anyway, the progression of diabetes will be fast if you have a family history or any genetic causes. Ethnically, Asians, especially Indians, are predisposed to diabetes. Indians, on average, get diagnosed with diabetes at least 10 years earlier than their counterparts.”

The doctors suggest that diabetes patients, if going off insulin, should:

• be regular with medication

• eat healthy and consciously

• inculcate lifestyle changes

• constantly monitor their sugar levels

Dr Chauhan says that this is especially important because if the diabetes patient has any “illnesses, surgery, or health issues, sugar levels can go up, and they might need to be put on insulin again,” says Dr Chauhan.

“Sometimes high sugar levels might not show symptoms. It can be a silent killer if the symptoms are life-threatening. Don’t be callous with the condition.”

Dr Phulrenu Chauhan