Why are diabetics prescribed insulin?

Insulin resance—a condition where the body’s cells respond inadequately to insulin—is a core challenge for diabetics. While reducing insulin levels may help manage insulin resance, it is not the sole solution.
Insulin resance often correlates with obesity and metabolic strain. Reducing insulin levels can improve insulin sensitivity, but as Dr Dheeraj Kapoor, Head of Endocrinology at Kokilaben Dhirubhai Ambani Hospital, explains, this approach alone doesn’t address all aspects of diabetes. Insulin resance arises from the combined issues of obesity, pancreatic beta-cell dysfunction, and systemic inflammation. Consequently, managing insulin resance requires a broader lifestyle intervention.
Why are diabetics prescribed insulin?
Even though lowering insulin levels can improve sensitivity, insulin therapy becomes necessary when the pancreas fails to produce sufficient insulin.
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Type 1 Diabetes: Patients lack endogenous insulin and need it for survival.
Type 2 Diabetes: As the disease progresses, the pancreas struggles to meet insulin demand due to declining beta-cell function, requiring insulin supplementation to maintain blood sugar control.

Kanikka Malhotra, consultant dietician and diabetes educator, highlights that insulin resance and deficiency coex in diabetes. Early interventions like weight loss and lifestyle adjustments may delay the need for insulin, but advanced stages of diabetes necessitate it.
Both experts emphasise that a proactive approach can improve quality of life and delay disease progression in diabetics (Source: Getty Images/Thinkstock)
How to improve insulin resance
Training the body to overcome insulin resance focuses on long-term, sustainable lifestyle habits, said Dr Kapoor:

Dietary Changes

Increase intake of fiber-rich foods like fruits, vegetables, and whole grains.
Limit refined carbs, sugary foods, and trans fats.

Regular Exercise

Commit to at least 150 minutes of moderate physical activity weekly, including cardio and resance training, as per the American Diabetes Association.

Weight Management

Losing just 5–10% of body weight can significantly enhance insulin sensitivity.

Adequate Sleep and Stress Reduction

Prioritize 7–8 hours of sleep per night to regulate hormonal balance.
Practice mindfulness, yoga, or relaxation exercises to manage stress effectively.

Intermittent Fasting (Supervised)

This approach may reduce insulin levels and improve sensitivity over time.

While lower insulin levels may help manage insulin resance, it is not a standalone strategy. Combining dietary changes, regular physical activity, weight management, and stress reduction provides the best chance for adequate control. Both experts emphasise that a proactive approach can improve the quality of life and delay disease progression in diabetics.