Dear XXXXXXX

Thanks for the query.

I understand your concern for your brother. Do you mean your brother is having type 1 diabetes- the one which depends on insulin? (Though you have mentioned type 2 diabetes- the one which can be controlled with oral medications and lifestyle measures)- Because type 2 diabetes since the age of 11 years is uncommon in India. Kindly clarify the type of diabetes.

I feel he's having type 1 diabetes which is very common to be detected at this early age and hence he's on insulin since last 8 years.

Now to answer your query, honestly as of now there has been no successful alternative therapy for this kind of diabetes other than taking insulin shots every day. Nasal sprays, oral capsules, etc., all have been tried and tested. In fact, I was amongst the investigators to test these newer insulin forms (from international drug makers) in patients with insulin dependency in my hospital. We found that nothing is working as efficiently and as safe as the injectable insulins.

There have been trials of pancreatic tissue transplantation, beta cell regeneration by stem cell technology and for sure some solution will come out after a few years.

But I always ask a patient who takes insulin shots every day these questions-
- Are you at any discomfort in taking insulin shots every day?
- Do you have problem sticking to the insulin schedule?
- Do you feel the pricks are painful?
- Do you have phobia to take injections in the public / in front of friends?
- Do you hate taking multiple injections because they still do not control your sugars the way you expect them to be?
- Are you confident that you use the proper technique of insulin injections?

And the answers from the patient help me understand why he / she does not like the injections and I give solutions to his / her phobic feelings and help him/her find it very, very easy and comfortable to deal with this daily insulin injection patterns. So my advice is, ask your brother to get in touch with me for any problem about the insulin pricks.

Also, you might have heard of insulin pump where a patient used continuous infusion of insulin by a sophisticated insulin pump and thus frequent pricks of insulin in a day are avoided. I can give you more information on this if you are interested. This option is available in India, but let me warn you that it is far more costlier than the usual insulin pricks.

In short,
1. Patient's relatives should not get discouraged of insulin injections when the patient needs them as life saving drugs.
2. If your brother isn't complaining about taking the shots himself then do not feel pity on him; your brother will certainly cope with his diabetes and other challenging situations in life very nicely. That's the beauty of children growing with this disorder.
3. If your brother has any issues about insulin pricks as listed above, please ask him to contact me, I shall help him to get flexible and friendly with the injections.
4. He can try the insulin pump if he still want something other than daily pricks.
5. Lastly we have to wait for a few years and hope that the new stem cell technology succeeds in dealing with problems such as diabetes.

Hope you got the answer. You may contact me again for any further clarification.

All the best!!!

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