In my endocrinology practice, I see many patients with diabetes. And a common question is why many oral diabetes medications stop working? The answer is because most of the oral diabetes medications depend on insulin production but insulin production tends to progressively decline.

Diabetes develops when our body does not produce ENOUGH insulin ON TIME. At the early phase of type 2 diabetes, insulin is still produced but not the right amount at the right moment. If you reduce the rapid demand for insulin by reducing simple carbohydrates and increasing fibers and proteins, insulin secretion from your pancreas may become enough to control blood glucose levels. Unfortunately, some diabetes patients progressively lose insulin production capacity. As insulin production further decreases, glucose control becomes more difficult and variability of glucose levels increases. High variability of glucose levels, or so-called brittle diabetes, indicates significantly reduced insulin production. Therefore, the blood test of insulin level is usually not necessary. Even in this case, insulin secretion is much higher than in type 1 diabetes.