Question: Should I switch to insulin now that I have had a heart attack?
Answer: I think the choice of medicine to control diabetes if you've had a heart attack -- whether it's three days ago, a month ago, or a year ago -- really depends on how much power you need to get your sugar level down.
Typically doctors today use pills, because patients are reluctant to use needles for their treatment for diabetes -- which insulin requires -- so that we tend to think of insulin as sort of a last resort for a lot of patients to control their glucose.
But as I said earlier, in many patients today, particularly with the lower sugar levels doctors want to get to to prevent these complications, insulin is being required more often at an earlier age in more and more patients. And there are several, what's called a clinical trials, out there today that are testing whether or not driving the sugar level down even below our current level will add more benefit in reducing these complications.
If that happens, your doctor's likely to go to insulin much sooner than they would if these trials were negative. So, I think we've got to sort of peel away all of that sort of folkloric distaste for insulin, look at it as a very effective and very safe drug to treat diabetes, and if you're told you need it, you ought to take it.