It is important to clearly separate two concepts that are often confused:
Insulin as a medication (therapy prescribed by a doctor)
Insulin dependence as a type of disease
1. “Insulin-dependent diabetes” is an outdated name for Type 1 Diabetes (T1D)
This is a fundamentally different autoimmune disease in which the pancreas stops producing insulin due to destruction of beta cells. Without insulin injections, a person with type 1 diabetes cannot survive. In T1D, insulin is replacement therapy that compensates for an absolute deficiency of the hormone. It is required from the moment of diagnosis and for life. This is where the historical term insulin-dependent comes from.
2. Type 2 Diabetes (T2D): Why Insulin May Be Needed
Type 2 diabetes is based on insulin resistance (the body’s cells respond poorly to insulin) and relative insulin deficiency (the pancreas produces insulin, but over time cannot overcome the resistance).
Treatment always begins with non-pharmacological measures (diet, physical activity) and oral medications that:
Reduce insulin resistance
Stimulate the body’s own insulin production
Increase glucose excretion by the kidneys, etc.
However, the disease is progressive. Over time (after 5, 10, or 15 years), pancreatic reserves may become depleted, and endogenous insulin is no longer sufficient to control blood glucose—even with tablets. Insulin may also be prescribed temporarily in cases of severe comorbid conditions, surgery, pregnancy, or when very high glucose levels pose an immediate health risk.
So What Is “Insulin-Dependent Type 2 Diabetes”?
It is not a separate type of diabetes, but a stage in the course of type 2 diabetes at which insulin therapy is prescribed—either in addition to oral medications or instead of them—to achieve target blood glucose levels.
Key Differences from Type 1 Diabetes
Insulin is not the first, but the last step in treatment, used after other options have been exhausted.
Partial preservation of endogenous insulin production. Patients usually retain some (though insufficient) secretion of their own insulin.
Insulin resistance remains the core problem, which is why insulin is often prescribed in combination with oral drugs (for example, metformin).
The goal of insulin therapy: not simply survival (as in T1D), but achieving and maintaining strict HbA1c targets to prevent severe complications affecting the kidneys, eyes, and blood vessels.
Why Is Correct Terminology Important?
Stigmatization.
The phrase “now you are insulin-dependent” can sound like a sentence or personal failure to a patient. In reality, it is a timely and correct therapeutic step that protects the body from the damaging effects of high blood glucose.Treatment strategy.
In T1D, insulin therapy follows one main approach (basal–bolus). In T2D, there are many options: sometimes only one injection of long-acting (basal) insulin at night is needed to control fasting glucose, while in other cases more complex regimens are required.Lifestyle considerations.
Starting insulin in T2D is not a reason to relax dietary control. On the contrary, nutrition, weight management, and physical activity become even more important, as they help reduce insulin doses and improve insulin sensitivity.
Correct Terminology
Incorrect / outdated:
“Insulin-dependent type 2 diabetes”Correct / modern:
Type 2 diabetes on intensified insulin therapy (multiple injections per day)
Type 2 diabetes on basal insulin therapy (1–2 injections of long-acting insulin)
Type 2 diabetes controlled with combination therapy (oral medications + insulin)
Conclusion
A person with type 2 diabetes who is prescribed insulin does not become a patient with type 1 diabetes. They remain a person with type 2 diabetes, but at a new stage of treatment that is more effective for their current condition. Insulin in type 2 diabetes is a powerful and modern tool for achieving glycemic control—not a sign of failure or worsening of the diagnosis. It represents a transition to a more active and precise disease-management strategy aimed at preserving quality of life and longevity.