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Overcoming Fears of Starting Insulin Injections

separator People who have type 1 diabetes always need to take insulin injections because their pancreas doesn’t produce insulin any longer. When you have type 2 diabetes, the much more common form, your pancreas still produces insulin, but your body doesn’t use it as effectively as it should. People with type 2 often hope they’ll be able to manage their condition through lifestyle changes such as eating the right foods in the right amounts, getting regular exercise and managing stress. They often are able to manage their blood sugar this way. Often, they may need to take medications that help their body use insulin more efficiently.

But sometimes when you have type 2, you do have to take insulin, even if you’ve tried very hard to manage your blood sugar in other ways. Many times, insulin becomes necessary when oral medications are no longer effective enough. It doesn’t mean you’ve failed; it just means that your body now needs insulin injections to keep your blood glucose in check. Very often, your doctor will recommend that you continue to take your oral medication even after you start on insulin injections. This is often the most effective way to help people control their blood sugar.

Answers to common concerns
It’s common to feel afraid of the idea of starting insulin. You may be wondering about some or all of the following issues:

Q:  I don’t like the idea of giving myself injections. Won’t they be very painful?

A: The newer needles today are quite thin and small and cause little, if any, pain. Your care team will work closely with you to show you how to inject yourself in the quickest, least painful way possible. Most people find that insulin shots don’t hurt.

Q: I’m really active. I’m always heading out the door to meet friends, go shopping, have dinner out. How will all that be affected when I have to start giving myself shots?

A: Most people find that once they figure out their injection and blood sugar testing patterns, they’re able to do all the things they enjoyed before they started taking insulin. Some are surprised to realize that taking insulin and regulating their blood sugar actually makes them feel better, so they’re able to do even more than they did before. But it’s certainly true that you’ll probably need more discipline in your routine than you’ve been used to.

Q: I’ve heard that when you start on insulin, it’s easier to develop low blood sugar (hypoglycemia).

A: This is a legitimate concern, but your care team will work with you to explain how you can avoid this problem. It’s important to know the symptoms of hypoglycemia and what to do about them. Read about how a woman named Linda, who has diabetes and takes insulin, handles low blood sugar episodes - "HOW LINDA MANAGES HER HYPOGLYCEMIA.”

Q: I’m worried that insulin will make me gain weight. Is that true?

A: Some people do gain weight after they start taking insulin. The reason for this is that your body hasn’t been making proper use of the calories you’ve been taking in. Instead of using those calories to create energy for your body’s cells, your body is flushing out those calories in your urine. When you start injecting insulin, your body begins to use the calories properly, and that’s why weight gain can occur. If you do gain weight, you’ll need to take in fewer calories. If you have trouble figuring out what you should focus on eating and not eating, be sure to talk with a registered dietitian to make an eating plan that will work well with your diabetes regimen.

Q: I have the feeling that needing to start insulin means my diabetes has reached a “terminal” stage. Is that true?

A: Not at all. It just means that you need to go to the next level to keep your blood sugar under control. Many people who take insulin have done so for years and years and years.

Things you can do to make the transition to insulin easier

► Make sure you understand exactly why it’s time to start insulin. If you have a nagging concern in the back of your mind that taking pills is still the best way to manage your blood sugar, you’re less likely to want to make a change. Talk with your doctor, your diabetes educator, nurse practitioner, etc., to learn exactly why now is the right time for you to adjust your treatment plan.

► Work closely with your care team as you go through this transition period. Each member of your team has a different perspective to contribute to you about giving yourself injections, which supplies would work best for you, how to prevent hypoglycemia and how to prevent weight gain.

► Take a friend to the appointments with you. Two heads are better than one when it comes to learning something new.

Read more about the different types of insulin and how they work in your body - “JUST FOUND OUT YOU NEED TO TAKE INSULIN".

Clinical Diabetes, 22:151, 2004; Physicians Weekly, 31 October 2005
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