Fear of insulin

I think fear of insulin is common. I think there are many people with T2 who delay using insulin because of this fear. Many if not most people with LADA/T1 don’t have the opportunity to think about and become fearful of insulin, they are just hit with the diagnosis one day and walk out of the office one day on insulin. Many have already told you that you really are not T2, but almost certainly LADA/T1, but your primary is not competent to make that diagnosis. As suggested, you really should see an endo. And I have to be honest, you will need to use insulin. So I’d like to take this discussion back to your question.

Fear of insulin.

Why do you fear insulin? Is it because you think it represents failure? Because injections will hurt? Are you worried about cost? Do you think you will have hypos? Please tell us more and perhaps we can help you with our own personal stories.

ps. And I have to advise you that the high carb low fat vegan diet from Barnard is probably the total opposite of what you need to do right now to control your blood sugars. You should be following a low carb diet. Please run away from this CHIP diet.

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Hi Joe,
Victoza is an injection, so you are already injecting :slight_smile: Insulin is …the same really and nothing to fear. You weight could also be due to the Victoza, is has a weightloss side effect in some.

From your GAD, you may be TD1, but that’s ok - nothing to fear from it and you can handle it well. You found this site and you now have a great support system.

Thanks you!

The chip diet is essentially Vegan. No dairy, meat, eggs, cheese etc. It stands for the Complete Health Improvement Plan…

Thanks…

That CHIP diet sounds like the old fat-is-bad-for-you-carbohydrates-are-good-for-you traditional wisdom that has been relentlessly pushed by popular culture for the past 50 or 60 years and is now being steadily discredited. Depending on how interested you are in this subject, there are some very good references readily available. One of the best starting points is Good Calories, Bad Calories by Gary Taubes.

But that’s really an aside. As Brian mentions, eating large quantities of carbohydrate is about the worst thing you could be doing right now. If one’s goal is to achieve high blood sugars, there’s no better way.

On the issue of insulin, I can offer a personal perspective, for what it’s worth. I am a “true” T2 who managed decent control for about 15 years using oral medications (no insulin). When my ability to maintain good control finally deteriorated beyond what I was willing to live with, I started reading everything I could get my hands on, including the books recommended earlier in this discussion as well as others. I concluded pretty quickly that insulin would give me good control again. It has. I feel like I’ve been let out of jail.

You didn’t say exactly what it is about insulin that you fear. If you could be more specific, there are many here who could provide helpful insights.

And last but not least, it seems pretty clear that you have been misdiagnosed. It’s surprisingly (and distressingly) common. Melitta, one of our members, has written extensively about the phenomenon. Check out this link.

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Joe, regardless of the ultimate diagnosis of “type”, it really doesn’t matter w.r.t. where you are right now. You are a severely out of control diabetic, and in terms of how you feel, your symptoms, and treating them, the prescription is the same regardless: You need to get your blood sugar under control.

I’m T2, and I’ve been exactly where you are. I understand the “fear” of insulin. If I may, it’s not really the insulin itself that’s scary, but what it MEANS to have to start taking it, how it will impact your life day to day, that it’s forever, and that this says something about failure and deterioration or, a word I’ve used before, you’re more “enfeebled”. Does that about sum up what you’re capturing with the word, “fear”?

I’ve got some comforting words for you. After that first day of taking insulin you will become a convert. Here’s what’s actually going to happen to you, and it will likely be large and dramatic. You will quickly feel SOOOOOO much better!

Your head will clear up and you’ll feel sharper than you have in a very long time.

Your appetite will come back strong, and eating will be a joy, rather than something you feel like you have to force.

You will have a TON of energy.

You will immediately cease being massively thirsty, drinking gallons, then having to pee all the time.

Any difficulties passing urine will go away.


I understand this fear. It feels like you’re crossing a line from “regular diabetic” to “ill diabetic”. Nothing could be further from the truth. Indeed, you’re very ill right now, doing a lot of damage to your body (slowly), and insulin is the way to make you well.

Once you get going, get a routine, and have this under control, you’re going to wish you had started this years ago.

This forum is one of the best places on the planet to learn about how to get yourself healthy and happy with insulin. We can help, and are happy to.

I myself use an Omnipod pump to administer insulin, and a Dexcom CGM to monitor my blood sugar. Start with shots (the “pens” are a great way to go), but don’t be afraid of looking at a pump in the near future. It seems to be another “hurdle” many people are wrongly afraid of, again seeing it as a further step of getting sicker/worse/feeble. Again, nothing could be further from the truth… it’s just a technology for delivering insulin, with much finer control, automation, and convenience. It’s also a lot more complicated, so you have to be willing to take that on.

Best of luck to you, and please report back to us about how you’re doing after you start insulin.

A final note: I’d urge you to discuss starting a basal/bolus regimen right away with your doctor, not just adding a long-acting basal insulin to your treatment protocol. While that approach is logistically much simpler, the best outcome will require bolus injections of fast-acting when you eat to really keep things where they need to be, given what you’ve described above.

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if you get back or stomach ache or start throwing up over the weekend, get to a dr ASAP
you should be ok till monday, but sometimes it comes on quick. you can also get urine ketostix from the pharmacy to check

Symptoms of DKA can appear quickly and may include:
frequent urination.
extreme thirst.
nausea.
vomiting.
abdominal pain.
confusion.
breath that smells fruity.
a flushed face.

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@Joeasaro, I think I’m of of the “poster kids” for what @Dave26 that management of your BG and you health is paramount to “type” or even choice of treatment. For your long-term health, you need to choose the best available treatment. From the beginning, my diagnosis has been sort of “murky.” Labelled Type 2, but like you, I was not overweight, was very active, and eating a healthy diet… My doctor didn’t even believe the diagnosis he was making! I was not feeling ill and was actually asymptomatic at the time. I was afraid of insulin AND afraid of needles.

I started on oral medications, modified my diet further, upped my exercise level – and got somewhat better control, but felt terrible and had bad side effects from the meds. My doctor didn’t wait too long (just4 months) before suggesting that I stop all the meds and take only insulin (basal and bolus). I did not want to do that, but I’m glad I did. Though it took a little time to get it right, my control improved dramatically. I made mistakes and gained some weight at the beginning (which I’m working hard now to lose), but felt and feel better that I ever did on the diabetes medications.

Today, I’m using an insulin pump and CGM, following a lower carb, moderate protein and fat diet, and have been maintaining A1c’s in the low 5’s (last one was 5.0), with few few low blood sugars - none severe. My own insulin production has continued to decline, but without affecting my ability to manage my BG fairly well. My endo recently decided to change my diagnosis to Type 1 – I’m not sure I agree with his decision or not, but it changes nothing about the way I treat my diabetes or approach a (hopefully) reasonable healthy diet.

From my perspective, the alternatives are much less favourable!

Hi, @Joeasaro
Many of us here find a different diet beneficial: low carb, high fat.

It is similar to Atkins or Paleo diets, but with some adjustments

For instance, I find eating less than 30 grams of carbs per day keeps my numbers in range overall.

Some people are able to handle 120 carbs in a day.

My specific diet is not vegan: I rely on eggs, milk fats, meats, chicken and fish every day.

I also have increased amounts of cream, butter and cheese at most meals.

I wouldn’t know how to eat low carb, high fat within vegan choices.

But I bet there is someone on this site who does. :slight_smile:

you must fear of not taking insulin because insulin is necessary for your blood sugar and for cells health

I was afraid of insulin (needles) before I started but insulin is the best thing I ever did. Couldn’t believe how much better I felt.

Hi I am new to this site. I had an A1C of 12.8 last month. The previous A1C fro Jan 2016 was 6.9 I was taking Invokana till a month ago and stopped because of dehydration and that it is no longer working. I have taken metformin for 16 years, now take 2000mg per day.

I am petrified of insulin because in Germany in 2008 I almost died with low blood sugars. it was the old vials and needle syringe. I don’t want to gain weight and am afraid of the yoyo and low blood sugar.

I also don’t know where this insulin comes from. Is it a pig? or is it synthetic? Insulin is a fat storing hormone. I gained 15 pounds in one month in germany. I am seeing the endo Nov 3 after waiting 5 months for an appt. I previously lived in Durango and there were no endos within 100 miles so I had a GP for 4 years. I eat low carb diet and exercise but at 54 next month, after 17 years of diabetes, and no-one being able to figure out what type I am, moving every few years with the government, I am burned out.

I also feel very tired, especially when I wake up and need strong coffee to get moving. I work full time and am getting burned out.

I need to know what is best insulin for me. I do not trust the doctors. I learn more in the forums than from the doctors. I have seen about 5 endos in my past 17 years dealing with this.

What can you all recommend for insulin that won’t cause weight gain? My sugars have bee 400 fasting and 250 in day sometimes 350. Glipizide prescribed and not working.

My C-peptide was 0.8 recently and I should have GAD65 on Monday. The doc did not even know about this test but wanted me to start insulin! I said I want the test first to figure out what my diagnosis is, Type 1, 2 1.5 or /??

Thanks

I don’t know that the type of insulin is that much of a factor in whether or not one gains weight on insulin. I think one is much more likely to gain weight if one doesn’t manage one’s eating and insulin dose properly. The most common problem I’ve heard about is with those who give themselves more insulin than they really need causing them to have a hypo. Then they have to treat the hypo with more food. Taking the time to learn how to do proper basal tests, then to calculate the actual need for meal time insulin based upon carbohydrate counting can prevent most of that.

If you need to go on insulin, I strongly recommend that you get either Think Like a Pancreas by Gary Scheiner or Using Insulin by John Walsh. After meeting my endo once, having him correctly diagnose me with LADA (latent autoimmune diabetes of adults), show me how to give myself an injection and giving me starting doses, he was going to then turn me back to my primary care provider. Well, she had misdiagnosed me and treated me as a type 2 for a year and a half even though my initial BG was 289 and A1c was 11.5. I had absolutely no faith in her knowing what she was doing regarding diabetes. So I got the book my Walsh and used it to get my doses adjusted before I even went back to her. Those books really do have enough information in them that one can do that if needed.

Hopefully you will have a better doctor and will get more guidance, but knowing the way my doctor proceeded with things, I knew it would take forever to get my doses adjusted. I felt it was a matter of self protection to do it before I went on a cross-country trip alone.

Insulin doesn’t cause weight gain. Overeating causes weight gain. All that exogenous insulin does is to restore the function that was lost when the pancreas stopped producing. Insulin, whether produced naturally by the body or introduced externally, will allow excess glucose to be stored as fat — but only if it is excess to current energy needs. It isn’t insulin that causes weight gain, it’s consuming more than you need.

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I’m glad you came here. There are certainly things about insulin which can make it dangerous or have side effects. But the real thing about insulin is that it is different than just going to a doctor and being prescribed a dose of a medication. You as the patient need to become responsible for making dosing decisions and choosing the right time to take insulin. I would tell that you as someone with T2 (although I believe type actually doesn’t matter), I’ve been on insulin for nearly six years. I tried very hard to learn how to properly use insulin and to use it safely and effectively. While insulin can do things like cause you to gain weight or have hypos, in all those six years I’ve never had a serious hypo and am still within 5lbs of the weight I was at six years ago. And I am about your age.

In the US, all insulins that are available are synthetic. Insulin made from pigs and cows has not been available for years in the US. The best insulins are the “modern analog insulins,” which have better and more predictable effects than older types of “human insulin.” There are basal analog insulins Levemir, Lantus and new ones like Tresiba and there are rapid bolus analog insulins like Humalog, Novolog and Apidra (there are more than these, but these are the main ones). And newer insulins like Tresiba (a basal insulin) have been found to cause fewer hypos. To be honest, having an A1c of 12.8 and running high blood sugars like you have, it is not surprising that you feel bad.

It is important to get on top of your diabetes. I would urge you to face your fear. Take action to avoid hypos. Get the books that @Uff_Da recommends. Read and post in these forums. And talk to your doctor, tell your doctor that you fear hypos and weight gain and ask him to help you with a treatment that help you avoid hypos. But that being said, I would urge you to start to get your head around insulin. For me insulin was like a miracle, drugs didn’t work. Properly used it can really do an amazing job controlling your blood sugars.

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Hi,

Since I have posted my original thoughts about the fear of going on insulin, I’ve gotten many responses back that are very encouraging. I guess I was just fearful of the progression. I have my first endo appointment on Monday and will be getting Lantus. Everyone says how much better I’ll feel almost immediately that I can’t wait to get there. I still feel like crap with bf’s all over the place, ears ringing etc etc…My attitude is getting better knowing that it will be fixed. Also, gaining a bit of weight back will be good as I had dropped to 161. In addition I downloaded think like a pancreas and am amazed at what I am reading. Thank you all for the encouragement here!!!

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Thank you. I will look into all of it. As you’re all aware there is too much information to wade through. Some of it ridiculous…

Thanks,

Joe

Thanks so much. Do you recommend all those insulins as “safe” for basal? and do i need a bolus? am afraid to take any insulin at night.

i see primary on Tuesday morning. I would like to get some insulin and not wait till Nov 3. I am feeling really tired. I think my body is wearing down from months of running high like 300-500.

What you you suggest I ask the GP for or do I wait 3 more weeks till Nov 3 to see endo?

Thanks!!!

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I have to be honest, with blood sugars in the 300-500 mg/dl range you could walk into an ER right now and likely be given immediate insulin and IV treatment to normalize your blood sugar. As soon as you were stabilized , they would likely hand you a basal insulin and tell you to follow up with your doctor on Monday. Blood sugars as high as you are experiencing not only are doing cumulative damage but you risk very serious health crises like DKA or HHS. And this is beyond making you totally feel bad.

So yes, I would personally advise you to see your GP as soon as possible and request (perhaps even demand) treatment and that treatment would typically start with a basal insulin. A doctor will typically start you with a small safe dose and work up. They can immediately give you a sample or a prescription and a starting dose. You can then call in every day or so and report your readings and have your doctor adjust your dosage. Many people find that a diabetes center with diabetes educators can help with insulin adjustment. And insulin treatment is a continuum. You may start with a long acting basal insulin with one or two shorts a day, but eventually many of us end up on an intensive regime where we bolus, taking rapid insulin for meals and correcting high blood sugars. If I had blood sugars in your range I would be take a bolus (repeatedly) until I brought my blood sugar into range.

And as to safety. The three modern basal insulins (Levemir, Lantus and Tresiba) that are mentioned above are quite safe. If you worry about overnight you can take your basal insulin first thing in the morning, then any “peak” will occur during the day when you will be awake and can take care of it. If you have good insurance and it is covered, Tresiba is really what I would consider the best. It’s effect is extremely flat and last a really long time, thus it is the least likely to cause hypos because of this. Your insurance may or may not cover it, but many doctors have samples that they can give out free to patients. During the insulin conversation with your doctor it is perfectly ok to ask about certain treatments such as Tresiba.

And in the meantime (until Tuesday), I actually ask that you consider restarting the Invokana for a couple of days and make sure you drink lots of water (with electrolytes). Both of these things can help bring down your blood sugars (yes just drinking water helps). Make sure you have recorded all your blood sugar readings in a log or on your meter to make sure you can vividly demonstrate to your doctor your blood sugars and how serious this is. And finally, I’d ask you to look in the mirror and remind yourself of how tough a time you have gone through. You have braved very serious things and although starting insulin may be a bit scary, you really can do this.

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