I am a diabetic and hesitent to try insulin
Type 1 or Type 2?
It doesn’t matter, really. I’m a Type 1, so my immune system has been destroying the cells that make insulin.
So what I need is insulin. Metformin and Glimepiride won’t help me. Metformin could only reduce glucose from the liver so well and glimepiride would be beating a dead horse. Increasing insulin production won’t help when your pancreas isn’t making enough on its own.
So, why would a Type 2 need insulin?
If your insulin resistance (which is what Type 2 is) is such that glimepiride cannot flog your pancreas enough, there can come a time when you’ve exceeded your pancreas’s ability to overcome your insulin resistance. You need insulin, but you can’t get enough from your pancreas to overcome your insulin resistance…
So you need insulin. (you also may need because of temporarily high blood glucose levels as well).
Insulin is not failure. If you need it, nothing else will really do. Allowing the glucose in your blood to be distributed to your body’s cells is much more important than your resistance to the idea of taking insulin. You will overcome your fear of injections. The needles don’t hurt very much (if at all) if you’re doing it right.
You’ll also discover that your control can be better. You’ll feel better.
As someone diagnosed with Type 1 at 43 (I’m 50 now), I wanted to get the treatment that works. What that treatment WAS changed over time, because, at first, my pancreas was still making enough insulin to be coaxed into working to cover my meals. After 18 months, that was not the case. I’d gone from 6-7% A1Cs to 10%.
Once I started using mealtime insulin, I was able to control my BG much better. Is it perfect? No, because diabetes. AND, the synthetic insulins aren’t perfect. They take too long to start working and stay around in the body too long. But it’s better than the previous treatment for Type 1: starvation diets.
So, yes, it’s a pain, but it is not failure. It’s reality. Can you change your reality? If you have Type 2, possibly (by lowering your insulin resistance), but there are no guarantees. For me and all the other Type 1s, until there is a cure–which has been 5-10 years away for 50 years–insulin it is.
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Hello!
Is there a piece of insulin therapy that you are more hesitant about? The actual shots, ths effects, the regimen, etc?
Maybe something very important to keep close is that insulin isn’t a failure or a step in any certain direction. It is simply a “different” treatment option for your diabetes. Whatever medication it is that makes each of live our best life with diabetes is the best option!
Have you started insulin therapy already?
We’re here for you!
Both in the public mind and (unfortunately) among many medical professionals who ought to know better, there is too often a tendency to view insulin as evidence of failure, i.e., a “last resort”. In reality that belief is complete nonsense, but there are understandable reasons for it.
Most people’s fears of insulin are based on one or both of the following:
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Most people have either known (or been told about) someone who was put on insulin and then faded out quickly. So insulin is associated in the popular mind with failure. Those cases are not the insulin’s fault; they are the fault of prescribing it when it’s too late to do any good. The tragedy is that if it had been prescribed soon enough, the person probably would never have reached that state in the first place. One of the BIG problems with the medical establishment is that too many doctors consider insulin a last resort and won’t prescribe it in time to make a difference.
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Some (many) people are afraid not of insulin itself, but rather of needles. 20 or 30 years ago, that made a lot more sense than it does now. Modern syringes and pens use needles so fine that they’re not a whole lot bigger than a human hair. Add to that the fact that insulin is injected subcutaneously, into the fat layer beneath the skin, and the result is that there is very little sensation at all. It isn’t like getting, say, a tetanus or flu shot. You may find this hard to believe, but a finger stick is considerably more uncomfortable than an insulin injection using current tools. So . . . bottom line. The key to good control is using the most appropriate tool available. In the individual case, perhaps that’s insulin and perhaps it’s not. But it most definitely is not something to fear. If it’s the right solution, it’s a gift. Pure and simple.
I have a real problem with that “last resort” mentality. It’s ridiculous. If you have a problem, you choose the right tool to fix that problem. If you had a broken leg, would you put off having a cast as long as possible? Would you consider it a “last resort”? Of course not! You’d want it and you’d want it RIGHT NOW. It would be the correct answer to the problem.
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To be apprehensive about insulin is completely normal. It is a powerful drug that demands respect. That being said it is not the monster that society makes it out to be. With the proper training it can be used safely.
Insulin has been used as a scare tactic by many doctors in an effort to keep their Type 2 patients in line. This has created an unnatural fear of insulin that is undeserved. This fear also spills over into T1 patients. This tactic has really been a disservice to the diabetic community.
I have been Type 2 for many years and I use insulin in the same way a Type 1 does. I feared it before starting but now I embrace it. In hindsight I can see that I should have started years earlier.
There is a lot of work that goes into its use but it is manageable. If you are T1 unfortunately it will become mandatory in a short while, just remember that it is not the end of the world. For Type 2’s that have reached the stage of requiring insulin I will repeat that it is not the end of the world. If you are T2 that now needs insulin embracing it will be the best thing you can do for yourself.
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I was really hesitant to use insulin, too. But although my PCP initially diagnosed me as a type 2 and treated me with type 2 oral meds for a year and a half, they really didn’t do all that much good, so in addition to them I had to basically starve myself to get my A1c down to 7.0 or lower. I ended up losing so much weight that I got down to a scrawny 105 pounds, way underweight. My doctor finally referred me to an endo, who put me on insulin before he even got the results of my antibody tests back, which showed me to have a version of type 1. Then he was going to turn me back to my PCP.
But I knew from her previous comments that she was extremely uneducated in using insulin and would take forever to get my doses adjusted properly. So upon the suggestion of those on a diabetic message board, I got the book Using Insulin by John Walsh and treated it like my insulin bible. Knowing what one is doing with insulin takes most of the fear out of it. Oh, I still three years later often hesitate before I jab the needle in my abdomen, but I know I have to do it to stay alive, and it isn’t nearly as bad as I had imagined.
If you do have to use insulin to get good control, if you learn all the ins and outs about it, you can do it with confidence. The book I mentioned is a good one, or another similar one is Think Like a Pancreas by Gary Scheiner. Knowledge is power.