Starting new insulin plan and scared!

It’s been 8.5 years of being diabetic and having dr’s and diabetes specialists trying to get me to give shots before I eat. The diabetes has gotten worse over the years and it’s time now. So I meet with the diatitian and diabetes nurse to put together a plan for my dr and next week I see my dr and I get started. I’m scared!!! Scared of having to much insulin and scared of not enough, scared of mixing up the pens, and just scared I won’t be able to do this. I live alone so if I have troubles I have no one to help me correct or tell me what I should do. Hoping I’m a fast learner but if You could please put me at ease if it’s as hard and scary as I am thinking or not. Thank you!

Chin up, and keep on going. You'll be fine :) Biggest recommendation and to give you a kind of safety net is test your bloods, and test often. It's also good to see how the new plan is working out through the day. The more info you gather on what your blood is doing, the more control you have, and the more you will believe in your control of it :) Stick to the plan.

Insulin pen wise, I always liked different coloured cases and pens. Used to have a Blue one for quick acting and a Silver one for long acting. Made it easier to quickly see :)

Just need to remember that there is nothing stopping any of us doing anything we want to do, eat, or enjoy. We just need to think a little more than most and react to it. Every day is a new lesson, but we all can do it! :)

If the pens are the disposible kind, I feel like a good doctor should give you different brand for each kind instead of giving you say levemir and novolog flex pens or lantus and apidra pens as those are easier to mix up than they should be. If you're in that situation, be sure to put stickers on the pens (maybe on the caps?) and regardless stickers might be a good idea even if you're like me and have Lantus and Novolog where the pens are drastically different in color.

If you're using reusable pens make sure that they're different colors. As far as I understand, most companies make reusable pens in different colors for the fact that most diabetics on insulin use long acting and rapid insulin. Stickers are a great idea here too.

I know you can do this. ask your dietitian and nurse to put in your plan things to help remind you of things. Even a simple checklist can help. And have faith in yourself, once these things start to become routine you won't even have to think of them, you will just do it. And I have faith in you.

When I was first diagnosed, I would get worried about using the wrong pen for an injection, so I put a piece of green tape on the fast-acting insulin pen and yellow tape on the long-acting insulin pen. That way, even if I was in a hurry and not paying much attention, the color would jump out to remind me pay attention to which one I was taking.

Hi hb. My Apidra and Levemir pens are not much different from each other, and I have mixed them up. I take a split dose of Levemir, so the doses are small and even if I do make a mistake, it's correctable, but a big nuisance. To prevent a mistake, I put each pen in a different colored mug, one mug short and one tall.

On the first over-hot day of summer, with my mugs/pens on my kitchen shelf, the pens were ruined--BG of over 400. So now the mugs/pens are in my fridge.

This is great news!!! I understand your fear, and probably a bit (or a lot!) of guilt and regret that your diabetes is so bad now that you have been enfeebled to the point of having to take insulin.

NOTHING COULD BE FURTHER FROM THE TRUTH. Insulin therapy is like taking thyroid hormone -- you are replacing something your body has become dysfunctional in producing.

In fact, you are very likely to feel energized, healthier, happier, mentally clearer, and just overall much much better. Insulin therapy is only going to improve your life, probably significantly. The trade-off is some inconvenience, and some new risks (hypoglycemia) that are managable.

I'm guessing you're Type 2, based on your time with diabetes but not on insulin. If so, and if your pancreas has enough function to handle basal requirements (likely true at this stage), I would advise simplifying your plan and just use a single type of insulin -- fast acting -- for meal-time and correction bolusing. Work to get your BG in line with something like Humalog, and learn how to use that insulin. This is the most complicated insulin to figure out, the one that you inject "as needed", and frankly will have the biggest impact on your BG control if you have some beta cell function.

It also eliminates the issues with potentially mixing up insulin pens, and one of the major hypo risks -- injecting fast-acting when you though you were injecting your basal.

Now, a lot of the terminology used above is probably confusing. The best thing you can do is spend and hour a day for the next week or so browsing around this site, asking questions, getting up to speed. Be an expert on your condition. Know what basal, bolus, fast-acting, long- acting, pre-bolusing, carb ratios, etc. etc. etc. all are before you inject anything. Get well informed and you will be successful, in control, and confident -- instead of scared.

This is an exciting time, trust me. I speak from experience as a 15 year T2 one year into insulin therapy and the only negative of the whole thing has been regret I didn't start many years earlier.

You can do it! Like you, I was on meds for about 8 years. About 4 years in, my doctor tried me on novalog shots. I wasn't happy about giving myself shots. My levels came down to a point where I was not having to give myself shots, so I abandon the novalog. Several years later, just recently, all the meds I was on was doing more harm than good. BS went up, started feeling bad, everyday I felt like a Mack truck hit ran over me. Doctor put me on insulin, long acting and the novalog. Since I've been on the insulin, eating less carbs, exercising more, and lost weight, I totally feel like a new person! Since my sugar levels have come down from the upper 200's down to lower 100's, I only give myself the one shot in the morning. Rarely have to give myself the novalog now. Again, you can do it! All the best, Tim.

hb, you're going to feel so much better, at least that's the overwhelming consensus of opinion from all my type2 friends on insulin. the most often heard comment is "I wish I started insulin earlier". please join this group

Maybe you can set some alarms to remind you to check your bg and inject. and come visit us in the chat room any time you want to talk. and like nya said, do lots of checking on your bgs at first, and keep good records of what you're eating and doing, that way it will be easier for your team to make any adjustments.

you can do this!!!!

I'm gonna agree I should of added this into my post, but I was misdiagnosed as a type 2 and my blood sugar was not the only day and night difference on insulin. For probably a good year or two I was VERY FATIGUED, irritable, severely depressed, not really myself...then I got diagnosed with diabetes. On metformin , I had no progress on anything, but when I was put on insulin after a proper diagnosis my mood went up a lot and I'm now a really happy energetic person. I went from feeling like mental and physical crap to pretty amazing and like I did a few years before. There was only improvement, and I have very few hypos and I actually feel like I live a normal life instead of being mad at everything and wanting to sleep all day.

It's definitely not failure or something bad for a type 2, it's taking care of yourself. It's just like type 2's who work hard with diet and exercise and get there without medications or can get off them even, it's doing what is best for YOU and finding what is best for YOU , and it's likely at this point insulin is best for you. Type 2 is progressive, where once you progress, you have to take the same strides you did before to further your treatment and improve it for your health.

I wish I fought a little more in the beginning for insulin though, even if I was a type 2, I'd fight for it. It seems like the most effective treatment with the least side effects. Other than hypos , but the rare amount of mild hypos (I've yet to go below 55 mg/dL) I have doesn't make me feel too bad compared to some of the risks attached to other diabetes drugs...where if I was a type 2 I wouldn't want those either.

I wish I fought a little more in the beginning for insulin though, even if I was a type 2, I'd fight for it. It seems like the most effective treatment with the least side effects. Other than hypos , but the rare amount of mild hypos (I've yet to go below 55 mg/dL) I have doesn't make me feel too bad compared to some of the risks attached to other diabetes drugs...where if I was a type 2 I wouldn't want those either.
You go girl!

Some valuable wisdom there. Before voluntarily going on (more accurately, demanding) insulin, I was taking a drug cocktail of metformin, glipizide, and Actos. It is my opinion that a decade of sulfonylureas played a part in the exhaustion of my beta cells and progression of my disease. Thiazolidinediones (Actos) have some scary side-effects, so I didn't really like taking that either.

June 2013: Dave has a diabetic crisis, decides to go for tight control, only possible with insulin.

July 2014: Tight control achieved, a1c last month 6.2 (down from the 11+ during the crisis a year ago). Now the only pill I pop in addition to a multivitamin and an 81mg daily aspirin is metformin.

And, like you, I've felt like a million bucks over the last year compared to years prior (excepting the cold or two I've had in the last year).

Do not be scared of getting treatment. I crossed the bridge to insulin year before last. With the help of many here on this board, I was able to educate myself and help in my own treatment. They will probably start you out on a low dose then gradually increase as you evaluate your glucose numbers and your diet. Time of day makes a difference too. I kept a diet journal with my numbers and my meds to track what my body was doing. For the best results, it takes a proactive approach by the person with diabetes. We, crossed that scary bridge when we first got diagnosed then when we had to navigate into insulin. Do not can do it. YOU CAN DO IT!!

This will get much easier once you get more comfortable with it. Obviously, too little insulin can be corrected with correction shots and too much insulin can be corrected with some carbs.

I get frustrated, like any diabetic, when have highs or if I have lows, but the best we can do as diabetic is work at getting our AVERAGE BG closer to normal. So, don't beat yourself up too much. This is clearly an iterative strategy and anything we do to treat our diabetes is far better than doing nothing.

You said you worry about "mixing up the pens." What pens are you currently using?

One suggestion is to always write down the dosing info in a log. I've been on a pump for 12 years and one of the things I like best is I can look back and see all those details. Once you get more used to it, it is easy to forget if you took a shot or not. Good luck! You can do this. Let us know how it goes.

I live alone and have had T1 for 40 years.
You can do it!
Ask, ask, ask questions. There is NO such thing as a dumb question. If you forget to ask, then call the office when you remember - don't wait.
And, write everything down, at least as first.
Could you maybe keep the pens in two separate places, like long acting on the top shelf and rapid acting on the bottom? Just anything to keep them distinct and separate.
Everyone here has given such great advice. That's what I love about TD!
All my best to you.

Thank you for the encoragement advice and the help. I am on humulin and was on NPHge for afew years, did the cocktail pills for afew of those years and went back to humulin a couple years ago. But it has always been just 2 shots aday(9am and 9 pm) I have a burgandy pen that I change the viles(?) in. My A1c went up to 10.5 earlier this year so my Dr gave me extra insulin and I had lows in the nights. I had a A1c done a month ago and it was down to 8.2. I finished school and had told my dr when I would be ready for another challenge in my life and it’s time. But this change scares me. I saw my dietitian today and got some help to get started, we have another meeting with the nurse next week and see the dr 2 days after that. So it’s going to be a busy week of learning!! The plan is to give a shot of mix 25 humulog and give a shot of the stuff I’m on now…humulin and test LOTS!!! My work schedule is a little wierd as far as when breaks are and when I eat so we have 2 plans set up for work days and non work days. I work at a restaurant in the kitchen.

I would second the opinion that you might want to go for a basal - bolus routine especially if you have a complicated work schedule. One way to make sure that you don't mix up your basal and bolus pens is to keep them in different places. I always kept my Lantus (basal) pen in my bedroom while I carried the Humalog (bolus) pen with me and left it near my kitchen over night.

Oh, and ask your friends and others you know who is a good endocrinologist to go to. That makes a big difference. Just starting out, too many confusing terms, names of medicines, etc...can be overwhelming and discouraging. It does take work but you will feel better after the adjustments are improved. Take it a day at a time. Learn to count carbs and what affects YOU the most by keeping a diary and checking glucose...and make sure your endocrinologist works closely with you. I had to report every 1-2 weeks on how my Lantus was doing for me, then how my Apidera,taken before meals were was working for me. Wear a medical alert.

Or, as I suggested in an earlier response, just focus on bolus insulin to start.

Type 1's can't do this, but T2s can if there's enough beta cell function to handle the basal needs, which at your stage of the disease (judging by what you've posted) is very likely the case.

This simplifies what you'll need to learn quite a bit, and eliminates the risk of overdosing bolus insulin when you think you're injecting basal, because you've mixed up the pens.

However, I agree with the others that you should stay away from the mixes. It's an "old-school" legacy treatment approach, and should only be used for patients that are incapable, for some reason, of managing separate bolus and basal administration.

Yeah,I agree with that being old school. I never understand why people get prescribed mixed insulin now unless they've been using them all along and that's what they're used to or something.

I saw someone on another forum say that people who use basal/bolus are lazy , and don't want to rework their life habits to improve their diabetes? I think it's the opposite. People who want to live normal lives and also control their diabetes well, probably should be doing basal/bolus. It's probably the easiest way for people to control their diabetes with insulin? It's probably easier if you get started on either bolus or basal first then ease into the other I think I see where you're coming from with your suggestion? I was started on basal first. Even that alone gave me an improvement and made me feel like I was on the upswing.