Here’s what you need to know when it’s time to start using insulin

If you’re about to start insulin, you may have some concerns about what it will mean for you. Dr Kate Marsh explains…

If you’re like most people with type 2 diabetes, you probably want to avoid taking insulin. You might worry about the side effects, the risk of low blood glucose levels (BGLs), how it might affect your lifestyle, the impact on your weight or you may fear the injections themselves.

But even if you’ve been careful with your diet and exercise, the need for insulin is a natural progression of type 2 diabetes. In fact it’s estimated that around half of those with type 2 diabetes will need insulin within 10 years of their diagnosis.

So, while it’s normal to be apprehensive about starting insulin, understanding more about the injections can help to reduce some of the fears you may have about the transition.

YOUR CONCERN

Insulin is the last resort

The facts: it’s understandable to think this, particularly if you’ve tried everything else possible to avoid insulin, but it’s not the case. In fact, there’s now a move to start people with type 2 diabetes on insulin earlier, rather than leaving it as a

“last resort”. The truth is that keeping your BGLs in your target range should be the goal, and if insulin helps to achieve this goal then it’s better to start sooner rather than later.

YOUR CONCERN Needing insulin means my diabetes is more serious

The facts: everyone with diabetes should take it seriously, regardless of how it is treated. The main problem with diabetes is the complications that occur from having high BGLs, so your goal should be to maintain your glucose levels as close to the normal range as possible. Whether you need insulin, tablets or just lifestyle changes to do this doesn’t matter

– it’s the high BGLs that are the serious concern.

YOUR CONCERN Needing insulin means I’ve failed

The facts: needing insulin doesn’t mean you’ve failed, it’s just a natural progression of your diabetes. It also doesn’t mean that all the efforts you’ve put into changing your diet and exercising have been wasted. Eating well, exercising regularly and losing weight can delay the need for insulin and will help to keep the dose of insulin you need smaller when you do need it. Remember that managing your diabetes isn’t just about BGLs either – a healthy lifestyle can go a long way towards improving your overall health and reducing your risk of experiencing complications, particularly heart disease.

YOUR CONCERN If I take insulin I could have a bad hypo

The facts: while hypoglycaemia, or a low blood glucose reaction, is more of a risk when you are taking insulin, you can significantly reduce your risk by understanding how insulin works and how to balance it with your food and activity levels. In addition, most hypos

“Needing insulin doesn’t mean you’ve failed, it’s just a natural progression of your diabetes.”

are relatively mild and easy to manage if you treat them promptly. When you start insulin, your diabetes educator can help you to understand more about hypos, what you can do to reduce your risk and how to treat them effectively if they do occur.

YOUR CONCERN The injections will be painful

The facts: some injections do hurt, particularly those most of us are familiar with, such as having blood taken (a large needle into a vein) or vaccinations (a large needle into muscle). Insulin injections are quite different. The needles are very small and fine and injections are given into the fatty tissue just underneath your skin where there are very few nerves. Syringes have largely been replaced with pen devices that are convenient and easy to use, so while it’s normal to be apprehensive about giving yourself an injection, most people find this is relatively easy and painless once they’ve managed to get past the first one. In fact, most people find it to be less painful than the finger prick to check their BGLs.

YOUR CONCERN I’ll gain weight if I start taking insulin

The facts: it’s normal to gain a few kilograms when you start insulin, mainly as a result of improving your BGLs. When your BGLs are high, some of the extra glucose is lost in your urine. Once you start insulin and your BGLs come down, you are able to use all of that glucose, so a small weight gain is common. But you can keep this to a minimum by eating well and exercising regularly. Starting insulin can also be a good time to see a dietitian, as they can not only help you to understand the relationship between the food you eat and insulin, but also help you come up with a plan to keep weight gain in check.

So, if the time has come for you to start taking insulin, don’t think about this as a failure. Instead, think about it as a way to help you lower your BGLs, reduce your risk of complications and, in doing so, improve your overall health and wellbeing.

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