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…

Diabetic Living - - Contents -

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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