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Warming Up to Insulin
By Amy Tenderich
December 2, 2008
5,168
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In case you haven’t heard, there’s a movement underway among medical professionals to get Type 2 
diabetics started on insulin therapy sooner. I know what you’re thinking: “Not me, no way!” But if you keep an open mind, look at the facts, and explore the reality of insulin therapy a little, you may find that your fear and loathing of insulin is quite unfounded.
Let’s break it down, myth by myth:
I just have “a little sugar problem,” so I don’t need insulin!
This is just silly. There is no such thing as “a little sugar problem.” The fact is that diabetes is a progressive illness, and many – if not most – Type 2 diabetics eventually reach a point at which the oral medications lose the ability to stimulate insulin absorption in the body (usually after a decade or so). So their doctors end up recommending injected insulin at some point in their therapy anyway.
And why wait so long? Starting earlier on insulin actually has many benefits: it more aggressively brings your blood glucose levels down, helping you more efficiently avoid the long-term damage diabetes can do. Furthermore, taking insulin, versus pills or other treatments, actually leads to better overall health and well-being. In a large-scale study of people with Type 2 diabetes in Europe (called UKPDS – United Kingdom Prospective Diabetes Study), nearly 70 percent of participants reported an “increase in well-being” following the change to insulin therapy. An average of 1% reduction in A1C levels was also associated with a nearly 30 percent drop in the risk of microvascular complications (small-vessel damage to eyes, nerves, etc.)
Insulin is only for patients at the “end of life”
This belief is an unfortunate holdover from a time when doctors indeed only tried insulin in adult diabetics as a last resort. So many people remember a Great Aunt or family friend who went on those “frightening shots” just before checking into the hospital or passing away. But these days, it’s just irrational to think of insulin as a sign of “bad” diabetes. That’s because insulin is the most effective and most natural treatment currently available for treating this illness – allowing us to live long, active and healthy lives.
The shots are painful
This is really not true. Just like pricking your finger for a glucose test, it occasionally stings a bit, but for the most part, the extremely fine needles available today have done away with the pain factor. Today, you can choose to use an injection pen that allows you to easily “dial up” your doses, and administers them with a tiny 30-guage needle. Or, if you need insulin throughout the day to cover all your food intake, you can consider wearing an insulin pump, which requires just one poke every 3 days when you change the infusion site.
Insulin is dangerous: I will go too low!
You do have to be more careful about hypoglycemia (low blood glucose) when you’re taking insulin. But two things help here: Most Type 2s start out with insulin gradually, by taking a once-a-day long-acting insulin first, and then slowly transitioning to using more short-acting insulin throughout the day. So you’ll have a chance to “learn the ropes.” Also, being on insulin forces you to be more conscientious about your diabetes. You will have to check your glucose more often in order fine tune your dosing. So you’ll find you are much more “plugged in” to where your glucose levels are and where they might be heading.
5. Life is not fun on insulin
Hey, diabetes is not fun! But don’t blame the insulin.
In fact, you might be surprised to learn that being on insulin may even be less restrictive than your current regimen. You may gain more freedom in your diet rather than less, because you can pretty much eat whatever you like (within reason) as long as you count the carbohydrates and dose accurately for the foods you choose. Of course you can’t load up on simple sugars, but you can mix and match your foods throughout the day. And you can reach for that extra piece of fruit as long as you increase your insulin dose accordingly.
So have you warmed up to the idea of taking insulin yet? Good. Now go talk it over with your doctor.
——-
Amy Tenderich is creator of the popular web log www.diabetesmine.com and co-author of the guidebook, “Know Your Numbers, Outlive Your Diabetes.”
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Comments (35 comments)
Add your commentWhy isn't there any mention of all the weight gain that will happen once you start taking insulin? And that it is impossible to lose the extra weight because insulin takes glucose two places: to your cells for energy and anything left over goes directly to your fat cells. Insulin then inhibits weight loss by preventing the release of that fat back into the blood stream.
You don't gain freedom, you gain a lard ass. Check out the Joslin Center and Mayo clinic websites. Both admit that gaining weight is a part of using insulin. Both say that you can minimize weight gain but then stop there. That is because they haven't got a clue how it can be accomplished.
insulin is the best!!!
The article has certainly given me some things to think about. o maybe rethink is a better way to put it.
Thank you Amy for suggessting this it has helped.
The stars were already shaded in and I couldn't change them so please don't go by them. I feel the articl has helped and I am considering insulin therapy.
Extremely helpful. I would like to possibly buy Amy's book.
My endocrinolgist tried workinng with diet and exerciss until I was operated on for breast cancer. Now its insulin and oral mledicine. My medical needs have radically changed. I would prefer just diet and exercise. That wasn't working. My biggest complaint…I've gone through two doctors, Neither has told me what type I am or what my acs1 is. All I know is my blood glucose should be around 120. Let me tell you that's hard work.
where can i find your book… let me know.
Mace Martinez jr.
Amy, I like to your articales very much… you are the first
person that I know that makes sense.
keep emailing your articals, I really enjoy reading them.
Mace Martinez jr.
I saw first hand all the complications that go along with diabetics, from my grandparents to my mother that ended up with multiple amputations. If insulin can cut that risk by 1% then you cannot afford to stick your nose in the air about it. I am now currently on insulin and besides it being a 'pain' as far as inconvenience for about 10 minutes, long enough for me to get my stuff together and take my shot, I love it, I'm no longer afraid of what the future holds for me when it comes to my diabetes
I appreciate the article it gave me some new information. I've been on insulin for about 4 years since none of the oral medications, either alone or in combination, worked for me.
I won't say I like it but I don't mind it. I take 2 shots a day 1 in the morning shortly after I get up and the 2nd just before bed. When I was in the hospital they gave me those 2 plus one after each meal based on the number of carbs the hospital dietician said were in the meal. I probably should be taking those extra shots at home but so far Doc hasn't said I need to, so I don't.
This is very interesting to me. I see the point totally. I use to be on it regular with oral medication too. But I crashed and dropped to not need ANY kind of Diabetic medication for some odd months. But when put back on I was elsewhere and I was put on oral medication and sliding scale only…as I am today.I now have a new doctor since then even, have not really talked about it, so I will, I go next Friday actually so we'll see what he says, something tells me he won't agree though, but ya never know. Thank you! Sheila
If your sugars are high, it is much better to start on insulin. It will get and keep you in much tighter control. tighter control means less problems or complications in the long run. It does seem to be the method of treatment anymore.
I think it's a great idea. You are already sticking yourself a number of times a day. injections are much less painful than you think.
The important thing to remember is to have some rapid acting sugar, juice hard candy on hand all the time. As insulin can drop your sugar low faster than an oral medication. It also seems that anymore it takes more than one oral med and people are put on at least two.
Talk with your Dr. if your sugars still run high on oral meds and see what he thinks.
If your sugars are high, it is much better to start on insulin. It will get and keep you in much tighter control. tighter control means less problems or complications in the long run. It does seem to be the method of treatment anymore.
I think it's a great idea. You are already sticking yourself a number of times a day. injections are much less painful than you think.
The important thing to remember is to have some rapid acting sugar, juice hard candy on hand all the time. As insulin can drop your sugar low faster than an oral medication. It also seems that anymore it takes more than one oral med and people are put on at least two.
Talk with your Dr. if your sugars still run high on oral meds and see what he thinks.
I really enjoyed reading this article, because it has given me better insite into taking insulin. I have taken more than my share of oral medications and my doctor says I'm running out of choices. My last appointment he brought up the idea of insulin use, this article makes me feel more comfortable about the possibility of beginning insulin to control my type 2
,.
Amy,
Great article.
Thanks,
Maggie P
I had developed drop foot due to my previous Doctor not listening to me. I was walking with a cane for nearly 4 months. My new doctor put me on insulin and within 2 weeks I no longer needed my cane. I think if the numbers aren't getting lower, you need to add insulin. It worked wonders for me. The shots don't hurt like they did many years ago when the needles were so big. The needles now are micro thin and much easier to deal with.
If you can't get your numbers down you need to do this, for yourself and your family.
I agree. I have friends that are type 2
and after being put on insulin, they seem to have better control which they didn't have before…Debe
Hi Jolie,
It is possible for a Type 2
to reduce or stop taking insulin, yes, but it's not too common. It depends on the "stage" of your diabetes, of course, and a huge commitment to lifestyle changes that will bring your glucose levels into a healthy range.
Is it true that once a Type II starts on insulin they can never get off of it? My doc started me on insulin after 5 years of oral meds no longer gave the control that we wanted. I was hopeful that once I lost weight and was able to manage my numbers with diet and exercise I would eventually be able to reduce the insulin or stop altogether. Am I wrong in thinking that? Thanks.
Insulin therepy is a have-to-have, to live, situation for people with Type 1 Diabetes. They no longer produce insulin because there pancrease quits making insulin. Type 2
Diabetics still produce insulin. They are just not able to absorb the insulin, the way they should. People with Type 2 
Diabetes can get there blood sugar levels in complete control, with the proper nutrition. They can even get rid of there Diabetes. Just a matter of some education on Diabetes, along with eating properly.
Diabetes. My daughter will have to take insulin for the rest of her life. There is NO CURE for Type 1. (as-of-yet) But, we still have hope that someday they will find a cure for this deadly disease
When my daughter was 12 years of age, she was diagnosed with Diabetes. Type 1, of course. Most of Type 1 Diabetics are children when diagnosed. At the time that she was diagnosed, her body was still producing insulin. Very little, from what I understand.
Once you start on insulin, your pancrease will stop producing insulin, too. You are giving up every chance to, ever rid your life, of Diabetes. Once insulin dependent, you can never go back.
You can beat your Type 2
Amy, this is extremely good, one of the best I have ever seen on the subject.
Karisue, injecting or infusing insulin is thought to relieve stress on the pancreas, which is likely producing all the insulin it can. It is thought that this injection/infusion will help cut down on beta cell exhaustion, prolonging your own production of insulin.
I have had 3 lows this year in the 50's. I use novolog in a cozmo pump. Before the pump, I used to have lows in the 40's at least once a week, from Glipizide, which is an oral medication that induces your pancreas to produce all the insulin it can.
I have an average A1c of 5.02 this year, and a Standard Deviation of 14, for those of you who know what both these terms mean. Moderately low carbohydrate intake of 80 per day helped me do this, and helped in loosing 35 pounds which I have kept off for a year.
's on insulin can accomplish control to a level that most T1's cannot reach.
Check out the December Diabetes Forecast if you want to read more about it. Type 2
-Lloyd