Is insulin bad for you?

The earliest injections given to people with diabetes were comprised of insulin derived from pigs. Nothing against pigs – we like bacon as much as the next person – but it was a relief when other forms of synthetic insulin were developed in the 1970s, enabling us to live longer, healthier lives with fewer contributions from our porcine friends.

But as terrific as the stuff is for controlling diabetes, it’s not without side effects.

Whether you’ve been taking insulin for a short time – or for a couple of decades like I have – you may sometimes wonder if that rumbling in your stomach is something you ate, or if it’s just your insulin talking.

Here, from people in the know, are four little-known insulin side effects that you may not know about, even if you’ve been using insulin for years.

An Inability to Tolerate Unreasonable People. Since insulin allows glucose to get where it needs to be (in our cells), it affects our blood-sugar levels rapidly. In the process, it may cause us to feel irritable, anxious and jittery, and totally unwilling to deal with the guy who cut in line at the coffee shop. Don’t worry; these unpleasant sensations should quickly resolve, and you’ll return to your normal, relaxed self. (If not, of course, consult your doctor.) Unfortunately, crazy people will still be among us, even after your insulin-induced irritability disappears.

Things are Looking Blurry, and You Haven’t Been Drinking. When taking insulin, your vision may sometimes be blurry, and it’s not because your eyeglasses need cleaning or the aliens are about to beam you up. It’s just another potential side effect of insulin, particularly when you first start to take it. The good news is, not only will this resolve fairly quickly, but as your body adjusts, you may end up with better vision than you did before you were diagnosed.

There are 10 Pounds You Can’t Seem to Shake. It’s not your lack of self-control, or the pastry shop on the way to work. Blame the insulin. It can cause weight gain, small deposits of fat on the surface of your skin, and that odd sense of kinship with water buffalo – sometimes called water retention. You may think this a negative, but millions of people would love to have something other than gluttony to blame for their extra pounds. If you gain weight while taking insulin, this doesn’t necessarily mean that you’re overindulging, but that your body is finally able to properly utilize all calories consumed. So, unless you double in size overnight, there’s probably nothing to worry about.

You Suddenly Want to Run Marathons. True, people with diabetes have to carefully balance their intake of food with the expenditure of energy. And a rapid heartbeat can be a side effect of insulin even without running 26.2 miles. But people like elite American ultrarunner Missy Foy and our friend Gavin Griffiths from Diathlete have demonstrated that with properly monitored glucose levels, people with diabetes can do pretty much everything that people without diabetes can. And a program of well-managed care will make you feel at the top of your game, and able to take on any challenge. Put that in your fine print, diabetes!

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What are the side effects of insulin therapy?

Diabetes impairs insulin production by the pancreas and use of this essential hormone by the body. The condition causes high blood sugar levels.

However, not every person with type 2 diabetes will need to take insulin. People with type 1, on the other hand, will have to supplement their insulin supply for the rest of their lives.

There are three main types of diabetes:

  • Type 1 diabetes: Typically starts in childhood when a person does not produce enough insulin. Usually results from the body’s immune system attacking an otherwise healthy pancreas.
  • Type 2 diabetes: Can develop at any age but 45 years is the average age of onset. Either the pancreas does not produce enough insulin, or the body’s cells become resistant to its actions.
  • Gestational diabetes: Occurs during pregnancy and makes it harder for a woman’s body to respond to insulin. Typically stops after childbirth but increases a woman’s risk of developing type 2 diabetes.

Type 1 and type 2 diabetes are usually lifelong conditions. According to the Centers for Disease Control and Prevention (CDC), more than 30 million people in the United States have diabetes. Type 2 diabetes is the most common, accounting for 90–95 percent of those with diabetes.

Insulin delivery devices

People with type 1 diabetes require daily insulin therapy to maintain regular blood sugar levels. However, the exact treatment regimen will vary from person to person.

An individual can deliver their insulin to their body through a pump. This is a machine that provides the hormone through a port, removing the need for injections. Some pumps are automatic, while others require more user input.

Some individuals may need to supply two to four doses every day. Extra shots of rapid- or short-acting insulin may be necessary at mealtimes.

People also use injections, pens, and inhalers to take insulin.

Here, learn more about insulin pens.

Types of insulin

A doctor can help customize a safe and effective insulin therapy regimen for a person with type 1 diabetes. According to the American Academy of Family Physicians, there are several different types of insulin that people can use separately or in combination.

These include:

  • Rapid-acting insulins that start to work within 15 minutes and can last around 3­–5 hours.
  • Short-acting insulins that take 30–60 minutes to start working and have a duration of 5–8 hours.
  • Intermediate-acting insulins that take 1–3 hours to start working but last 12–16 hours.
  • Long-acting insulins that start to work in about 1 hour and can last 20–26 hours.
  • Premixed insulins that combine a rapid- or short-acting insulin with a longer-lasting one.

A doctor will prescribe one of these insulins or a mixture alongside a carefully controlled schedule. Following this closely will reduce the risk of side effects and complications.

Learn about different types of insulin here.

Non-insulin treatments

People with type 2 diabetes can often manage their condition without insulin therapy.

Alternative treatment options include lifestyle and dietary changes and non-insulin medications, such as metformin. However, if a person is unable to control their blood sugar levels using these treatments, a doctor may recommend insulin therapy.

Women with gestational diabetes typically receive insulin, but they can also manage their diabetes with metformin. A doctor will explain the safest way to take these medications during pregnancy.

If you have recently been prescribed insulin, or have switched to a new type of insulin, you may be concerned about the side effects.

You might also be experiencing side effects and not know where they are coming from.

Similarly, you may be looking for information for a friend or family member.

What are the side effects of insulin?

Insulin side effects amongst diabetics are rare, but when they do occur, allergic reactions can be severe and can pose a significant risk to health.

What do I do if I have an adverse reaction to my insulin?

If you experience mild allergic reactions such as swelling, itching or redness around the injection site, experts advise diabetics to consult their GPs. Similarly, sustained nausea and vomiting are signs of insulin allergy.

How do I know if my insulin is working?

When taking insulin, diabetics are advised by experts to regularly check blood glucose levels using testing kits.

If blood glucose tests show fluctuating or above-average blood sugar levels, diabetes is not being properly controlled and insulin is not working.

Transcript

Insulin is the oldest medication for diabetes and is usually well tolerated by most people. There are various side effects that occur from insulin. Hypoglycemia is the most common, but not the only one. The side effects mentioned in this video are those that are included in patient information leaflets for a number of different insulin types.

Check your insulin’s patient information leaflet to see which side effects are listed as applicable to the insulin you are taking. If you notice any of the side effects, tell your doctor.

Insulin is injected to reduce blood glucose levels and may lead to hypoglycemia. Hypoglycemia is a low blood glucose level which should be treated with carbohydrate. For more information on this specific area please see our treating hypoglycemia video

Some people may get a local allergy –that is itching, redness or swelling at the site of the injection. This will usually clear up within a few days or weeks.

In rare some cases people may get a more severe allergic reaction, known as a systemic allergy, which can include:

  • A rash across the body
  • Trouble breathing
  • Nausea
  • Rapid heartbeat
  • Sweating
  • Drop in blood pressure

Tell your doctor immediately if you have these symptoms.

Lipodystrophy is a relatively rare side effect that causes thickening or pitting of the skin.
It can be described as an abnormality in the way fat is distributed. If you notice bulges or any caving in of the skin, speak to your doctor.

Oedema is known as a swelling of the arms or ankles as a result of fluid retention. Oedema may result from starting or a change to insulin therapy.

And finally, some types of insulin list eyesight problems as a rarer side effect.

Download a FREE insulin duration chart for your phone, desktop or as a printout.

Avoiding infection when taking insulin

When taking insulin, try to avoid infection by using disposable needles and syringes, and sterilising any reusable equipment.

Do some drugs interact with insulin?

Some drugs are known to interact with insulin, and diabetics should be aware of this list. Your GP or physician should provide detailed information of how any extra drug affects insulin.

Some medications that are known to influence insulin are shown below, but diabetics should consult their GP for further information:

  • ACE inhibitors – Accupril and Lotensin
  • Anabolic steroids – Anadrol-50
  • Appetite suppressants – Tenuate
  • Aspirin
  • Beta-blocking blood pressure medicines – Tenormin and Lopressor
  • Diuretics – Lasix and Dyazide
  • Epinephrine (EpiPen)
  • Estrogens – Premarin
  • Isoniazid (Nydrazid)
  • Major tranquilizers – Mellaril and Thorazine
  • MAO inhibitors (antidepressants Nardil and Parnate)
  • Niacin (Nicobid)
  • Octreotide (Sandostatin)
  • Oral contraceptives
  • Oral drugs for diabetes – Diabinese and Orinase
  • Phenytoin (Dilantin)
  • Steroid medications – prednisone
  • Sulfa antibiotics – Bactrim and Septra
  • Thyroid medications – Synthroid

If you cannot find the answers that you need here, please ask a question in the Diabetes Forum

Does Insulin Have Health Risks?

Faced with the prospect of daily insulin injections, you may be more worried about needles and syringes than potential health risks of this diabetes treatment.

In fact, insulin has been so finely tuned that health risks, side effects, and complications from insulin therapy for people with type 2 diabetes are fewer than ever before. That doesn’t mean problems don’t exist, but most are easily overcome with proper education, close communication with your doctor, and following his or her directions.

Here are some potential side effects of insulin therapy that you should know about:

Low Blood Sugar (Hypoglycemia)

Low blood sugar is the most serious complication associated with insulin. Also referred to as insulin reaction, it occurs when your blood sugar drops below a certain level. If your insulin dose is too high or is delivered too quickly, your blood sugar level may drop so low that it can impair brain function. In the most severe and untreated cases, low blood sugar can cause you to have a seizure, pass out, or even go into a coma.

Signs and symptoms of low blood sugar include feeling weak, drowsy, or dizzy, experiencing shakiness, confusion, anxiety, nausea, or headache, blurred vision, and sometimes a loss of consciousness.

Although not always possible to do, the only way to know for certain if you’re experiencing low blood sugar is to test your blood sugar level — a reading under 70 mg/dl often indicates hypoglycemia. Some people can dip to that level without any signs or symptoms, especially if they’ve had diabetes for a long time. If you test and see low blood sugar numbers yet feel no effects, talk to your doctor.

To treat low blood sugar, Take a glucose tablet (“sugar pill”) or sip a sugary drink as soon as you see a dangerous blood sugar reading or detect any signs or symptoms. This will bring your blood sugar level back up.

To prevent low blood sugar, it’s important to understand how insulin works and to be vigilant about your treatment regimen, says Joel Zonszein, MD, director of clinical diabetes at Montefiore Medical Center in the Bronx, N.Y. Make sure your doctor spends the time necessary to teach you what you need to know about insulin therapy for type 2 diabetes.

“Everyone who takes insulin should know how to monitor their blood sugar,” says Aaron Cypess, MD, PhD, MMSc, an assistant professor at the Harvard Medical School and an assistant investigator and staff physician at the Joslin Diabetes Center in Boston. But don’t think of your initial insulin education as all you’ll ever need — have your doctor repeatedly review the signs and symptoms of low blood sugar with you, he says. “The problem with insulin is that it has a very narrow range that works, and finding that proper range can be tricky.”

Weight Gain

A six-year study done at McMaster University in Ontario, Canada, looked at a variety of possible outcomes of insulin use and confirmed that the treatment can lead to weight gain. But the researchers found that the average amount of weight participants put on was modest — about 3.5 pounds over the course of the study.

Insulin is a growth hormone that promotes the storage of essential nutrients, including fats, which can be a problem if you need to lose weight. Work with your doctor or a dietitian to map out a weight-loss strategy.

Allergic Reactions and Infections

Because insulin formulations are no longer dependent on early sources such as pigs or cows, allergic reactions are much less common. Still, mild reactions may include swelling, itching, redness at the injection site, nausea, and vomiting.

You can avoid infection from insulin use by using disposable needles and syringes and by sterilizing reusable equipment.

Drug Interactions

As with virtually every drug, there is the potential for a negative interaction with other medications you’re taking, even over-the-counter drugs and dietary supplements. Possible insulin interactions include alpha and beta blockers and other high blood pressure drugs, steroids, hormone-based contraceptive pills, asthma and cold medications, aspirin, thyroid medications, and even other diabetes drugs. Always go over all of the medications you take with all of your doctors you see and your pharmacist to prevent problems.

Practice Insulin Safety

The key to reducing insulin risks and complications is good education and regular visits with your doctor at least every three to six months.

If your doctor has decided that insulin is the best treatment choice for you, whether in addition to other drugs or by itself, you can rest easy: Insulin is a safe and effective medication for type 2 diabetes, says Derek LeRoith, MD, PhD, a professor of medicine, endocrinology, diabetes, and bone disease at the Icahn School of Medicine at Mount Sinai Hospital in New York.

The Effects of Insulin on the Body

Insulin is a hormone produced by the pancreas. Its function is to allow other cells to transform glucose into energy throughout your body. Without insulin, cells are starved for energy and must seek an alternate source. This can lead to life-threatening complications.

Insulin is a natural hormone produced in the pancreas. When you eat, your pancreas releases insulin to help your body make energy out of sugars (glucose). It also helps you store energy. Insulin is a vital part of metabolism. Without it, your body would cease to function.

In type 1 diabetes, the pancreas is no longer able to produce insulin. In Type 2 diabetes, the pancreas initially produces insulin, but the cells of your body are unable to make good use of the insulin (insulin resistance).

Uncontrolled diabetes allows glucose to build up in the blood rather than being distributed to cells or stored. This can wreak havoc with virtually every part of your body. Complications of diabetes include kidney disease, nerve damage, eye problems, and stomach problems.

People with Type 1 diabetes need insulin therapy to live. Some people with Type 2 diabetes must also take insulin therapy to control blood sugar levels and avoid complications. Insulin is usually injected into the abdomen, but it can also be injected into the upper arms, thighs, or buttocks. Injection sites should be rotated within the same general location. Frequent injections in the same spot can cause fatty deposits that make delivery of insulin more difficult. Some people use a pump, which delivers insulin through a catheter placed underneath the skin of the abdomen.

Endocrine, Excretory, and Digestive Systems

When you eat, food travels to your stomach and small intestines where it is broken down into nutrients. The nutrients are absorbed and distributed via your bloodstream. The pancreas is an organ located in your abdomen between your stomach and your spine. This integral component of your digestive system produces insulin and releases it into the bloodstream when you eat. Insulin is an important part of metabolism and necessary for turning glucose into energy and distributing it to cells all throughout your body.

Insulin helps the liver, muscle, and fat cells to store the glucose you don’t need right away, so it can be used for energy later. In turn, the liver produces less glucose on its own. This keeps your blood glucose levels in check. The liver releases small amounts of glucose into your bloodstream between meals to keep your blood sugars within that healthy range.

Circulatory System

When insulin enters your bloodstream, it helps cells throughout your body — including in your central nervous system and cardiovascular system — to absorb glucose. It’s the circulatory system’s job to deliver insulin.

As long as the pancreas produces enough insulin and your body can use it properly, blood sugar levels will be kept within a healthy range. A buildup of glucose in the blood (hyperglycemia) can cause complications like nerve damage (neuropathy), kidney damage, and eye problems. Symptoms of high blood glucose include excessive thirst and frequent urination. Too little glucose in the blood (hypoglycemia) can make you feel irritable, tired, or confused. Low blood sugar can lead to loss of consciousness.

When you don’t have enough insulin, your body’s cells begin to starve. Because the cells can’t use the glucose, they begin to break down fat for energy. In addition to a buildup of glucose in your blood, this process creates a dangerous buildup of chemicals called ketones. Symptoms include sweet-smelling breath, dry mouth, nausea, and vomiting. Your body tries to get rid of the ketones through your urine, but sometimes it can’t keep up. This causes a life-threatening condition called ketoacidosis.

If you have diabetes, insulin therapy can do the job your pancreas can’t. Rapid-acting insulin reaches the bloodstream within 15 minutes and keeps working for up to four hours. Short-acting insulin enters the bloodstream within 30 minutes and works for up to six hours. Intermediate-acting insulin finds its way into your bloodstream within two to four hours and is effective for about 18 hours. Long-acting insulin starts working within a few hours and keeps glucose levels even for about 24 hours.

Blood tests can quickly indicate whether your glucose levels are too high or too low.

18 Questions About Taking Insulin

Stuart Weiss, MD, is a clinical assistant professor of endocrinology, diabetes, and metabolism at New York University’s Department of Medicine, NYU Medical Center, in New York City.

Q: I have type 2 diabetes. Do I have to take insulin?

A: For people with type 2 diabetes, insulin is a very nice tool that’s better if used sooner rather than later. (Unlike in type 2 diabetes, in type 1 diabetes insulin is a requirement, not an option.) What happens in type 2 diabetes is that physicians may use insulin as a threat, an “if you” thing—if you don’t lose some weight, if you don’t do some exercise, if you don’t follow the diet, then you’re going to wind up on insulin. That’s really not how people with type 2 diabetes should view insulin—as a punishment. Insulin is a very, very safe therapy, and people should not hesitate to use it if needed.

The people with type 2 diabetes who must take insulin are those who are unable to control their blood sugar even while on several different oral medications. But if you start using insulin before you reach that point, you can help preserve the function of your insulin-producing pancreatic cells for a longer time. And the longer you continue to make your own natural insulin, the longer you can get by with a less complicated insulin regimen, possibly taking just one shot a day.

Q: But I’m afraid of shots!

A: You don’t need to be, if you’re talking about insulin. If you’re picturing big syringes that you have to boil and sterilize, think again. Modern insulin needles are very thin and disposable—no sterilizing necessary. There are also insulin pens equipped with an insulin cartridge and disposable needles that are so simple even a child can use them. Either type of delivery system makes using insulin very easy and virtually painless—really.

If you pinch the injection site before giving yourself a shot, it will hurt even less. Still, the needles are so small these days that pain is not really an issue any more.

Q: Won’t too much insulin cause me to go into a coma?

A: Theoretically yes, if you take lots and lots of insulin. But in reality, the kind of severe hypoglycemia (low blood sugar) that would cause someone to go into a coma is extremely rare in people with type 2 diabetes. Hypoglycemia is a bigger risk for those with type 1 diabetes.

Q: Will I have to take insulin forever?

A: It depends. Many people can eliminate their need for insulin if they eat less, exercise more, and lose weight, and if their beta cells (which make insulin in the body) are still functioning adequately. But if your doctor has waited to prescribe insulin until you can no longer make this hormone on your own, then yes, you will have to be on insulin for the rest of your life.

Q: Why can’t I just take a pill?

A: Some diabetes medications aren’t great to use long-term, while insulin is extremely safe. Rather than waiting to take insulin until you’re on several different oral agents—none of which are working any more—it’s better to start well before you’ve added a second or even a third medication.

Q: How many times a day do I have to take insulin?

A: If you can start insulin really early in the course of the disease, one shot a day may do the trick. People whose disease has progressed further may need to take it several times a day, typically with each meal.

RELATED: 20 Tasty Diabetic-Friendly Recipes

Q: Won’t I gain weight?

A: Weight gain is the first sign that your diabetes is under control, whether it’s with oral agents or insulin, because your body starts being able to process sugar again. But the weight is typically gained in a healthier pattern; you may notice that your clothes fit you differently. I tell patients to pay more attention to how their clothes fit than to what their weight is.

Q: Will I ever be able to get on a plane with needles?

A: Airport security employees are pretty familiar and comfortable with diabetic fliers bringing their equipment with them. First, you should notify the security officer that you have diabetes and are carrying supplies with you. As long as any insulin you bring with you has a professionally printed label identifying the medication (the original box it came in usually carries this labeling), you’ll be fine.

You are allowed to take insulin, insulin-loaded dispensing products, unused syringes, and other supplies through the checkpoint once they have been screened. You may want to bring a note from your doctor stating that you have diabetes and need insulin treatment, just to be sure. But nobody has ever come to me and told me that they’ve had trouble bringing their insulin and other supplies on a plane.

Q: How do I prevent hypoglycemia?

A: Hypoglycemia occurs when you have too much insulin in the body, so blood sugar drops too low. Symptoms include anxiety and confusion, sweating, hunger, and, in rare cases, seizures and coma. To prevent this, make sure to match your insulin intake to your food intake, which can take some trial and error. And you should always have a sugar source on hand; eating some will quickly reverse hypoglycemia advise patients to buy glucose tablets. While candy can work too, you’ll be less tempted to snack on the tablets, which aren’t all that tasty.

RELATED: Can Diabetes Kill You?

Q: How can I exercise while taking insulin?

A: Exercise is great because it’s a natural way to lower your blood sugar. However, if you’re taking insulin you need to take this into account when planning your day. You may experience low blood sugar during exercise, or afterward. Again, having a sugar source handy—watered-down Gatorade, glucose tablets, candy—is important, and can quickly reverse blood sugar that is too low.

Q: What kind of food can I eat while taking insulin?

A: You will still have to eat a healthy diet. You can eat as much fish, poultry, and green vegetables (with the exception of peas) as you like, as these are less likely to affect blood sugar as much as carbohydrate-rich food. You’ll need to match your insulin to the amount of carbohydrates you eat in a meal. However, some foods can make it harder for the insulin to control your rise in blood sugar.

You should limit starchy vegetables like potatoes, corn, and peas, which can cause blood sugar to rise. With fruit you also need to be careful. Berries are okay, but pineapples and grapes and cherries are tough.

Eating a piece of fruit as an afternoon snack is a very reasonable thing to do, but not as a before-bed snack or first time in the morning, which can make it harder for insulin to control blood sugar.(That is because hormones that are associated with waking up make it more difficult for insulin to work, and when you’re asleep, your sugar will rise because you’re burning fewer calories.) It can take some trial and error to figure out what food you can eat while keeping blood sugar in the safe zone.

Q: How do I store insulin?

A: Once insulin has been opened, for pretty much all types of insulin you can store it at room temperature for about six weeks. It doesn’t have to be refrigerated. However, you should keep it in a relatively cool place, especially if the room temperature in your home is 85° or more.

Q: What IS insulin? Is it a drug or a hormone?

A: In a way, it’s both. But first and foremost, insulin is a hormone. The beta cells of the pancreas make insulin and release it when you eat a meal. It lowers the blood sugar by multiple mechanisms, but basically by causing cells to take the sugar out of the blood. And for people who aren’t making enough insulin on their own, and must take it to treat their diabetes, insulin is, technically, a drug.

Q: What exactly is insulin resistance?

A: Insulin resistance occurs when a person becomes less sensitive to the hormone and he or she needs to release more and more insulin to lower the blood sugar by the same amount. Insulin resistance further depletes the insulin-producing cells of the pancreas and leads to progression of diabetes. Obesity is a major contributor to insulin resistance, while a healthy diet and physical activity can help improve insulin sensitivity.

Q: Can insulin prevent diabetes complications, like nerve damage, heart disease, and blindness?

A: There is evidence to suggest that if taking insulin leads to better blood sugar control, people are less likely to develop complications. And the earlier you are able to get your blood sugar under tight control, the better your chance of avoiding these complications.

Q: What if I skip my insulin? Could I die?

A: Odds are you won’t. But it depends on how often or for how long you skip your insulin. I tell my patients who use insulin multiple times a day that if they miss a shot, they need to cut the carbohydrate content of the food they eat that day, drink more water to counter the dehydration associated with higher blood sugar, and eat more green vegetables and less starch.

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Q: What is an insulin pump? Do I need one?

A: Probably not. An insulin pump is basically a system for delivering the hormone to your body. It can be adjusted to release different amounts throughout the day. While these devices can be helpful for people with type 1 diabetes, for most type 2 diabetics they’re not necessary.

Q: Can I get addicted to insulin?

A: If you’re asking whether your body can become dependent on insulin, it depends. If your body is still producing some insulin on its own, there’s a chance you could reduce your need for extra insulin by eating healthier, becoming more active, and losing weight. However, if your body can no longer produce any insulin on its own, you will indeed be dependent on it, but not because you’re taking insulin as a drug. In type 2 diabetes, insulin resistance damages your natural insulin-producing cells and this may increase your need for taking insulin as a drug. Disease progression can leave you dependent on insulin—not the insulin itself.

One of my nurse educator colleagues was recently featured in a teaching video on how to inject insulin. As part of the video, we asked people who have diabetes and who take insulin to answer some questions about what it’s like to have diabetes, including following a meal plan and injecting insulin. While a few of the people (two of them were young women) boldly stated that they disliked having to take insulin (or as one woman put, “poke herself”), all of them agreed that insulin was a good thing and that, if you need it, take it.

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As a dietitian, I’ve dealt mostly with the “food” end of diabetes, but of course, food and insulin are so closely intertwined that you really can’t talk about one without the other (and vice versa). More and more people have diabetes, as you’re aware, and more and more people are taking insulin. Now, you know that if you have Type 1 diabetes, you have to take insulin in order to live. Right now, there are no other options for treating Type 1.

With Type 2 diabetes, things are a little murkier. Some people with Type 2 can manage just fine, at least for a while, by following a meal plan, controlling their weight, and getting regular exercise. Most people, though, are started off on a medicine (usually metformin), along with a meal plan and physical activity. After a few years, one or two more medicines (usually pills) are added. And then, after that, typically comes insulin. It’s at this stage where people beg, plead, cry, or yell to do anything to stay off of the dreaded “needle.” Why is this? Well, an obvious reason is that most of us don’t like needles. They can hurt. They’re sharp. They look long. But there are other reasons for not wanting to go on insulin, besides having to “take a needle.” I’ve listed some of the big ones, below. You may have others.

Top 5 Reasons for Not Wanting to Go on Insulin
Having to go on insulin means that you’ve failed. Why would needing to start insulin mean that you’re a failure? You may not feel this way, but plenty of people do. “If only I’d followed my meal plan/lost more weight/done more exercise…” may be the thought that races through your mind. Or maybe you’ve shaken your fist at your diabetes pills, blaming them for letting you down. The reality is that Type 2 diabetes changes over time. The beta cells in your pancreas stop making enough insulin, and as a result, blood glucose levels get too high. In some people, this progression happens more quickly than in others. Everyone’s different. But holding yourself responsible isn’t going to change much. It may help you to keep in mind that your body needs insulin, whether you make your own or you inject it.

Going on insulin means that your diabetes is getting worse. This one is closely tied to the first reason. Your diabetes isn’t really “worsening,” it’s just changing. That’s what Type 2 diabetes does. What you should try to realize is that insulin is a helper and works to keep your blood glucose levels in a safe range so that you can avoid short-term complications (like high blood glucose) and long-term complications (like eye, kidney, and heart disease).

Insulin will cause all sorts of unpleasant side effects. The insulin that you inject is practically identical to the insulin that your body makes. Insulin is a hormone, so it’s safe and natural. The major side effect of insulin is low blood glucose (hypoglycemia) and that can easily be prevented and treated. Diabetes pills, while extremely beneficial, have way more side effects than insulin. Insulin does not cause blindness, amputation, or other complications. Not taking insulin (if you need it) is what can lead to problems. Remember that your goal is to keep your blood glucose and your A1C in your target range: insulin will help you do that, big time.

Taking insulin will hurt. OK, years ago, needles were long and thick and they most likely did hurt somewhat. Today’s needles are super-thin and they come in a variety of lengths. Insulin pen needles are now available in 4-, 5-, 6-, 8-, and 12.7-millimeter (mm) lengths, while syringes come in 8- and 12.7-mm lengths (syringe needles need to be longer to penetrate the rubber stopper on the insulin bottle). If your pen or syringe needle is causing discomfort, let your doctor or educator know. You might be able to switch to a shorter and/or thinner needle, or it may be that your injection technique needs tweaking (for example, if you’re injecting into muscle rather than fatty tissue, it may cause discomfort).

Insulin will interfere with your lifestyle. Yes, you’ll need to stop and take an injection (or bolus an insulin dose with your pump), but it’s not a whole lot different than checking your blood glucose with your meter or taking your pills. Thanks to newer types of insulin, you can do everything that you’ve always done, such as go out to eat, travel, ski all day, and even skip a meal or two, depending on the type of insulin that you need to take. Yes, you’ll need to check your blood glucose more often than when you were taking pills, and yes, you’ll need to make sure you eat if you take mealtime insulin. While these may seem like inconveniences, on the flip side, you’ll very likely feel better (because your glucose levels are lower), and your diabetes control will improve.

What are your thoughts about starting on insulin? Do you agree that insulin is a good thing?

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