Don’t Worry If You Need to Start Insulin

Face your fears! Get answers to your concerns and the lowdown on starting insulin to treat diabetes.

Daniela Lissandrello
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Here’s the plain truth about type 2 diabetes: It’s a progressive disease, which means that over time, your pancreas will produce less and less of its own insulin. Eventually, oral meds will likely not be enough to keep your blood sugar in check. So if your doctor has told you that insulin may be the next step, don’t panic. More important, don’t let these common concerns and outright misconceptions prevent you from embracing the therapy that can help you lead a long and active life.

Concern: “Insulin injections will hurt”
No doubt about it, vaccine shots do hurt—that’s because they’re injected deep into your arm muscle. Not so with insulin injections, which are administered just below the skin in fatty tissue with few nerve endings. Plus, “the needle tips today are very short and extremely fine,” says Beverly Adler, PhD, CDE, author of My Sweet Life: Successful Women with Diabetes. “There is no pain involved.” And she should know: With her 37-year history of type 1 diabetes, she’s given herself countless injections. If you’re still anxious, however, try one of these techniques:

  • Try using a numbing cream before injecting. A cheaper alternative? Place an ice pack directly on the site for 10 to 20 seconds prior to beginning.
  • Ask your pharmacist for saline solution, also known as sodium chloride, so you can practice giving yourself a dose without the pressure of real medicine.
  • Use an insulin pen, which doesn’t contain a syringe and can help you avoid having to watch the injection.
  • Consider an insulin pump. The device administers the hormone through a catheter, eliminating the need for injections. 

Concern: “It will make me gain weight”
It’s true—because insulin helps your body use and store glucose properly as well as metabolize fat and protein more efficiently, weight gain can result. But these strategies can help the scale hold steady:

  • Eat three meals and a few snacks a day. A balance of “healthy food and nutrition choices, along with physical activity” is the best way to keep your blood sugar steady and help you control your weight, says Dr. Adler. Skipping meals, on the other hand, slows your metabolism and stokes hunger, priming you for a binge later on.
  • Don’t make this mistake—thinking that insulin means you can eat whatever you want. Before taking insulin, you could eat more than your body required without gaining weight. That’s because you were wasting rather than storing many nutrients. Now that you’re on insulin, every calorie counts, so it’s important to eat a healthy, moderate diet. Ask your doctor or diabetes educator for guidelines. 

Concern: “I failed at controlling my diabetes”
It’s common to feel guilty, anxious, distressed and even reluctant to take insulin, a phenomenon known as “psychological insulin resistance” (PIR). Yet the fact is, it’s not your fault you need insulin. “You need to recognize what you can and can’t control,” says Dr. Adler. “You can control making healthy food choices, eating reasonable portions, exercising, losing weight, taking your medications, managing stress and visiting your doctor on a regular basis. You can’t control the beta-cell failure [the ability of your body to supply the necessary insulin].” Chances are, even if you had followed your doctor’s advice, you’d still need insulin—not because you failed, but because your pancreas failed you! 

Concern: “Uh oh, taking insulin means I’m really sick”
No, it just means your pancreas isn’t able to meet your body’s demand for insulin. Luckily, injected insulin can make up the shortfall to help keep your blood sugar in check and head off the complications of diabetes, including blindness, nerve and kidney damage, heart disease and amputation. 

Concern: “I’ll have no freedom or flexibility”
While it may seem like life will start to revolve around monitoring your glucose once you begin taking insulin, the reality is that you have options. Dr. Adler notes that “long-acting insulins used for basal dosing are ‘peakless’—they generally work for 24 hours and are taken once a day. The fast-acting insulins used for bolus dosing start within five to 15 minutes after injecting, which means that the shot is taken right before the meal.” Another option? The pump, which lets you adjust your insulin levels according to your food intake and activity. No matter which method you choose, achieving more stable blood sugar will ease your stress and help you feel more in charge of your everyday routine. 

April 2013