Q&A: Type 2 diabetes and starting insulin

Tuesday, 2 June 2020

Concerned about starting insulin? More than half of people starting insulin will have worries. You are not expected to know all the answers. Consider what is concerning you and write a list of questions to take to your doctor. Your doctor will appreciate anything you mention, as it will help them to offer you the best possible support. For more information please read this fact sheet or call 1300 342 238 to talk to a health professional.

Will I get hypoglycaemia?

Your doctor will start you on a low dose of insulin and increase it slowly. This should reduce the risk of hypoglycaemia. Make sure you are eating regularly. If you change your diet or physical activity levels, consult your doctor about your insulin dose. This factsheet explains how to reduce your risk of having a hypo and how to manage them.

I hate the thought of needles, will injections hurt?

The needles which you will use are very thin and short and the area you will generally begin injecting has less sensation than your finger. The sharp you prick your finger with to take a blood glucose reading is thicker. Giving yourself an insulin injection is a lot less painful than measuring your blood glucose levels (BGLs).

The first time you inject you will probably be quite nervous, but as with all things we continue to do it gets much easier with practice. Your practice nurse or diabetes educator will go through what to do and will be happy to help you refine your technique.

I am concerned this will disrupt my life

The devices for injecting insulin are easy to use and reliable. You may have to check your blood glucose levels more often, however starting insulin can give you a lot more energy and a lot fewer symptoms. There are options for travelling with insulin and for remembering to use your insulinInsulin pens are portable for when you go out and can be administered discreetly as needed. Insulin will improve your long-term health giving you a better quality of life for longer.

I am angry. I did everything right why do I have to start insulin?

Diabetes is unpredictable and can make you feel ‘out of control’.  You done everything right but things haven’t happened the way you planned. Anger is a natural reaction. Don’t let get in the way of keeping happy and healthy. If you can’t work through these feelings please talk with your doctor who may recommend you speak with a psychologist. It is a strength to ask for help when you need it. Staying angry will have a negative impact on your diabetes and your overall health and happiness.

I feel like I’ve failed. If I eat less and exercise do I have to start insulin?

Starting insulin is not a failure. You could eat practically nothing and exercise to exhaustion but still come to a point of requiring insulin. If you are taking medications now to lower your blood glucose you may be aware that they do not replace insulin. Oral and injectable (not insulin) medications work by helping the insulin your body produces work more efficiently. Once your pancreas is not making enough of its insulin you need to start supplementing insulin through injections. You may continue to take some of those medications as they will still help the insulin both made by you and injected work well. Insulin is just another medication to help you live well with diabetes.

Will I put on weight with insulin?

Starting insulin is a good time to check how much and how often you are eating carbohydrates during the day. A dietitian can assist you with getting this balance correct. If you overeat carbohydrates you will put on weight with insulin. This happens without injecting insulin as well. Insulin converts carbohydrates not used for energy into fat. If you are having to manage hypoglycaemia with carbohydrates talk with your doctor about getting your insulin doses correct. Starting insulin doesn’t have to lead to weight gain.

Does starting insulin mean my diabetes is becoming serious?

Diabetes should always be taken seriously. Often people start insulin when they are older. As your pancreas ages it needs a little help. Aging brings lots of health concerns, so it is only natural to associate starting insulin with those health concerns. Starting insulin can keep you out of hospital and healthier and happier for longer. Delaying starting insulin can have serious consequences. Diabetes is no more serious when starting insulin. Insulin just another tool to help you live well.

 

Donna Itzstein, Pharmacist CDE

 

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