Should I Start Using Insulin To Treat My Type 2 Diabetes?
Type 2 diabetes is a chronic condition that affects your ability to control blood sugar. When you eat, your body breaks down carbohydrates into sugar or glucose. This glucose then enters your bloodstream. It is what you test when you use your glucometer. Normally, the body makes insulin to move glucose out of the blood and into cells. Inside cells, it is used for energy.1
Diabetics do not have enough insulin to control their blood sugar. This can be due to the pancreas not making enough insulin or from insulin resistance. Over time, your ability to make insulin decreases. You may also stop responding to your oral diabetes drugs. Many people with diabetes end up needing insulin. Your doctor can help you decide when it is right to add insulin to your treatment plan.1,2
Understanding drugs for diabetes
Keeping your blood sugar steady is important because changing blood sugar levels damage blood vessels. This is why heart disease is common in diabetics. Many diabetics start on oral drugs that raise insulin levels or lower blood sugar. Oral drugs may work at first, but these drugs, along with lifestyle changes, may stop controlling your blood sugar. You may need to adjust your drugs or start insulin.2-4
How do I know it is time to start insulin?
Monitoring your blood sugar at home, along with routine blood work during doctor’s visits, helps doctors know if your diabetes is controlled. If your daily blood sugar levels and your hemoglobin A1C are regularly high, your doctor may suggest insulin. The right dose and form of insulin can control your blood sugar.1,5
Know the facts about insulin
There are many types of insulin. They are categorized by how fast they work. You may be given one or more of the following types of insulin:2,6
- Rapid-acting – works in about 15 minutes and lasts for 2 to 4 hours
- Regular (short-acting) – works in 30 minutes and lasts for 3 to 6 hours
- Intermediate – works in 2 to 4 hours and lasts 12 to 18 hours
- Long-acting – takes hours to deliver and lasts about 24 hours
- Ultra-long – works in 6 hours and lasts about 36 hours
Your doctor will work with you to figure out what insulin will control your blood sugar.2
How do I take insulin?
Insulin is a liquid that you inject into the fat of your stomach, outer thigh, or upper arm. It cannot be taken orally since your body would break it down and it would not work. You may need an injection once a day, twice a day, or before meals. You may be given a vial of insulin and have to draw it up with a needle and syringe. You may be given a pre-dosed insulin injectable, which many find more manageable.2,6
Insulin injectables, or insulin pens, are prescribed by a doctor. They give exact doses of insulin, and many find them easy to use. They come with a container of insulin inside them. They can be disposable or reusable. Reusable pens come with insulin refills that are easily installed.
Mental challenges to starting insulin
Many people with diabetes see insulin dependence as a failure on their part, but this is not the case. Diabetes worsens with time even though you may be doing all you can to control it. Over the course of the disease, your pancreas makes less insulin, and you may stop responding to drugs. This is why insulin doses are adjusted with time.1-3
Common fears about insulin
Many people with diabetes are nervous about daily injections. Some fear the shots will be painful. Others worry about side effects like weight gain and hypoglycemia, which happens if you take too much insulin. Talk to your doctor about your concerns. Your healthcare provider can walk you through how to give yourself injections and what to expect.3
Understand that you are not alone
The American Diabetes Association or the Association of Diabetes Care and Education Specialists (ADCES) may be able to help manage your diabetes. ADCES offers information and “diabetes education programs” that can help you make lifestyle changes, monitor blood sugar, and inject insulin correctly. Some education programs are covered by Medicare or insurance.7
The stress of living with diabetes
Starting insulin may mean lifestyle adjustments, which can be hard to accept. Managing a chronic illness and starting insulin can be stressful. Depression and anxiety are common in people with diabetes. Diabetes symptoms may be worse in those with depression. Talk openly with your doctor about any stress or feelings of depression. You may also seek out a counselor.8
Insulin is not a punishment
Even if you change your diet, exercise more, and get to a healthy weight, you still may need insulin. Needing insulin is not a punishment for doing something wrong. It is the nature of the disease to need insulin as time goes on. You have many options with what type of insulin to take. Your doctor can help you decide which insulin fits your lifestyle and works best to control your blood sugar.9
Do you live with any sleep disorders (eg. insomnia, sleep apnea, RLS) in addition to your diabetes?