I recently read a wonderful article written by a fellow contributor, “The Fear of Insulin.” In this very candid article, Shelley (TheLongPointGirl) shares her reasons for being fearful of insulin therapy.1
Shelley, like many others with type 2 diabetes share similar concerns. In this article, I hope to ease some of those worries by addressing some of Shelley’s fears.
“Fear of being slotted into a protocol without thought”
- Over the years several protocols/decisions trees have been developed to assist health care providers in initiating and titrating diabetes medications (i.e. pills, insulin, or both). While such tools can help guide treatment, diabetes is not a “one size fits all” disease. What works for one person may not work for another person. Diabetes medical management plans (i.e. medication, monitoring, etc.) need to be customized to meet your personal goals all while taking into consideration your health history.
- If you feel as though your voice is not being heard and that your goals are not being considered, it is important that you be up front with your health care provider as well as the other members of your health care team.
- Consider bringing a trusted family member or friend to your next appointment. Speaking up and advocating for yourself can be easier if you have the support of family/friends.
“Fear of daily or several needles per day”1
Two common reasons that insulin injections are feared include:
- Fear of injection pain
Technology has improved drastically since insulin first became commercially available in 1920s. This improvement in technology has helped decrease injection discomfort.Tips that help reduce injection pain:
- Practice giving an injection into an orange or pin cushion. Practicing before you give yourself an injection can help ease worries thus allowing you to relax. Pain may be increased, if you give an injection while your body is tense.
- Ask about meeting with a diabetes educator (CDE). A CDE can demonstrate proper injection technique.
- Ask your doctor to prescribe an insulin pen with pen needle tips instead of using an insulin vial and syringe. Pen needle tips tend to be shorter and thinner in comparison to syringes both of which can reduce injection discomfort.
- Always use a new syringe or pen needle tip. Old/previously used syringes/pen needles become dull with repeated use thus increasing injection discomfort.
There are several products that can aid in insulin injection, some of which include:
- i-Port Advance (by Medtronic): This device is an injection port that reduces the frequency of injections. For more information please refer to the following link.
- BD AutoShield Duo Pen Needle: This pen needle tip is concealed so the user does not have to see the needle. For more information please refer to the following link.
“Fear of messing up the dose” 1
- Keep your insulin regimen clearly written and in a convenient place, ideally where you keep your diabetes supplies. Keep your health care providers contact information in the same area.
- Using an insulin pen may lessen the chance of giving an inaccurate dose in comparison to using a vial and syringe.
- If you have a visual impairment and/or limited dexterity, there are products that can help prevent dosing errors.
- BD Magni-Guide Scale Magnifier and Needle Guide. For more information please refer to the following link.
- Have a trusted family member or friend double check that you’re injecting the correction insulin (if you take more than one type of insulin) and that your dose is correct.
“Fear of weight gain” 1
- Weight gain can occur with insulin therapy. This often results from a history chronically elevated blood glucose levels that are now starting to improve/decrease therefore calories (glucose) previously lost in the urine are now being absorbed resulting in unwanted weight gain. Weight gain can be reduced and potentially prevented by decreasing calorie intake by about 300 calories per day if A1c is greater than 8% before starting insulin therapy.
- It is important to speak with your health care provider before starting a diet. A registered dietitian experienced in diabetes care, can help meet your weight management goals.
“Fear of the effect on my license/job” 1
- Know your rights. The American Diabetes Association is a great resource for helping you to better understand your rights at work.
“Fear of the unknown” 1
Dani DiPirro offers a few suggestions on how to overcome fear of the unknown:
- “Accept Uncertainty”
- “Focus on the possibilities rather than the problems”
- “Surround yourself with support” 2