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Johns Hopkins MedicineMeds iconMeds | Insulin

Are You Resisting Insulin Therapy?

Starting an insulin regimen takes some effort—but better glucose control is worth it

Are You Resisting Insulin Therapy?A lot of people with Type 2 diabetes dread the day they have to start taking insulin. They resist it even after they have run out of other options to keep their diabetes under control.

Perhaps you worry that having to take insulin means that your diabetes is getting worse, that you have failed to take care of yourself or that it might complicate your daily life.

If you have any of these concerns, talk to your doctor or a diabetes educator. Get the facts—they could change your mind about insulin. Here are some common questions and answers about starting an insulin regimen.

Does taking insulin mean my diabetes is getting worse?

Taking insulin will make your diabetes better, not worse, because insulin does such a good job of lowering blood glucose. Your blood glucose levels (along with your blood pressure and cholesterol levels) tell you whether your diabetes is getting better or worse. Keeping these levels under control dramatically increases your chances for a long, healthy life free of diabetes complications such as kidney and eye damage. In a major, long-term study published in the “New England Journal of Medicine,” participants who had intensive insulin treatment lowered their risk of developing cardiovascular disease by 50 percent! This study focused on patients with Type 1 diabetes but experts believe that people with Type 2 diabetes may reap the same benefits.

Do I have to take insulin because I didn’t take care of myself?

Taking insulin will make your diabetes better, not worse, because insulin does such a good job of lowering blood glucose.Not taking good care of yourself can hasten the day you need to take insulin. But even people who’ve practiced good self-care may still need insulin. This is because when you have Type 2 diabetes, your body makes less and less of its own insulin over time. Eventually, many people make so little insulin that their blood glucose rises no matter how carefully they eat, how much they exercise or how many glucose-lowering medications they take.

Will insulin really help me manage my diabetes?

Better blood glucose control means better long-term health. Many of my patients who start taking insulin notice immediate benefits. They report that once their blood glucose levels are closer to normal, they have more energy, get more things done, sleep better at night and are in a much better mood.

Will taking insulin complicate my life?

My sister and son both have Type 1 diabetes. They started taking insulin the day they were diagnosed. For my sister that day was in March 1959; she took her first shots with a big glass syringe that had to be boiled each time she used it. Today you can choose to take insulin using disposable syringes, insulin pens or insulin pumps. And the types of insulin available now are designed to help you keep your blood glucose levels as close to normal as possible throughout the day while protecting you from levels that go too low. In early 2006, the Food and Drug Administration approved a powdered form of insulin taken through an inhaler, not a needle, for some patients with Type 1 and Type 2 diabetes.

Despite these advances, starting and staying on insulin therapy does take effort. Each shot takes up to five minutes to administer. You must take precautions like keeping the vial in a cool place and having needles, alcohol wipes and other supplies on hand. These inconveniences pale compared to the much harsher consequences of poor glucose control, like frequent fatigue and blurred vision, not to mention the long-term disease complications (kidney disease, nerve damage and blindness) that can curb mobility and limit independence.

Five good reasons to take insulin:

  1. It will help you feel better if medications are not controlling your blood glucose levels adequately.
  2. It will lower your risk of diabetes-related complications.
  3. Because insulin is available in fast-, medium- and long-acting forms, you can tailor your insulin regimen and doses to your lifestyle, and make changes day-to-day if you need to, based on when and what you eat.
  4. Tailoring your insulin regimen to your circumstances can help you avoid the uncomfortable and sometimes dangerous symptoms of glucose highs and lows.
  5. You can choose from several insulin delivery methods (syringe, insulin pen, pump and, soon, inhaler) the one that best suits your lifestyle.

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