Insulin is perhaps the most misunderstood drug on the planet. Many people with type 2 diabetes (PWDs) avoid it, and some even accuse it of causing diabetes complications. Yet insulin is one of the best treatments available for getting and keeping blood glucose levels on target.
Insulin is a must for treating type 1 diabetes and likely after years with type 2 diabetes. Type 2 is a progressive disease. As the body makes less of its own insulin, pills may become less effective over time. Eventually meal plans, exercise, and multiple pills won't cut it anymore. To help lower your blood sugar, your provider may prescribe insulin. Here are things to know about the medication:
1. It's not your fault
Starting insulin is not a sign of failure. It's not something you caused. It's not something that's always preventable. And you aren't any sicker than when you were taking pills only.
Unfortunately, many PWDs never get this message. William H. Polonsky, Ph.D., associate clinical professor at the University of California, San Diego, and founder of the Behavioral Diabetes Institute, says many people equate insulin with illness. He says studies have shown one-third to one-half of people who are prescribed insulin are unwilling or reluctant to take it. While health care providers may blame fear of needles for this response, research by Polonsky and others has shown that the No. 1 reason is "the sense that insulin signifies personal failure and a 'worsening' of diabetes."
Nothing could be farther from the truth. "Most people's fears and concerns about insulin are understandable, but are based on false information," Polonsky says. Cleveland Clinic endocrinologist Betul Hatipoglu, M.D., agrees. She tells patients not to fear insulin. "By explaining to them what science knows about diabetes today, I try to help them accept their disease state and unload the guilty feeling," she says.
2. It's safe
If type 2 diabetes runs in your family or you live in a community where it's common, you've likely heard stories along the line of, "They put Grandpa on insulin; then he went blind and died!"
The sad truth is that if Grandpa had started insulin 10 years earlier, he'd probably still be with us today. It's waiting too long to control blood sugar that opens the door to complications, not the insulin itself.
"It is definitely not true that you will develop complications from diabetes faster once you start insulin," Hatipoglu says. In fact, "Insulin is the best drug we have to treat diabetes and prevent complications," says Kathleen Colleran, M.D., endocrinologist and professor of medicine at the University of New Mexico Health Sciences Center.
"The main problem is we start it too late," Colleran says, "after complications are evolving. Patients, families, and society then associate insulin use as a cause of the complications. In reality, if we use it earlier in the game, we could likely prevent many of those complications by getting patients under control more quickly."
Historically, clinicians have used insulin as a threat to scare patients into an improved lifestyle, Colleran says. This misguided approach has led to insulin being used as a last resort. "People are creeped out by insulin," Polonsky says.
But attitudes are changing. Colleran says clinicians are now painting insulin "as a valuable treatment -- not as a punishment -- early in the disease course."