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Making The Move From Pills To Insulin
Reviewed by Staff of Diabetes Digest

For many people with type 2 diabetes, deciding to start insulin is a hard choice to make. Even when your pancreas can’t keep up and your blood glucose levels are increasing, it is easy to put it off. But once you make the decision, the next question is how to get started. Here are some tips that may help you start and stay with insulin.

Ask for a referral to a diabetes educator

Starting to take insulin is about more than just learning to give yourself a shot. You also need to know a lot about blood glucose levels, how many times a day and when to check your blood glucose, what the numbers mean and how to balance your insulin with your food. Your diabetes educator can also show you some tricks to make the injections easier and less painful. He or she also can show you the latest insulin injection devices.

Increasing numbers of health care plans, as well as Medicare, cover diabetes education. Call your diabetes educator or diabetes education program to see if your health care plan covers this service. Taking insulin means that you have more choices to make. Seeing an educator can help you to make wise choices.

Changing your mind

Even after you decide to start taking insulin, some of your fears will probably not go away. You may worry about pain, low blood glucose reactions and a loss of freedom. Keep in mind that taking insulin does not mean that you have failed to manage your diabetes. It just means that you need a different way to keep your blood glucose levels on target. It may also help to know that many people say they don’t know why they waited so long to start taking insulin because they feel so much better once they do. Sometimes knowing more facts and speaking to a good listener can help.

Know your blood glucose level

Checking your blood glucose level goes hand in hand with taking insulin. For the first few days, it is helpful to check your blood glucose fairly often. Be sure to talk with your health care provider about what your blood glucose targets should be before and after meals and when your insulin has the greatest effect on your blood glucose level.

 Many providers ask that you call and let them know your blood glucose results so your insulin dose can be adjusted. Others teach you to make the adjustments yourself. Insulin doses are not like pills. Most people start with a low dose and then add more based on how their bodies respond. Taking more insulin does not mean that your diabetes is worse. It just means that your body needs more insulin to keep your blood glucose in your target ranges. Learning to make these adjustments can give you more freedom and better blood glucose results.

Use your meal plan

Although people may tell you that you can eat whatever you want once you begin taking insulin, that isn’t quite true. Insulin helps your body use food more efficiently. This means that if you start taking insulin and eat the same amount of food as before, you are likely to gain a few pounds.

If this is a concern for you, make a plan to become more active or ask your health care provider for a referralto a dietitian. In fact, seeing a dietitian when you start insulin is a smart idea. You can learn to count carbohydrates or use meal planning methods for more freedom and better glucose levels.

Know what to watch out for

Ask your educator or health care provider about the warning signs of a low blood glucose reaction. Find out about how to prevent low blood glucose levels and what to do if you have one. After a low blood glucose reaction, try to figure out why it happened. Did you wait too long to eat, get too much exercise or eat too little? Also, ask how to keep your blood glucose from getting too high and when to call your health care provider.

 Overcoming the fear

You will probably give yourself your first shot in your health care provider’s office. Most people are surprised that the shots really aren’t very painful. In fact, many people say an insulin shot is less painful than sticking your finger when you check your blood glucose. But the first shot on your own is still tough. Some people want to be alone, while others want a family member present to offer support.

Either way, gather up the things you need and draw or dial up your dose if you are using a pen. Pick the spot to give your shot. Then take a deep breath in and out, and just do it. Putting it off doesn’t make it any easier. Once you take the needle out, take another deep breath and congratulate yourself for doing all that you can to take care of your health.

Staying with insulin

 Once you get past the first shot, the rest are usually easier. But some people still struggle. They wonder if they really need insulin. They may decide to skip an injection if they have done all the right things for their diabetes that day. Insulin reactions or weight gain may keep some people from staying with insulin. Talk with your health care provider or diabetes educator about any of these Insulin is a big step for most people with type 2 diabetes. Try not to think of it as the last resort. Think of it, instead, as the first step toward a longer and healthier life. There is help and support available if you ask.

The right time to take your insulin

If you take insulin and struggle to manage high and low blood glucose numbers, one reason may be the timing of your injections. Coordinating when you take your insulin with your meals, your physical activity and other parts of your diabetes care plan can help, so here are some tips to help you time your insulin just right.

  • Take insulin at similar times. The more often you are able to take your insulin at the same time each day, the easier it becomes to keep your blood glucose in control. This isn’t always easy. If you want a more flexible insulin plan, talk with your health care provider about taking more injections, using a long-acting and rapid-acting insulin plan, using an insulin pen or switching to an insulin pump.
  • Eat at similar times. Eating your meals at similar times each day also makes it easier to manage your blood glucose.
  • When you eat, you need insulin readily available. This will help to keep your blood glucose level from going too high. Carbohydrates in food make blood glucose rise. It’s easier to keep blood glucose from going too high by having insulin in your body when you eat than to lower blood glucose that has already gotten too high.
  • Give regular and rapid-acting insulin a running start. The reason regular insulin is typically taken 30 minutes before a meal is to give it a running start to lower blood glucose before the carbohydrates from your meal raise it. Rapid-acting insulin is typically taken 5 to 15 minutes before a meal to give it a running start. But it is very important not to delay the meal.

Paying attention to timing won’t solve all of the ups and downs of blood glucose levels, but it can help to make managing your diabetes a bit easier.

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