"The only thing we have to fear is, fear itself"

Last time around, I talked a bit about fear. You know, the heart-pounding, sweat-inducing, adrenalin-pumping sensation. We've all been there. The last post was on doctor-office fear. But we all know that's far from the only one out there. My phobias include:
-birds flying freely indoors [especially inside supermarkets; what's the deal with that?],
-unexpected change, especially at work [one of my recurring nightmares involves me walking into my studio at work, only to find the equipment completely changed, and having no idea on how to use it],
-not getting the last cookie [O.K., as a diabetic I shouldn't be eating more than an occasional cookie in the first place. But I've wanted the last treat available since I was a child, and I'm not sure that one's going to change anytime soon].


But, based on my experience listening to and talking with diabetics [especially type II diabetics], the numero uno fear is...

THE NEEDLE.

I get it, of course. Most people equate insulin therapy with failure, with the continuing degeneration of their health, with jabbing a needle into yourself several times a day, for God's sake! That can't be good, can it?

Well, yeah. Let's begin with a quick review. Diabetes is a disease of the liver. Among other functions, the liver produces insulin, which the body uses to turn blood sugars into energy. In type I diabetes, the liver doesn't make insulin, forcing type I diabetics to inject it into their bodies. Pregnant women who contract gestational diabetes are also forced to use insulin temporarily, as oral medications aren't effective for them. Type II diabetics usually begin their treatment regimen with a combination of oral medications [like metformin], diet changes, and regular exercise. Metformin, and other oral medicines, work on the receptors that allow insulin to turn blood sugar into energy. But diabetes is a degenerative disease; it gets worse as your life continues. After a while, there is a risk of "burning out" the receptors through the stimulation of the oral meds. It just makes sense to add insulin, making the job of the receptors easier. Thus, injecting insulin becomes a greater and greater likelihood for type II diabetics.

There are reasons that people would rather not use insulin:
-injections are painful/difficult - Not so much, nowadays; in addition to the syringe/vial method, which can be difficult for some, insulin is available in the "pen" dispenser. It's small [really about the size of a pen], easy to dispense the correct amount [just set a dial on the device], simple and discreet to use [set the amount, screw a disposable needle on the dispenser, inject into an area of body fat, safely dispose of the needle, and you're done]. As for the needles, they are much thinner than they used to be, thus causing less pain [personally, I find jabbing my finger for blood sugar testing much more uncomfortable].
-insulin must be kept refrigerated until use - Most modern insulin can be stored at room temperatures for up to 28 days, some longer [this refers to the vial or pen in current use; those yet to be opened should be kept in the refrigerator, BUT NOT THE FREEZER].
-"I'm afraid I'll become addicted to insulin" - Not really. Insulin, in and of itself, is NOT addictive. The better your control through other means [medication, diet, exercise] becomes, the less insulin you may need. It may happen that you'll need to stay on insulin, but it's not due to using insulin.
-"I'll gain weight" - Okay, you've got me on that one. Many people who've gotten on insulin have gained some weight. But, with your sugars under better control, you'll almost certainly feel more like doing the exercise needed to take off those extra pounds. Besides, while carrying a few extra pounds is far from ideal, it's better than having higher-than-healthy blood sugar levels.

If you'd like a more complete look at how insulin is used to treat diabetes, WebMD has a good explanation here. The insulin manufacturer Sanofi Aventis operates the website GoInsulin.com; I'm a little reluctant to send you to a site operated by those with "an agenda". Noting that, the site is a good "support" source for those who, after conversation with their health-care providers, decide that insulin may be helpful in their treatment.

I've used insulin for a couple of years now, in addition to oral medication. I've used a long-lasting insulin for all that time, and recently have added a fast-acting product at mealtime. It helps me; it may or may not help you. Only you and your doctor can decide if you should use it. But it's not as difficult, painful, or complicated as you may have heard or believed. Don't reject it out of hand. Do your homework before making a decision.

-Mike Riley