When I wrote this blog, I knew then
that more would be said on the topic. Insulin for most doctors is
not a word they want to hear. They threaten patients with it to
convince patients to stay on oral medications. Then they stack oral
medication on top of oral medication. This causes many patients to
conclude that when they are required to use insulin that they have
failed and this is their punishment.
And many people listen to these inept
doctors when they should know better. Insulin is just another tool
in the arsenal for managing diabetes. Many people with type 2
diabetes do use insulin. Others feel that using insulin makes them a
failure. This should never be the case, but our doctors have been
behind promoting this to keep patients on oral medications and
because of the fact that doctors fear hypoglycemia to the point it
clouds their thinking.
Insulin is simply a necessary and
beneficial addition to diabetes management. There are a few reasons
why people that have not needed insulin to require it (and possibly
on a temporary basis). Gestational diabetes, surgery, broken bones,
cancer, and taking steroidal medicines (prednisone for example) can
require some people to take insulin for a temporary period. Then
some people end up needing insulin on a permanent basis as they age
because the pancreas becomes unable to produce enough insulin.
Sometimes they have been on oral medications that force the pancreas
to produce insulin and the pancreas can no longer produce sufficient
insulin.
Now back to feeling as a failure
because of needing insulin. When we age, the functioning of our
pancreas often decreases and becomes unable to produce the quantity
of insulin necessary for our cells to function and provide the energy
we need. Because we are human, we don't always maintain a healthy
food plan and exercise regimen and our blood glucose levels rise
dramatically to a level only insulin can control.
When the dose of insulin is discussed,
I urge you to read this about the three methods of dosing. It has
been the experience of our support group that most doctors, CDEs, and
dietitians all prefer the fixed dose of insulin. This in turn forces
us, as patients, to eat a fixed number of carbs which may not be the
best solution.
Yes, we need to learn how to count
carbs and know what foods are safe in a food plan. This we can use
when we are not feeling like eating but a snack, are under stress,
have an infection, cannot exercise, or need to avoid food. This will
help in managing our blood glucose levels and prevent having an
episode of hypoglycemia. The amount of insulin needed will also
depend on a patient’s weight, eating habits, exercise levels, other
illnesses, and level of insulin resistance.
I prefer the third dosing method and
use it because I have learned how with a little help from the
endocrinologist. Having insulin resistance does make the adjusting
more complicated at times as the level of insulin resistance has
varied for me. Just when I think I have it down, it changes. I
would encourage you to read this on blood glucose variables and this
on more variables.
I am happy that I am on insulin and one
500 mg dose of metformin ER. I am better able to manage my diabetes,
even with all the variables. I moved from oral medications to
insulin about 3 months after diagnosis. Therefore, I had none of the
feelings of failure, as I was able to embrace insulin and a better
tool for the management of my diabetes.
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