February 14, 2014

Is There A Best Way for Type 2 To Bolus?

Everyone seems to recommend something different when type 2 people are put on insulin. I know that everyone is afraid of insulin and doctors and others are all worried about people not injecting their insulin. This is discussed at great length in this Joslin blog, but I wonder if this is the best way. I dislike that the blog author is giving many of the insulin myths credit without giving them the recognition and doing something to disprove them.

It is as if the author believes the myths and it reads as if this is why they need to find new ways to ease patients new to insulin into injecting. I realize that some people start out with basal insulin (long acting) before bed and this is reasonable if they need help with the oral medication.

A little background here. I went from two oral medications to basal (Lantus – long acting) and bolus (Novolog – rapid acting) insulin during the day and have never looked back. I knew that I needed insulin for better diabetes health and I was ready for it. I have not regretted the decision and I have been better off as a result. I was working part-time and my boss knew that I had diabetes when I was in the hospital for a heart problem. There was never any problem with finding time for injecting and taking care of my diabetes.

I know not everyone is given the latitude by their employer to take care of their diabetes like I was, but the Americans with Disabilities Act can be used if there are problems. Yes, diabetes falls within the disabilities and provides some protection at your job. And, yes, I admit to being a trifle callous after having a great boss and other employees to protect me. At least he knew about the Americans with Disabilities Act and made sure all employees knew something about it.

As a result, I find that too many people -
  1. Want to keep diabetes a secret.
  2. Are afraid to inject insulin without complete privacy.
  3. Let their fears overcome their health needs.
  4. Cling to diabetes myths because they don't understand insulin.

The above reasons are bad enough, but then add to this the fear of what the doctor is saying about insulin being a punishment and common sense health care goes out the window. Then when bloggers on the Joslin diabetes blog have to use words like – too burdensome and overwhelming, and more cumbersome, people have to wonder if there is something wrong with insulin.

I have a fear that too many diabetes care professionals are not using positive thinking about insulin and the benefits of insulin, but are letting people with type 2 diabetes dictate the necessity of avoiding insulin. Yes, they want adherence to insulin and are therefore trying to baby step patients into insulin. This is unfortunate for many people that need insulin to better manage their diabetes.

If it seems like I am saying to push insulin all at once, yes, I am because then you adjust and should take it in stride. I know many people that have done this and most of the members of our support group started insulin in one day and are all happy they did and were able to improve their diabetes management. I can feel for those that do not have a family support structure, workplace support structure, or support group for support, but the quicker they move away from oral medications to the full insulin regimen, the better they will be.

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