August 11, 2014

Insulin Myths and Problems They Cause – Part 1

Insulin myths are promoted by doctors that do not understand diabetes and are afraid of patients having a hypoglycemia episode. They use threats about failing when taking oral medications and the threat of insulin if they don't succeed. This atmosphere generated by doctors can lead to the following myths.

Myth 1: “It’s my fault I am being put on insulin because I didn’t do what I was supposed to do.”
No, it is not your fault! You have not received the education necessary to better manage your diabetes, and have had a threatening attitude from your medical providers. These doctors have used threats and left insulin as the medication of last resort. It is your fault that you let them do this to you and did not ask for insulin before it became necessary. This may have prevented this myth – diabetes is progressive from becoming true.

The doctors, CDE's, and others believe that diabetes is progressive because this is what they see in their daily practice. But because of their attitude and threatening ways of leaving insulin as a medication of last resort, they cannot help but see this. Their disrespect for us and treating us as people capable of making some decisions for ourselves is a disgrace to all doctors. There are a few doctors and more endocrinologists that will start us on insulin earlier before our pancreas is worn out and allow us to manage our diabetes to prevent it from becoming progressive.

It is inevitable that the insulin-producing beta cells of the pancreas will deteriorate over time, resulting in insulin deficiency. In other words, the pancreas cannot keep up with the body’s need for insulin no matter what you’ve done to manage your diabetes. Accordingly, insulin treatment is a normal and effective way of replacing the body’s insulin. Think of it as a form of 'hormone replacement therapy.' The goal of all diabetes treatment is to find the right combination of treatments to provide the best blood glucose control while minimizing side effects and insulin is the best of those options. Then remember that there are lifestyle changes that can help and for the different lifestyle changes, read my blog here.

Myth 2: “Insulin injections hurt.”
Most people are surprised by how little an insulin injection actually hurts. With the small, fine needles available today, insulin injections are virtually painless. Insulin is injected into the layer of fat below the skin where there are no pain receptors. In fact, most people feel that the finger pricks used to measure their blood glucose levels hurt much more than their insulin injections. Still more of us have learned how to prick our fingers that greatly eliminates much of this pain.

Myth 3: “Now that I am on insulin therapy, I will have more episodes of low blood glucose.”
Although some episodes of hypoglycemia, or low blood glucose (defined as a level below 70 mg/dl) may occur in people using insulin, severe hypoglycemia is rare and has been shown to affect only about 0.5% of people with Type 2 diabetes. You can learn how to prevent, recognize, and treat hypoglycemia, therefore avoiding severe hypoglycemia episodes.

Early symptoms of hypoglycemia include shakiness, nervousness, sweating, and confusion. People with diabetes should always carry glucose tablets with them, along with a blood glucose meter to check glucose levels when any of these symptoms occur. Treatment is usually 15 grams of carbohydrate, examples of which include 3 or 4 glucose tablets, 4 ounces (1/2 cup) of fruit juice or regular (non-diet) cola, or 5 or 6 pieces of hard candy.

Blood glucose levels should be checked again in 15 minutes and, if levels are still low, the steps above should be repeated until the glucose level is 70 mg/dl or higher. Strong evidence has demonstrated that the benefits of achieving good blood glucose control outweigh minor episodes of hypoglycemia as long as these episodes are not too severe or too frequent. Never allow blood glucose levels to become hypoglycemic if at all possible. Do not over consume when experiencing a low and put yourself in a yo-yo situation of highs and lows.

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