Do You Have 'Psychological Insulin Resistance'?
Get the facts about insulin use before you decide against incorporating it into your lifestyle.
By Richard Rubin, PhD, CDE
Today I want to tell you about a really interesting study I'm involved in. It's called the Diabetes Attitudes, Wishes, and Needs (DAWN) study. DAWN researchers interviewed over 5,000 people with diabetes and almost 3,000 health care providers in 13 countries around the world. Questions focused on diabetes care and factors that affect care, especially the emotional side of diabetes. Novo Nordisk, a company that makes insulin and insulin delivery devices funded the study; I am a member of the international scientific advisory board that monitors the study.
One of the most fascinating DAWN findings to emerge so far is strong evidence of a condition I call psychological insulin resistance. More than half (57%) of the people with type 2 diabetes surveyed for DAWN who were not taking insulin said they were worried about taking it.
The reasons for these worries are clear from what these people told the interviewers. Almost half (48%) said taking insulin meant they had failed to follow self-care recommendations, and very few (23%) believed insulin would help them manage their diabetes. So lots of people around the world have psychological insulin resistance and it keeps many of them from getting the treatment they need to improve their glucose control.
Do you have psychological insulin resistance? The American Diabetes Association says keeping your A1c level 7% or lower is a key to staying healthy. If your A1c levels are higher than 7% and you are saying no to insulin, overcoming your psychological insulin resistance could pay off big time.
What it takes to overcome your resistance depends on why you are resisting. I'll tell you about some of the reasons for saying no to insulin I've heard over the years. See if any of them sound like your concerns.
Shots hurt. Are your fears based on memories of the big needles people used years ago to give themselves insulin? If so, you should know that times have changed. Today's syringes and insulin pens have very short, very thin needles that go only into the fatty layer right under your skin where you have very few nerve endings. That's why many people say it hurts less to take insulin than to stick your finger to check your blood glucose. Ask your health care provider to show you one of the new needles; if you try sticking yourself you will see what I mean.
Life will be more complicated. There is more to manage when you start taking insulin – more stuff to carry, more planning to make sure you eat and exercise at the right time to avoid going low, and more situations where you have to deal with your diabetes in public or work really hard not to. Most people tell me that with time and experience they found tricks that worked to make all this more manageable. Insulin delivery devices like pens can also make taking insulin easier and more discreet. And a growing number of people with type 2 diabetes are using insulin pumps. Talk to your health care provider about ways to make living with insulin as complication-free as possible.
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