Do You Have Psychological Insulin Resistance? (Continued)

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Insulin causes low blood glucose reactions. New technology has made a big difference here as well. The key to avoiding lows is to match what a normally functioning pancreas does. We aren’t there yet, but the new insulin “analogs” help us get closer. Rapid-acting analogs do a better job covering meals and not hanging around too long, and long-acting analogs do a better job of providing a nice steady drip all day without unwelcome peaks. So people taking these new insulin analogs cut their risk of low blood glucose reactions. Your health care provider can tell you more about your insulin options.

Taking insulin means I’ve failed. Since no one manages diabetes perfectly, everyone can point to things they have “done wrong” when it comes to caring for their diabetes. So I’m not surprised that many people feel these “misdeeds” are the reason they need to take insulin. They are especially likely to feel this way if their health care providers used insulin as a threat. The DAWN study found that 53% of physicians surveyed (and 69% in the US) said they did just that.

No question about it, working hard to eat right and stay active is a good thing, Still, when you have type 2 diabetes, doing everything possible to maintain a healthy lifestyle is very often not enough to keep blood glucose levels where they belong forever. That’s because your pancreas makes less and less insulin over time. When your body is no longer making enough on its own, adding insulin to your regimen is the best way to stay healthy. Taking insulin at that point isn’t a sign you’ve failed; its a sign your pancreas has let you down – again.

Taking insulin means my diabetes is getting worse. Here is another concern I hear often. But taking insulin could actually make your diabetes better. That’s because changes in your blood glucose levels (and blood pressure and cholesterol levels) tell you whether your diabetes is getting worse – or better, not the treatment you are using. Insulin can help you keep your blood glucose levels as close to normal as possible, and that could make your diabetes – and your life – much, much better.

It hurts me to see how few people interviewed for the DAWN study recognized the benefits of insulin. I recall the words of Elizabeth Hughes, a young woman who was one of the first people to receive insulin after it was discovered 80 years ago. She said, “This is a miracle that will help me lead a normal life.” Elizabeth might have been overstating matters a bit, but she did live for more than 60 years after she started taking insulin.

Insulin causes complications. This is closely related to the previous fear, and I I hear it most often from people who saw family members or others developed complications after starting to take insulin; it seemed the treatment caused the complications. But insulin doesn’t cause complications, it prevents them. Unfortunately, that’s only true if it is given soon enough, before the damage that makes complications inevitable has been done. When my patients realize that insulin got there too late for their relatives, they usually want to be sure the same thing does not happen to them.

So if insulin is right for you, get to it as soon as possible. Talk to your health care provider about improving your chances for a long healthy life with diabetes. One of my patients vowed to die with diabetes, not from it. Taking the right medication at the right time could help you do the same.

Richard Rubin, PhD, CDE, is an Associate Professor in Medicine and in Pediatrics at the Johns Hopkins University School of Medicine in Baltimore, MD. An active member of the American Diabetes Association and the American Association of Diabetes Educators, Dr. Rubin has written over 100 articles, books, and book chapters for people with diabetes and for diabetes health care providers. He writes about emotional and behavioral issues related to diabetes for dLife.

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NOTE: The information is not intended to be a replacement or substitute for consultation with a qualified medical professional or for professional medical advice related to diabetes or another medical condition. Please contact your physician or medical professional with any questions and concerns about your medical condition.

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