Coping with insulin

Although many people diagnosed with type 2 diabetes will be prescribed tablets (e.g. metformin) eventually many people will be transferred to insulin. Insulin cannot cure diabetes - there is still no cure for diabetes - but it can slow the progress of the disease and make it easier for some people to control their blood glucose. Those who had changed to insulin from tablets said that they felt much better because insulin kept their blood glucose more stable. 

Tina takes one long-acting insulin in the day and another (Levemir) at night which she says works well.

Shahnaz explains how she increases the amount of insulin she takes when she returns to Pakistan and her diet changes.

Most people we interviewed who were on insulin had had diabetes for five or more years and most of them had started with  oral medication such as metformin (see 'Talking about - Oral Medication'). Only a few people had been prescribed insulin directly after being diagnosed. The kind of insulin and also the dosage varied from person to person, according to their blood glucose level and their state of health; few people could recall the name of the insulin they were taking. 

Three main varieties of insulin are used; they differ in how long their action lasts. 'Basal' insulin gives background protection throughout the day; quick-acting or 'prandial' insulin is usually taken twice or three times a day before meals and counteracts the effects of the food on glucose levels; the slow-acting or night time insulin is usually taken last thing at night. Many people said it had taken them some time to find the right balance between quick and slow-acting insulins.

Philip has recently changed from Mixtard 20 to NovoMix 30 and says he keeps a record of his blood glucose levels.

Gareth takes higher doses of insulin now than he did before and advises newly diagnosed diabetics to record their readings.

Some experienced insulin users had developed routines that worked for them and preferred to stick to their own tried and tested methods of coping. Others valued deciding for themselves whether to raise the insulin dosage depending on what they were planning to do or eat. The 'Dosage Adjustment For Normal Eating' or DAFNE routine (see Information) was thought by several people we interviewed to be a good way for very active people to manage their insulin.

Philip sticks to a particular routine with his insulin but says other kinds of routine may work better for others.

Several people said that being 'insulin-dependent' had given them an illness identity which made them feel they were defined by their diabetes. Others who were not on insulin felt that it marked a point of no return, and that they intended to resist it for as long as possible. Others not yet on insulin were simply worried by the thought of it. 

Now he is insulin-dependent Darren has to carry his medication around with him and feels he is labelled an 'ill person'.

People also talked about the practical difficulties of taking insulin during their everyday lives; how they managed their injections when they went out for meals with friends and how they had to use different parts of the body to avoid getting sore patches of skin. 

Brian does 5 injections a day and explains how he remembers whereto injects.

Several people stressed to the importance of keeping insulin cool when travelling. 

Several said they had not been told how they should dispose of their used needles or 'sharps'. Several people noted how important it was to keep injection sites clean and also to shake the insulin container before the injection.

Although the pros and cons of traditional forms of insulin made from animals as opposed to newer 'human' insulins manufactured synthetically have been hotly debated for years, no one we met expressed an opinion on this subject.