Have I done a ‘bad’ job at managing my diabetes?
Have I failed?
Does it hurt?
Do I now have type 1 diabetes?
What do I do?
These are just some of the questions that might be going through your mind when your doctor says, you need to start injecting insulin. As with trying anything new, you might be feeling a bit overwhelmed with what’s to come and what it all means for you and your life.
Placing blame does not help the situation. Diabetes is not anyone’s fault. Starting on insulin is not your fault and you have not ‘failed’! Diabetes is a very complex and multifaceted condition with many factors contributing to the overall picture. Some things are within our control, while others are frustratingly out of our control.
The ‘pooped out’ pancreas
In type 2 diabetes, our pancreas does initially produce insulin. The insulin however, has some difficulties opening the rusty locks into our muscle cells (insulin resistance). In response to the insulin resistance, our pancreas tries to produce more insulin. The pancreas can keep up with this demand for quite a long time, especially when we start to help it by exercising, considering our food intake and taking medications. But sometimes our pancreas just gets ‘pooped out’ and slows down. The age of our pancreas, how hard it has been working and whether it is genetically predisposed, are all factors which might see our pancreas slow done its insulin production. When this happens, sometimes it needs a helping hand, which is where injecting insulin comes in. Just as we might change oral medications for our blood pressure, cholesterol or pain relief, our diabetes medication will change over time. This might depend on our changing lifestyles, age or circumstances. Insulin is just another tool we can use in our diabetes management.
So do I have type 1 diabetes now that I am on insulin?
Type 1 diabetes and type 2 diabetes are like chalk and cheese. Type 1 diabetes is an autoimmune condition where the insulin producing beta cells are attacked and destroyed by our own body. People living with type 1 diabetes do not have the ability to produce insulin and therefore, must inject insulin from the day of diagnosis.
Type 2 diabetes is not an autoimmune condition, rather a complex metabolic condition where our body has difficulty utilising glucose due to insulin resistance and/or reduced insulin production. There are multiple mechanisms involved in type 2 diabetes involving the pancreas, the liver and the inefficient use of insulin (or locks on the muscle door).
So when you have type 2 diabetes and commence insulin, you still have type 2 diabetes. You have not developed an autoimmune condition. You are simply someone who has type 2 diabetes and are using insulin to help treat that diabetes.
Does it hurt?
Here is the size of the needle that are used to inject insulin – they are tiny! Often 4mm long.
Most people do not find insulin injections painful. Talk to your diabetes educator to make sure you are using the correct technique to ensure effective insulin delivery and to minimise any discomfort.
What do I do?
While insulin is a very safe and effective diabetes treatment, there are some extra things you may wish to consider. Our pancreas is a complex and sophisticated organ and although we are pretty clever, it is hard to be as good as your pancreas in delivering insulin. We need to keep an eye on the balance of insulin and glucose available in our blood. You may find it useful to talk to a diabetes educator and/or dietitian to make sure you are getting that balance right.
- NPS MedicineWise (external link)
- ADEA (external link) – find a diabetes educator
- MedSmart is a new SMART program run through Diabetes WA. It contains all the information you will need to manage all your diabetes related medications. For more information or to book into a MedSmart session, call 1300 136 588.
Marian is a Diabetes Educator and an Accredited Exercise Physiologist at Diabetes WA.