Dialog

Volume 9, Issue 2, Spring 2008

Living with Diabetes  
You are a key player on your health care team when it comes to managing your diabetes.
 

Taking insulin: A natural part of diabetes

What happened to inhaled insulin? January 27, 2006, the Food and Drug Administration approved Exubera® for use by adults with type 1 and type 2 diabetes. The powder form of insulin could be breathed in through the mouth and was promoted as a long-awaited alternative to insulin injections. However, on October 18, 2007, Pfizer Inc. announced it will stop making Exubera. The manufacturer said the decision had nothing to do with the safety of inhaled insulin. There simply were not enough people taking Exubera to justify the expense of making it.

"If you don't diet, exercise and take your pills, you'll have to go on insulin," doctors used to -- and sometimes still do -- warn their patients with diabetes.

"Now we realize that taking insulin isn't a sign of failure, it's just part of the natural progression of diabetes," says Janelle Duffee, certified diabetes nurse educator with Allina Medical Clinic.

Although injecting insulin can seem unnatural, it actually helps your body continue a natural process. Duffee explains, "Insulin is not a drug; it is a hormone that your body produces. When your pancreas tires out and stops making insulin, you need to get the hormone another way."

Since insulin is a natural substance, it poses little threat to medicines you may be taking. "You don't have to worry about drug interactions or the usual drug side effects," says Duffee.

Gaining weight and other worries

When people start taking insulin, they often worry about gaining weight.

"When blood glucose is high, your body is eliminating around 400 calories a day," says Duffee. "But when you start taking insulin, your glucose goes down and your body starts using the calories it was eliminating."

When Duffee works with patients who have just started taking insulin, she encourages a combination of changing what you eat and becoming more activity. "This will help with limiting the weight gain" she says.

Some patients tell Duffee that they're afraid taking insulin might cause diabetes problems like blindness. "You hear about the little old lady who started taking insulin, then went blind," she says. "But it wasn't the insulin that made her go blind; it was years of having high blood glucose.

"Insulin does not cause complications, high blood glucose does. Insulin helps bring your blood glucose down so that any problems don't develop or get worse."

Injecting insulin

A hand holds an insulin pump or two insulin pens laying on a white counter.

Currently, the only way to get insulin is through injection. Giving yourself shots can be intimidating, but it doesn't have to be, according to Duffee.

"People often associate insulin with a big old syringe, needles and vials of solution," she says. "That used to be the case, but now we have convenient, disposable pens."

Insulin pens are self-contained, disposable units already filled with insulin. A simple dial helps you select the amount needed. "It helps keep your doses accurate, especially if you have limited dexterity."

Another way to take insulin is through a pump. Worn at the waist, the small device releases insulin into the body through a tiny plastic tube placed under the skin. Insulin pumps are recommended for people who are willing to…

  • test their blood glucose six to eight times a day, and
  • learn how to adjust their dose based on the meter readings.

"To be successful with an insulin pump, you really need to be motivated to take care of your diabetes," says Duffee.


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Related Resources


 

Source: Allina Patient Education, Basic Skills for Living with Diabetes, dia-ahc-90196; Diabetes eMagazine, Jan./Feb. 2002, Is the insulin pump for you?; Janelle Duffee, certified diabetes nurse educator, Allina Medical Clinic

United States Food and Drug Administration; Pfizer, Inc.

First published: 04/24/2008
Last updated: 04/24/2008

Reviewed by: Mary Frederick, RN, MS, CDE, diabetes program manager, Allina Medical Clinic

 

Dialog: Living with Diabetes comes courtesy of Allina.com. Part of Allina Hospitals & Clinics, the Web site offers reliable health and wellness information, physician referral and other health resources, especially for people who live in Minnesota and western Wisconsin.

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