Sugar Matters
May 2, 2008

You ask: Insulin???

This week is for anyone who sat in a doctor’s chair sometime (or coming in the future) and had him/her say to you, “Mr/Mrs So-and-So, I think we should start you on some insulin.”

I have seen a range of responses from patients when I start this conversation:{{more}}

#1-Loud voice, “ INSULIN??? Mercy no, not insulin!”
#2-Teary or frightened soft voice, “Oh please don’t ask me to do that.”
#3-Calm, half smile, nodding head but thinking, “Insulin eh? Well you might ask me to take it BUT I am not taking it when I leave this office, no way no how…”
#4-Calm, accepting, “Insulin huh (take deep breath). Okay, I thought so.”

Of course, every doctor hopes to have the reaction in #4 but that is not often the case. Why do folks have this reaction to the idea of insulin? I have found there are some common concerns about insulin that make this a Soufriere of a mountain to climb.

The first big one is the fear of using a needle on yourself. Yes, admit it, even you guys with muscles ripping out of your clothes. Many people have a very natural fear of needles because we don’t like pain. Some of you will not believe me when I say from experience and from my patients telling me: the needle used for insulin shots is not as painful as the needle prick for your glucose check or a blood draw. It really is not, assuming you give the shot properly (right through the skin without lingering, no dull needles etc). Truly, after they get over the first poke, all of my patients tell me it wasn’t as bad as they thought it would be.

The second big fear is about passing out from low blood sugars. Although many diabetes pills can also do this, insulin gets the points for causing the most fear about hypoglycemia. Between TV and stories from your neighbor’s fourth cousin, the legend of insulin grows. But this is a normal concern and should be-no one wants you passing out anywhere. You should work with your doctor carefully to come up with good insulin regimens and eating habits to help decrease any chances of you passing out in church, at the beach or, heaven forbid, while driving. You need to stay safe.

The last common concern is that once you start insulin your health goes downhill-you are on insulin for the rest of your life, your kidneys will go, you will lose your sight etc. None of this is true. Some people do not need insulin for the rest of their lives, it may be temporary. And insulin does not CAUSE kidney problems or legs dropping off — high glucose and infections cause those problems. Insulin is here to HELP you.

There are some other issues people have with insulin-weight gain, the issue of wanting to hide it from co-workers or family, expenses etc. And those are also valid concerns that should be addressed when you speak to your doctor. Please do not shut down your doctor when he/she speaks to you about insulin. And don’t call up your local Obeah woman either. As you will see next week, there are many times when you truly need insulin for your life’s sake. Believe me.

Until next week, stay healthy Vincies.

Anita Ramsetty, MD
endodocs@endocrinehelp.com
Medical Director Endocrine Care Group
www.endocrinehelp.com
Tel: 843-798-4227