12 Myths About Insulin and Type 2 Diabetes
Insulin facts vs. fiction
When you hear the word “insulin,” do you picture giant needles (ouch!) or pop culture portrayals of insulin users with low blood sugar (like Julia Roberts losing it in Steel Magnolias)?
Either way, most people think of insulin as a difficult, painful, or potentially scary medical treatment.
The problem is that if you have type 2 diabetes, you need to know the real deal before you can make an informed choice about whether or not this potentially lifesaving therapy is right for you.
Here, we take a look at the facts and fiction about insulin when it comes to treating type 2 diabetes.
Diabetics always need insulin
Of adults with diabetes, only 14% use insulin, 13% use insulin and oral medication, 57% take oral medication only, and 16% control blood sugar with diet and exercise alone, according to the CDC.
The point is to get blood sugarwhich can be a highly toxic poison in the bodyinto the safe zone by any means necessary.
Taking insulin means you’ve ‘failed’
The fact is that type 2 diabetes is a progressive illness, meaning that over time you may need to change what you do to make sure your blood sugar is in a healthy range. Eating right and exercise will always be important, but medication needs can vary.
“A large percentage of people with type 2 diabetes will ultimately need insulin, and we don’t see it as a failure,” she says.
Insulin injections hurt
In fact, most people would say that the finger pricks used to measure blood glucose levels hurt more than insulin injections.
“When people get their first injection, they often say, ‘I can't believe it didn’t hurt,’” says Dr. Crandall. What’s more, you may not need to use syringes at all.
There are injector pens on the market that allow you to dial the dose of insulin, snap on a tiny needle, and inject painlessly. Really.
Insulin can cause dangerously low blood sugar
A prolonged episode of low blood sugar could cause a loss of consciousness or coma. Still, most people with type 2 can easily recognize the symptoms, which include anxiety, shaky hands, sweating, and an urge to eat.
Consuming a bit of sugar—a few Life Savers, diluted juice, or glucose tablets—quickly reverses the low blood sugar.
Insulin is forever
Some people who lose a lot of weight (naturally or with the help of bariatric surgery) may find that they no longer need insulin, while others who lose weight may still need it.
(It largely depends on how much damage diabetes has done to the insulin-producing cells of the pancreas.)
“It is not always a one-way street,” Dr. Crandall says.
Insulin is difficult to take
“Today, insulin comes in pen injectors that are easy to carry with you, don’t require refrigeration, and can be used discreetly, often just once a day,” Dr. Crandall says.
“There are a large variety of insulin and insulin regimens that are much more convenient than they used to be,” she adds.
Oral medications are better than insulin
Still, they don’t work for everyone. "For some people, insulin is the easiest and best because it always works, but some people respond to pills, and others don’t," says Dr. Crandall.
Not all oral medications have a tried-and-true safety record. For example, Avandia was restricted by the FDA because of research suggesting that it ups the risk of heart attack.
Insulin will make you gain weight
However, the insulin therapy itself does not induce weight gain. It’s because if a diabetes treatment is working, the body begins to process blood glucose more normally, and the result can be weight gain. (This is one reason unexplained weight loss can be an early symptom of diabetes.)
The good news is that this tends to level out as insulin therapy continues, and the weight gain may be transient, explains Dr. Crandall.
People with type 2 don’t make insulin
This happens because type 2 diabetes is caused by insulin resistance, a condition in which the body loses the ability to respond normally to the hormone.
Taking insulin shots can help overcome insulin resistance, and they can take the place of naturally occurring insulin production, which does tend to dwindle over time.
Insulin means your diabetes is “serious”
In reality, high blood sugar poisons the body, damaging the heart, kidney, eyes, and nerves.
The point is to make sure your blood sugar is under control, whether it takes diet, exercise, pills, insulin, or all of these combined.
Insulin use requires multiple daily injections
This may be enough to control blood sugar on its own, or it can be combined with oral medications.
If blood sugar is still too high after meals, however, you may need to take insulin several times a day, just before eating.
Insulin is a treatment of last resort
“By the time a person with type 2 starts insulin therapy, they likely already have diabetes-related complication because of poor blood sugar control,” Dr. Crandall says.
Because high blood sugar is so toxic and can up the risk of heart attack, stroke, and other problems, you shouldn’t waste too much time undergoing treatments that aren’t getting your blood sugar under control.
In fact, starting insulin sooner may avoid complications, cause oral medications to work better (and be effective longer), or allow you to use a less-complicated insulin regimen for a longer period of time.