Remembering to take insulin
I inject a basal insulin, and for me, the most difficult thing about using insulin is remembering to inject it.
The problem is that I don’t absolutely need the insulin. I’m type 2, and if I don’t take the insulin, I won’t go into DKA (diabetic ketoacidosis). So not taking it isn’t life-threatening.
I’m taking it because I figure the lower the A1c, the better, and although mine wasn’t terrible, it wasn’t spectacular either. Also, I didn’t want to wear out my beta cells. So I started using Lantus, and then switchend to Levemir when a continuous glucose monitor suggested that I was going low at night with the Lantus.
The problem is that I keep forgetting to take it. Another problem is that I keep forgetting whether I’ve taken it or not. I’m easily distracted, and if I’ve just injected my insulin and I’m heading for the notebook where I write down that I’ve injected and the telephone rings, or even if I just have an idea I want to write about or something I want to look up, I’ll forget all about the notebook.
There are, of course, very organized people who lead very organized lives, and they’d set up a routine and take their insulin at a set time every day. For them it wouldn’t be a problem.
I’m not like that. I never know ahead of time what I’ll be doing the next day. I live alone and for the most part I get up when I wake up, eat when I’m hungry, and go to bed when I’m sleepy. I could get into a routine of injecting insulin first thing when I got out of bed in the morning, but I’m not a morning person, and I like to relax when I first get up, not organize insulin supplies.
So how can we remember if we’ve taken our insulin? There are various approaches that work for different folks.
1. If you take your insulin at the same time every day, you can set an alarm that warns you that it’s time to take the insulin. There are even reminders that you can set for many time points each day to remind you that it’s time for your pills or insulin. Here’s one example. [Note that I’m not recommending any of the products I mention. I haven’t tried them myself. They’re just examples of what’s available.]
2. Some people actually fill all the syringes they’ll be using that day first thing in the morning. Although this won’t remind you when to take your insulin, at least you’ll know whether or not you’ve taken a particular dose. For bolus insulins, this obviously works only if you take exactly the same dose every day, which most people don’t.
3. Some people just label all the syringes they’ll be using that day and put them out. Then if your Monday lunch syringe is gone, or moved into a used syringe pile, it means you’ve taken that dose. However, labeling tiny syringes seems like a lot of work to me.
4. Instead of labeling, you could alter a weekly pill organizer to accept syringes, and when you’d taken a particular shot, you could put the used syringe into the appropriate slot. Or you could use one of those bill-paying reminders that have slots for each day, although they tend to be expensive.
5. Some people put the insulin bottles, not the syringes, in a pill organizer box. After taking a shot, they move the bottle to the next slot.
6. Some people have developed complex systems that not only remind you to take your shots but remind you to rotate the sites. Here’s a patent application for one such gizmo.
7. Manufacturers are developing pens that display the time and amount of your last shot. This would obviously be wonderful, but not cheap.
The system that turns out to work for me – and is cheap – is as follows. I take a lot of pills, and I keep them in a weekly pill organizer. When I take out a syringe, I remove the orange cap from the syringe and put that into that day’s pill slot. At the end of the week when all the pills are gone, I remove the syringe caps.
Then if there’s a syringe cap in today’s box, I know I’ve taken my insulin. In fact, it’s happened several times that I couldn’t remember if I’d done the insulin or not, and this system worked.
There’s just one problem, though. Now I have to remember not to swallow the orange syringe caps when I take my evening pills. This problem could easily be solved by buying one of those pill organizers that has slots for different times of the day and putting the syringe caps in a slot not used for pills. So far (knock wood), I haven’t swallowed any plastic caps.
I’m sure others have found other systems that work for them. What is your method?
Gretchen wrote for HealthCentral as a patient expert for Diabetes.