What To Ask Your Doctor About Insulin

by David Mendosa Patient Advocate

If you have type 2 diabetes, you may have always thought that taking insulin was something you used when everything else failed to manage your blood glucose level. In fact, insulin may give you the most control over your diabetes if you aren’t ready to change what you eat when you go on a very low-carb diet.

“If you don’t shape up, I’m going to make you inject insulin,” is a threat we may hear from our doctors. How about turning the table on your doctor and ask for it yourself?

If you really want to regain your health, taking insulin is the quickest way to get there. None of the other good diabetes drugs -- the non-insulin injectables or metformin -- can bring your blood glucose level down to normal nearly as assuredly as insulin can. While a very low-carb diet can work wonders, some people find it difficult to give up the bread and sweets and others are still suspicious of the amount of fat you need to eat for energy.

Two major myths about insulin

While everyone who has type 1 diabetes has to take insulin, of course, only one-fourth of people with type 2 diabetes do. This relatively low proportion is due to two misunderstandings:

  1. Insulin has an undeserved reputation as being difficult to get just right. The amount and time that you take it certainly can be tricky to figure out for the older bolus insulins that you need to take before each meal. But for several years now we have been able to use a basal insulin that we take just once a day without having to calculate how much we eat and when we ate it.

  2. Until recently, all types of insulin required us to inject it with a needle, and many people fear that the injection would hurt. In fact, unlike the fingerstick tests that we have to take to check our blood glucose level, insulin injections, they rarely or ever hurt. Even if you have needle phobia, we now have a great way to overcome it called the “Buzzy.” Furthermore, a type of insulin that doesn’t have to be injected became available a few months ago.

What you should ask your doctor about insulin

If your blood glucose level as measured with an A1C test is above 6.0, you can do your body a big favor when you ask your doctor to prescribe insulin. Here are the first questions to ask:

  1. Should I take a long-acting insulin? Should I take it once a day, or twice a day, like some people tell me to?

  2. Instead, should I take a rapid-acting insulin that is inhaled, so I don’t have to inject it?

  3. Or should I take both, at least at first?

  4. What should I do if insulin makes my blood glucose level gets too low?

  5. What other side effects might I get?

  6. Should I get a continuous glucose monitoring system, or CGMS?

  7. What about getting an insulin pump?

Your doctor will probably be pleased to hear your request to take insulin, especially if he or she has been nagging you to take it. The beta cells in your pancreas that have been working so hard ever since you got diabetes will also be happy, appreciating the break that taking insulin will give them.

David Mendosa
Meet Our Writer
David Mendosa

David Mendosa was a journalist who learned in 1994 that he had type 2 diabetes, which he wrote about exclusively. He died in May 2017 after a short illness unrelated to diabetes. He wrote thousands of diabetes articles, two books about it, created one of the first diabetes websites, and published a monthly newsletter, “Diabetes Update.” His very low-carbohydrate diet, A1C level of 5.3, and BMI of 19.8 kept his diabetes in remission without any drugs until his death.