Things I Wish I Had Known When I Started Taking Insulin
by Corinna Cornejo Patient Advocate
Starting insulin is a significant change in how you manage diabetes. Not only do you need to learn about insulin dosing, but also safe insulin storage, how to take an injection, possible side effects, and more. Here are a few things I wish I’d known when making this transition.

Insulin Syringes Come in a Variety of Lengths and Gauges
If that needle seems awfully long or kind of big, talk to your doctor or nurse about using a different size syringe. Smaller, shorter needles can reduce discomfort.

Products Are Available That Help Make Injections Easier
Poking yourself with a needle takes some getting used to. Thankfully there are products that can help. A favorite is the Inject-Ease. This device sends the filled syringe needle into your skin quickly and painlessly with the help of a spring-loaded mechanism.
Not All Insulins Are the Same
There is more than one type of insulin. Insulin types are categorized by how long they take to begin affecting blood glucose levels and when they peak. Insulin also comes premixed, combining two types of insulin in a single dose. Proper dosing and the effect of insulin depends on the type(s) used. Because of this, one type of insulin cannot simply replace another.

Lipohypertrophy Is a Word Worth Knowing and Understanding
Lipohypertrophy is when a bump of thickened tissue develops in the subcutaneous fat layer. Skin lesions at the sites of insulin injections, referred to as lipodystrophy, can present as lipoatrophy (LA) or lipohypertrophy (LH). Caused by repeatedly injecting insulin in the same spot, lipos make insulin absorption unpredictable and can lead to hypo- or hyper-glycemic episodes. The best way to avoid developing lipos is to change your injection site each time you take a shot.

There’s More Than One Way to Administer Insulin
Taking insulin shots by syringe is the most common way to take insulin, but it’s not the only option available. Insulin pens and insulin pumps are commonly used. Insulin pens contain cartridges of insulin and use disposable needles. Pens can make insulin more portable because they are compact and self-contained. Also, many insulin pens don’t require refrigeration once they’re opened.

Other Ways to Administer Insulin
Insulin pumps are becoming more common. This medical device attaches to the body using a catheter (called a subcutaneous cannula) and allows the user to inject insulin at the press of a button (after doing some math to calculate the dose needed, of course).
Inhaled insulin is also available. Using an oral inhaler (similar to those used for asthma) the person breaths in the insulin in as a mist. Inhaled insulins are limited to rapid-acting insulins.
You Can Learn to Think Like a Pancreas
Managing diabetes with insulin is complex. Thankfully, there is a practical guide written for the layperson. Gary Scheiner’s Think Like a Pancreas lays it all out in plain language: the basics of what and how blood glucose is affected, how to insulin therapy works, and how to calculate insulin doses. Patients should always discuss with their health care providers how to manage their insulin doses.

Taking Insulin Is Nothing to Be Ashamed of
Insulin is a treatment, not a judgement. Some people won’t be comfortable seeing you giving yourself a shot. You might not feel comfortable taking a shot in public. These are times that call for teachable moments and problem solving—not skipping a dose and compromising your health.

Insulin Is the Sixth Most Expensive Liquid in the World
Right after Chanel No. 5, insulin is the next most expensive liquid in the world at $9,400 per gallon. Thankfully, you don’t have to buy insulin by the gallon. But the high price will take a substantial bite out of your monthly budget, especially if your doctor prescribes an insulin not covered by your insurance or if you don’t have health insurance.

Easy, Affordable Access to Insulin Is out of Reach for More Than Half of People With Type 2 Diabetes Who Need It Worldwide.
Lancet reports that less than half of the 63 million people with type 2 diabetes who need it worldwide have easy and affordable access to insulin. Looking ahead to 2030, as the number of people with type 2 diabetes is expected to more than double, the rate of insulin accessibility is not expected to improve.