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Diabetes Health

Insulin Blues

Deepti Sharma explores ways to deal with the emotional and psychological aspects of going on insulin therapy.

Ever since the first clinical trials with artificially extracted insulin, insulin therapy has saved millions of lives around the world. Still to a person with Diabetes, going on insulin involves a tough phase of adjustment and learning. The psychological impact of switching to insulin therapy might be hard to deal with, for both the patient and their families. It is important to help each other deal with the situation and learn to see insulin therapy as the life-saving solution that it is, rather than as a bane. Three Diabetes Educators speak about the three most common psychological responses to insulin therapy and our suggestions to overcome them.

Fear

As kids, we’ve all been afraid of syringes till some point of time. Some of us outgrow that fear, but the idea of having to inject yourself every day, and sometimes more than once a day, would intimidate the bravest of us. But there are other fears associated with insulin – the fear of social stigma and sometimes, the fear of being dependent on something for life.

“Counselling patients on the necessity of insulin and its benefits is an important part of our work,” says K N Raut, a Pune-based Diabetes Educator. He and his colleagues Vidya Gokhale and Swati Alekar help diabetics learn the ropes of managing their condition. Fear, apprehension and embarrassment at having to use insulin are very common in the patients they come across, they reveal.

The first step to mitigate the fear is to acknowledge it – remember you’re not the only one who’s afraid of needles. Talk about your discomfort and don’t hesitate to ask for help. The insulin pens available today have a much shorter and finer needle than traditional syringes, and if inserted at the right location (abdomen or thighs, which have more body fat) not very painful. It may help to practice first on a fruit or a rubber ball.

Guilt

“Many patients, when put on insulin, tell us they’ll do anything we say from now on,” shares Vidya. It is important to understand that insulin is not your punishment for doing something wrong. In Type 1 Diabetes, the pancreas simply does not produce the insulin needed by the body. This happens due to some unusual behaviour on part of the body’s immune system, which turns against the islet cells that produce insulin. Why the immune system in some people acts this way, destroying the vital islet cells, is something scientists have still not understood, so there is no known way to prevent Type 1 Diabetes.

The case is different in Type 2 Diabetes. In most cases, the pancreas does produce insulin, but it is either not enough to meet the body’s requirement, or the body is unable to use the insulin (insulin resistance). Lifestyle modification, proper diet, exercise and medication helps keep the blood glucose level in control. However, in some cases, the function of pancreas in Type 2 Diabetes declines over the years, and the patient may eventually need insulin therapy.

So, the factors leading to a situation where you need to inject insulin – either through a syringe, pen or an insulin pump – are complex and usually not under your control. If your physician tells you to start using insulin, focus on its benefits rather than mulling over what went wrong.

Resentment

“Sometimes when my daughter has to prick herself, tears well up in her eyes,” says Anjali Mishra (name changed), whose teenaged daughter was diagnosed with Diabetes at the age of five. You cannot miss the quiver in the lady’s voice as she talks about her young daughter’s trials. The resentment at having to inject yourself or your loved ones every day – “why me?” is another common reaction to insulin therapy.

“We often find parents who have to prick their young children every day suffer much more emotionally than the kids themselves,” shares Swati. “We need to explain to them that these injections are in the best interest of the child, and failing to administer them regularly could lead to further complications and a lot of pain,” she explains. Vidya and her colleagues organise group sessions for children with Diabetes and their guardians who can help and support each other in coming to terms with the realities of Diabetes management.

Eventually with knowledge, practice and the support of your loved ones, you’ll learn to see insulin as your friend.

Share your experience of switching to insulin for the first time, and how you learnt to cope with it. Write to editorial@diabeteshealth.co.in

Remember…

  • You’re not alone
  • It’s not your fault
  • It is not harmful
  • You won’t get addicted

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