Tips for overcoming barriers to insulin therapy

Insulin plays an important role in managing diabetes. However, to get the full benefits of insulin therapy you need to take it exactly as prescribed by your healthcare provider. Often people find it hard to take their medication as prescribed. There are many reasons why this happens, and the specific reasons vary from person to person. If you can discover what makes it harder for you to take your insulin as prescribed, you can find ways to overcome these barriers.

Some general tips

Know your medicines. Be sure you have all of the information you need to take your medicines properly. Here is a list of information to know about every medication you take:

  • The name of the medication
  • The amount (dose) prescribed
  • When to take the medication
  • Whether it is taken before, with, or after eating
  • How to store the medication
  • What the medication does for you
  • How to tell if the medication is working as expected
  • What to do if you have a side effect
  • What to do if you miss a dose

Solve problems together with your diabetes-care team. Sometimes the biggest barrier to getting the full benefit of your medication is poor communication. Your healthcare providers want to know if you are having problems taking your insulin.

Separate fact from fiction. “Common knowledge” is often partly or totally incorrect. For some reason, there seems to be more “common knowledge” about health than almost anything other subject! Some people’s views about insulin and other diabetes medications are based on information that is out of date or simply incorrect. Be sure to check out any information you hear from other sources with your diabetes care team.

Overcoming specific barriers

The chart that follows lists some of the barriers you might need to overcome when making insulin part of your diabetes care plan. Also listed are some suggested tips to help you overcome these barriers.

Possible BarriersSuggested Solutions

Injecting insulin hurts.

You will most likely be surprised to find out that the shorter, finer needles in prefilled disposable insulin pens make insulin injections more comfortable. Ask your healthcare provider if a prefilled disposable insulin pen might be right for you.
 
Be sure to rotate the sites where you give your shots as your healthcare provider directed. This can go a long way towards preventing bruising and changes in your skin that can make it more difficult to inject.

Taking insulin is too inconvenient and difficult

Prefilled disposable insulin pens offer simple, adjustable dosing in an easy-to-carry, discrete pen-like delivery system. Talk to your healthcare provider about whether an insulin pen might be right for you or visit insulindevice.com to see an online demo of insulin pens from Novo Nordisk.

I have a hard time remembering to take my insulin.

If you take a long-acting insulin at bedtime, it can help to associate taking your insulin with something you already do at bedtime. Many people find that keeping their insulin with their toothbrush is a helpful reminder.
 
If you find it hard to remember to take your Regular (short-acting) insulin 30- minutes before meals, talk to your healthcare provider to see if a rapid- acting insulin analog would be a good option for you. Rapid-acting insulin analogs work fast, allowing you to take your insulin and eat within 5 to 10 minutes of injecting, instead of waiting the 30 minutes required with Regular insulin.
 
There are many ways you can take insulin. If you are having difficulty following your current plan, talk with your healthcare provider to see if there is another option that would work better for you and your lifestyle.

Taking insulin makes me feel like I have failed to manage my diabetes.

It is important to realize that type 2 diabetes is a progressive disease. Most people who have type 2 diabetes – even if they follow their diabetes care plan closely – will eventually need to advance to insulin therapy. When this happens, don’t assume the change has occurred because you did something wrong.
 
The most important thing you can do now is to work on accepting this change in treatment. You can start by learning what you need to know about making insulin a part of your new daily routine.

I’m afraid of the side effects of insulin.

People who have had diabetes for a while and have not effectively managed their blood glucose are at a greater risk for serious health conditions such as heart disease, kidney disease, and amputations. Sometimes people relate starting insulin to these health conditions when in reality it was the long-term uncontrolled blood glucose levels the probably lead to these problems, not starting insulin. Keeping your blood glucose levels as close to normal as possible can help to reduce your risk of developing complications of diabetes. When you take insulin according to your diabetes-care plan, it is a safe and effective way of treating your diabetes.
 
The most common side effect of insulin therapy is hypoglycemia or low blood glucose. Although severe hypoglycemia is rare, it is more common in people with type 1 diabetes. Studies show that people with type 1 diabetes average about one severe hypoglycemic event a year. People with type 2 diabetes generally experience severe hypoglycemia much less often, even when taking insulin. Checking your blood glucose frequently can help you avoid hypoglycemia. Knowing the warning signs of hypoglycemia and treating it quickly can help you avoid severe hypoglycemia

Insulin costs too much.

Novo Nordisk prefilled disposable insulin pens are covered by many managed care plans. For reimbursement assistance for Novo Nordisk products, please call 1-877-NOVO-777 (1-877-668-6777).
 
If you are having trouble affording your medications, talk to your healthcare provider.

I am confused about how and when to take my insulin.

Be sure to get written instructions on when, how much, and how to take your insulin.
 
Don’t hesitate to ask questions until you understand what to do.

I don’t believe I really need to take insulin for my diabetes.

Sometimes these feelings of doubt are of away of coping with the news that you need to take insulin. Talk with your healthcare provider about why you need to advance to insulin therapy, and what to expect from taking insulin.
 
You can also read about insulin in the medication section of this website and find tips for coping in the Advancing to Insulin section.

Taking insulin means I have to give up activities I enjoy.

In most cases, you can continue to take part in any of the activities you enjoyed before you started insulin therapy. You just may need to monitor your blood glucose more frequently and add some snacks to make sure your blood glucose stays as close to normal as possible. Talk to your healthcare provider about how to accommodate specific activities.

I feel embarrassed to take insulin.

As of 2007, nearly 15 million people in the United States had been diagnosed with diabetes, and about 28% take insulin.
 
Even though there is no reason to feel embarrassed about taking insulin, it is a common feeling, especially when you first start insulin therapy. To help you overcome this barrier, ask your healthcare provider if a prefilled disposable insulin pen might be right for you instead of a syringe. Insulin pens fit in your pocket or purse, making them discreet and easy to carry. Their quick, adjustable dosing making injecting insulin easy.

Insulin options are constantly changing and expanding. The best insulin choice for you will be one that manages your blood glucose, while also meeting your lifestyle needs. You and your healthcare provider will work together to devise an insulin plan that will work for you.

Sources: Hayes RP, Bowman L, et. al. Understanding diabetes medications form the perspective of patients with type 2 diabetes. Prerequisite to medication concordance. The Diabetes Educator 2006;32(3):404-414.

Illustrated Guide to Insulin Therapy. Novo Nordisk.

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