There is probably no other disease than diabetes where people are happy to give other people unsolicited advice and information. This is likely because it is such a common illness. Starting insulin, in particular, seems to carry with it many myths that you may have heard from well-meaning friends or family members.
If your healthcare provider has recommended insulin, you may feel worried about what this means for your diabetes. You may also wonder if injections will hurt, whether you will gain weight or whether you will need insulin for the rest of your life.
The good news is that many of the things you may have heard about insulin simply aren’t true. Here are some common myths—and the facts you should know.
Article highlights
- Starting insulin does not mean you have failed at managing your diabetes.
- Learn the truth about common concerns surrounding insulin.
- Find out what to expect when you start insulin.
- Understand insulin, weight gain and low blood sugar.
Myth 1: Needing insulin means I have failed at managing my diabetes.
Fact: Needing insulin is not a sign of failure.
Type 2 diabetes is a progressive condition. Over time, the body may produce less insulin and become less responsive to the insulin it does produce. As a result, some people eventually need insulin to help manage their blood glucose.
Needing insulin does not mean that you have done something wrong or have not worked hard enough to manage your diabetes. It means your treatment needs have changed. Insulin may be recommended when blood glucose levels remain above target despite other medications and lifestyle changes. It may also be started earlier when blood glucose is very high or there are symptoms of high blood glucose or metabolic decompensation.
Myth 2: Insulin injections hurt.
Fact: Insulin injections usually cause very little discomfort.
With newer technologies, such as insulin pens and small, thin needles, most people find insulin injections easier and less uncomfortable than they expected. Your healthcare provider or diabetes educator can show you how to inject insulin correctly and help you choose an appropriate needle and injection technique.
If your injections are painful, let your healthcare team know. There may be a problem with your technique, injection site or needle that can be corrected.
Myth 3: Insulin is difficult to use.
Fact: It can take some practice, but using insulin is usually straightforward.
When you first start insulin, there are some important things to learn. These include how much insulin to take, when to take it, how to inject it, how to store it and what to do if your blood glucose is too high or too low. Many people use prefilled insulin pens, which make measuring and administering insulin relatively simple.
Your insulin routine may also need to be adjusted over time. Your healthcare team can help you fine-tune your dose based on your blood glucose readings and changes in your health or lifestyle.
Myth 4: I can inject insulin anywhere.
Fact: Insulin needs to be injected into the fatty tissue just under the skin.
Common injection sites include the abdomen, outer thighs, buttocks and upper arms. It is important to rotate your injection sites and move around within an area rather than repeatedly injecting in exactly the same spot. Repeated injections in the same area can cause changes in the fatty tissue and affect insulin absorption.
Ask your healthcare provider or diabetes educator to show you where and how to inject your insulin.
Myth 5: Insulin always causes weight gain.
Fact: Weight gain can occur with insulin, but it isn’t inevitable.
Some people gain weight after starting insulin. If your blood glucose has been very high, some of the initial weight change may be related to the body retaining fluid as blood glucose improves. Insulin can also make it easier for the body to use glucose for energy rather than losing glucose through the urine. How much weight a person gains varies.
The type of insulin and other medications you take can also affect your risk of weight gain. Your healthcare team can help you develop a treatment plan that manages blood glucose while also considering your weight and overall health.
Myth 6: Insulin will cause dangerously low blood sugar.
Fact: Insulin can cause low blood sugar, but you can learn how to prevent and treat it.
Because insulin lowers blood glucose, hypoglycemia is an important consideration for anyone who uses insulin. A low blood glucose level is generally considered to be below 4.0 mmol/L.
The risk of hypoglycemia varies depending on the type and dose of insulin and other medications you take. It is important to learn the signs of low blood sugar and how to treat it.
Everyone starting insulin should receive education about recognizing, preventing and treating hypoglycemia.
Keep a source of fast-acting carbohydrate with you in case you need to treat a low blood sugar.
Myth 7: Insulin causes blindness, kidney failure or other diabetes complications.
Fact: Diabetes—not insulin—is responsible for these complications.
This is one of the biggest myths about insulin.
Some people remember a relative who started insulin and later developed complications such as vision or kidney problems. However, these complications are related to diabetes and, particularly, the effects of high blood glucose and other risk factors—not to insulin itself.
In fact, managing blood glucose effectively is an important part of reducing the risk of diabetes-related complications.
Myth 8: Starting insulin means I will need several injections every day.
Fact: Not necessarily.
Many people with type 2 diabetes who start insulin begin with a basal insulin that provides background insulin coverage. Depending on the insulin used, this may be given once daily.
If additional insulin is needed, mealtime insulin can be added. Some people eventually require multiple injections each day, while others may use a simpler insulin regimen.
There are also newer insulin options. For example, insulin icodec is a once-weekly basal insulin approved and marketed in Canada. Whether this or another insulin is appropriate depends on your individual circumstances.
Myth 9: Once I start insulin, I will have to take it forever.
Fact: Some people use insulin temporarily, while others need it long term.
How long you need insulin depends on why it was started and how your diabetes responds to treatment.
For some people, insulin is used temporarily—for example, when blood glucose is very high or during certain health situations. For others, insulin becomes a long-term part of their diabetes treatment.
Your treatment plan can be reassessed over time. However, never reduce or stop insulin on your own. Always talk with your healthcare provider before making changes.
Myth 10: Insulin is only used as a last resort.
Fact: Insulin can be an appropriate treatment at different stages of type 2 diabetes.
Insulin is not simply a “last resort.” Diabetes Canada recommends considering insulin in several situations, including when there is symptomatic hyperglycemia or metabolic decompensation, when blood glucose remains above target despite non-insulin medications, or when other medications cannot be used. In some instances, it may even be started at the time of diagnosis.
The decision to start insulin should be individualized based on your blood glucose levels, other health conditions, medications, lifestyle and preferences.
Myth 11: Taking insulin means I now have type 1 diabetes.
Fact: Taking insulin does not change the type of diabetes you have.
If you have type 2 diabetes and start taking insulin, you still have type 2 diabetes.
People with type 1 diabetes need insulin because their bodies produce little or no insulin. People with type 2 diabetes may eventually need insulin because their bodies don’t produce enough insulin or don’t use insulin effectively enough to keep blood glucose within their target range.
What should I know before starting insulin?
Starting insulin may feel like a big change, but you don’t have to figure everything out on your own. Your healthcare team can teach you how to use insulin safely and help you adjust your treatment as needed.
Before you start, make sure you know:
- What type of insulin you are taking
- How much to take and when to take it
- Where and how to inject it
- How to store your insulin
- How often to check your blood glucose (sugar)
- How to recognize and treat low blood sugar
- What to do if you miss a dose
- When to contact your healthcare team
It can take time to fine-tune your insulin routine, and your needs may change with illness, activity, eating patterns, medications and other life events.
3-Step Action Plan for Starting Insulin
- Ask questions about why insulin is recommended and how it will help you.
- Learn your routine including dosing, injections and treating low blood sugar.
- Track your blood glucose and work with your healthcare team to fine-tune treatment.
Starting insulin doesn’t mean you have failed at managing your diabetes. Insulin is an effective treatment that can help bring blood glucose into your target range and may be an important part of diabetes management.
If your healthcare provider recommends insulin, ask questions, learn how to use it safely and give yourself time to become comfortable with your new routine.
