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Questions about changing to Insulin in Type 2

F

fiona35

Well-Known Member
Messages
227
Type of diabetes
Treatment type
Insulin
Just wondered if anyone could answer a few questions for me about changing from tablets to Insulin in a Type 2 diabetic.

I'm due to see the Diabetic team at the hospital shortly and my GP has mentioned they may put me on insulin as my last HBA1c's have been 8.4 and 8.2, naturally I am at the moment trying to reduce my carbs to try and avoid this but I have been looking for answers to these questions on the Internet and not having much luck so if anyone knows I would be truly grateful. :)

1 - I'm not a fan of needles - is anyone! but if you use an Insulin Pen do you have to put the needle in yourself ie deliberatly stab yourself! and then inject or does it work like the spring loaded lancet devices where you don't see the needle, ie press the pen against your skin and then press for the needle to go in therefore not seeing it?

2 - Would you have to take any time off work to adjust to the Insulin or can you go straight back to work?

3 - I know you would have to inform the DVLA and Insurance company about driving but do you have to temporarily stop driving for a few days to adjust or just carry on as per usual but doing extra tests?
 
Hello Fiona, Regarding the three points you asked for info on:

Point 1: When using a pen device, generally all pens are the same, some better at dialing in the dose of insulin than others. The choice of pen you are given will depend on the type of insulin that your GP or diabetic clinic start you off on. The best pens in my opinion are the Nova pens from NovaNordisk. The insulin comes in a cartridge, just like an ink pen, you dial in the amount required, this shows up on a small window at the back of the pen. Units of insulin are administered in 1 unit doses, or if you require less you can have the same pen in 0.5 units (demi or Junior pen) The insulin used in these pens is a) NovaRapid, which you take before eating a meal, usually something that has more than 15grm of carbohydrate in it for most people, and b) Levimir, which is a basal (background insulin, taken one or two times per day, this keeps you bg stable between meals and at night when you are sleeping)

As for stabbing yourself, you can do that if you wish, but the normal method is to first select a needle size according to the thickness of your body fat, they start at 6mm for leaner people and go up to 12mm for people with more body fat, this is trial and error, until you find a size you are comfortable with. to use you screw on the needle on the frond of the pen, dial in the required units of insulin, select the area of your body to inject, most people use the fatty area around the abdomen, pinch an area of fat between two fingers and gently insert the needle, it is often better to insert at a slight angle, to the full depth, hold the pen steady and apply a pressure to the button on the end of the pen, count for at least 15 sec's and withdraw the needle. No big deal really.

One manufacture, I can not think of the name at the moment, produces a device that injects by compressed air, I have been told that this is more painful than a needle with most people.

Point 2/3: Normally there is no need to take time off work. My best tip is to start using insulin over a weekend, when you are not working. The only issue with starting insulin is safety of dosage. Your diabetic clinic will start you off on what they think is the right dose, they usually under dose for safety and build up the rate over a short period of time. If you inject to much insulin and do not have enough carbs to cover it, there is a danger that you will go hypo, that is your blood glucose will drop rapidly and there is a chance that you could pass out. So the best practice is to be at home over the weekend with someone with you if this happens. always keep some dextros tablets or some thing quick acting with you, to eat if you feel faint, As far as driving goes, let someone else drive you for a couple of days until you get into the hang of it.

One last point in this long story! Get use to testing your bg more often now that you are using insulin. Test first thing in the morning, before meals, two hours after meals, before exercise, after exercise, before driving, or as often as you feel you need to. the key to good management is matching insulin to the amount of food you eat, combined with regular testing to learn what the effect of what your are eating is having on you blood glucose.

Again I hope this is not too much information overload for you, don't worry it will soon become second nature to you.
 
One last point in this long story! Get use to testing your bg more often now that you are using insulin. Test first thing in the morning, before meals, two hours after meals, before exercise, after exercise, before driving, or as often as you feel you need to. the key to good management is matching insulin to the amount of food you eat, combined with regular testing to learn what the effect of what your are eating is having on you blood glucose.
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If you can get enough strips that is!!! Having had 5 years labelled a Type 2, four of those on insulin, I have had to fight every inch of the way to get enough test strips. I hope you are treated better.
Nobody could have feared injecting more than I did at the beginning, Fiona but trust me, it becomes no more bothersome than brushing your teeth. You might be put on a mixed insulin, like I was (Novomix30) and the pens are really so easy to use.
As Geoff said, for the first couple of days, it's a good idea to be at home if you can but you'll soon have the hang of things.Promise.
 
Thanks Guys, your comments have helped alot and I'm not so scared now! :oops:

I keep telling myself that lots of little kids inject everyday and if they have to do I can learn to do it too, instead of screwing my face up when the nurse comes near me a needle!
 
Forgot to say, Fiona, the needles are TINY. Really. Before I had my first jab, I had visions of needles like those used for taking blood. :lol: To be honest, you practically need a magnifying glass to even see mine. I find the lancets for my finger-pricking more painful than my insulin jabs.
Hopethis helps to reassure you.
 
HI FIONA - in response to your Q3, yes you must inform DVLA and insurance company - you will get a driving licence for 3 years. But if you are an HGV driver then you will lose that licence, also some occupations like emergency vehicle drivers and taxi drivers (depending where you live) are affected
 
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