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The Case for Insulin and Insulin Pens

Theresa Garnero, APRN, MSN, BC-ADM, CDE

Apr 1, 2006

From the Spring Research Guide

Several months ago, I met Sophia, a woman in her mid-40s who had been struggling to manage her type 2 diabetes for years. Her blood glucose levels were typically well above 300 mg/dl, and she had an equally high A1C of 12.5%. She made it clear that the last thing she wanted was insulin.

I worked with Sophia to make several changes. She began a walking program, counted her carbohydrates, tested her blood glucose readings regularly, developed a medication reminder system to minimize the number of times she forgot to take her diabetes pills and worked on reducing the stress in her life. She was really trying hard.

Despite all of these positive behaviors, her blood glucose levels, though improved, were still too high, in the 200s. Her pancreas was going on early retirement and needed help.

We finally had a serious conversation about going on insulin and how it could bring those numbers down into the protection range. Sophia wanted to wait and see. She still didn’t want to introduce insulin at this point. As much as I tried to convince her otherwise, my role was to provide her with the information she needed and to support her decision.

At her next visit, Sophia reported she had an unexpected visit to the hospital. She had a “minor” heart attack. During the course of her stay, she was put on insulin and her blood pressure medications were increased. For the first time in years, her glucose values were less than 200 mg/dl. For the first time, she witnessed how insulin really made the difference in her numbers.

After being released from the hospital, she learned about a modern approach to insulin delivery: the insulin pen. Insulin pens are small, convenient for active people and easy to use. Sophia needed two pens for the two types of insulin she was now taking. The OptiClik pen handled her 24-hour time-released insulin, and a NovoLog FlexPen allowed her to take a fast-acting insulin before meals.

Insulin became the key to managing her diabetes, and insulin pens made injecting that much easier. With our subsequent appointments and by working with her physician to fine-tune her insulin doses, Sophia’s glucose values were mostly in target. She remarked, “Insulin was the best thing that happened to me. I have so much more energy!”

As a certified diabetes educator, I have witnessed the advantages of the insulin-pen delivery systems. Not only are they attractive and convenient for travel, they often reduce people’s fears about using insulin. For people who are visually impaired or who have dexterity problems, insulin pens offer helpful features that address those concerns, whereas the syringe-and-vial method might not be a viable option.

Sophia’s success resulted from seeking assistance from the diabetes care team, from being consistent with her self-management and from her willingness to try a different approach. So what if the insulin pen was the last thing she tried—it worked!

Categories: A1c Test, Blood Glucose, Diabetes, Diabetes, Insulin, Pens, Professional Issues, Syringes, Type 2 Issues

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Apr 1, 2006

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