Man, 63 years of age, type 2 diabetes, obesity, hypertension and hyperlipidemia, referred to me, a CDE, to start him on and teach him how to use insulin. He has had diabetes education in the past, tried lower carb eating and physical activity, but glucose levels still elevated. He told me he felt like a failure. He said he learned he was insulin resistant, made too much insulin, which was causing his co-morbidities. He was very resistant to start insulin, especially since he thought insulin was the cause of his problem.
I started re-teaching him. Started by letting him know insulin is not a bad hormone, in fact a lifesaver for many. The problem he learned about earlier was not the whole story. More to the story is we all need insulin, but the right balance. In his case — although at one time he may have been “making” too much, which can cause weight gain, hypertension and hyperlipidemia — it was “not enough” to bring his glucose down. I taught him that yes, decreasing his carbohydrate intake and being more active and losing weight plus the other medicines he took have helped, but there’s no guarantee it would help bring his glucose down enough. He listened, and started taking his insulin as prescribed. In 3 months, his A1C had come down from 10.2% to 7.5%. Although not quite to target, he was on his way, and was no longer resistant to taking insulin.
- Teach patients about the benefits of insulin early on.
- Prevent insulin resistance (psychological insulin resistance) by not teaching a patient that he or she will never need to take insulin.
If you have a “Diabetes Disaster Averted” story, please let us know! If we feature your Disaster Averted in our Diabetes Clinical Mastery Series e-newsletter, you will receive a $25 gift card. Please click here to submit a short summary of the incident, what you feel you learned from handling the incident, and your name and title. If you prefer to remain anonymous, please let us know, but still give us your name and address (so we can send you the gift card).
Copyright © 2017 HIPER, LLC