Several months ago, I met Sophia, a woman in her mid-40swho had been struggling to manage her type 2 diabetes foryears. Her blood glucose levels were typically well above 300mg/dl, and she had an equally high A1C of 12.5%. She madeit clear that the last thing she wanted was insulin.
I worked with Sophia to make several changes. She begana walking program, counted her carbohydrates, tested herblood glucose readings regularly, developed a medicationreminder system to minimize the number of times she forgotto take her diabetes pills and worked on reducing the stressin her life. She was really trying hard.
Despite all of these positive behaviors, her blood glucoselevels, though improved, were still too high, in the 200s. Herpancreas was going on early retirement and needed help.
We finally had a serious conversation about going oninsulin and how it could bring those numbers down intothe protection range. Sophia wanted to wait and see. Shestill didn’t want to introduce insulin at this point. As muchas I tried to convince her otherwise, my role was to provideher with the information she needed and to support herdecision.
At her next visit, Sophia reported she had an unexpectedvisit to the hospital. She had a “minor” heart attack. Duringthe course of her stay, she was put on insulin and her bloodpressure medications were increased. For the first time inyears, her glucose values were less than 200 mg/dl. Forthe first time, she witnessed how insulin really made thedifference in her numbers.
After being released from the hospital, she learned about amodern approach to insulin delivery: the insulin pen. Insulinpens are small, convenient for active people and easy to use.Sophia needed two pens for the two types of insulin she wasnow taking. The OptiClik pen handled her 24-hour time-releasedinsulin, and a NovoLog FlexPen allowed her to take afast-acting insulin before meals.
Insulin became the key to managing her diabetes, and insulinpens made injecting that much easier. With our subsequentappointments and by working with her physician to fine-tuneher insulin doses, Sophia’s glucose values were mostlyin target. She remarked, “Insulin was the best thing thathappened to me. I have so much more energy!”
As a certified diabetes educator, I have witnessed theadvantages of the insulin-pen delivery systems. Not onlyare they attractive and convenient for travel, they oftenreduce people’s fears about using insulin. For people whoare visually impaired or who have dexterity problems, insulinpens offer helpful features that address those concerns,whereas the syringe-and-vial method might not be a viableoption.
Sophia’s success resulted from seeking assistance from thediabetes care team, from being consistent with her self-managementand from her willingness to try a differentapproach. So what if the insulin pen was the last thing shetried—it worked!