Common Myths About Insulin

Many people with diabetes put off starting treatment because they fear insulin. That fear is understandable. But some of what you have heard is not accurate. In this article we check each belief against its source. If you take insulin, do not stop it or change the amount without your doctor.

“Insulin is addictive”

No. A diabetes educator at the Braden Diabetes Center (MarinHealth), answering this exact question, writes that insulin is not addictive and is necessary for life functions. Dr V. Mohan, an endocrinologist in India, also says some people mistakenly believe insulin is addictive like narcotic drugs, while it is a life-saving medicine and not addictive.

NIDDK, the American Diabetes Association and Diabetes UK do not use the word “addiction” on the pages we opened for this article, so this answer rests on those two sources. But these three sources show why someone who has started insulin usually keeps taking it:

• NIDDK says that in type 1 diabetes insulin must be taken, because the pancreas does not make it.
• In type 2, the pancreas gradually makes less. In the words of the American Diabetes Association, the condition is “progressive.” Pills that were enough at the start may not be enough later.
• Insulin is a hormone the body makes on its own.

So continuing insulin comes from the body’s need for this hormone, not from a craving or a dependence on a drug. That is why stopping it raises glucose, and why it is dangerous in type 1. Diabetes UK also writes that some people need insulin only during certain periods. If you are still worried, talk it over with your doctor.

“Needing insulin means my treatment has failed”

The American Diabetes Association writes that using insulin to bring glucose into a healthy range is a good thing, not a bad one. Diabetes UK says that needing insulin is not your fault and does not mean you have managed your diabetes badly. It describes insulin as one more treatment for staying healthy. The NHS also writes that if other medicines are not enough, insulin is added.

“Insulin is only for type 1 diabetes”

NIDDK writes that this is not so. Many people with type 2 also come to need medicine, and sometimes insulin, over time. Sometimes it is temporary, for example during pregnancy or a hospital stay. Diabetes UK says insulin may be needed for a short time at the start to bring very high glucose down quickly.

“Insulin means the last stage”

Diabetes UK writes that insulin is sometimes needed at the start, for a short time. The same source says some people need it only during certain periods, such as pregnancy, severe illness or after surgery. So insulin does not mean “the end of the line,” and it is not “for life” in every case. How long you need it is for your doctor to say, and until then do not stop it yourself.

“Insulin in pregnancy is dangerous”

NIDDK writes that insulin is safe in pregnancy and is often used to control diabetes during pregnancy. High glucose in the first weeks of pregnancy raises the risk of birth defects, so fear of insulin should not cause a delay. The need for it changes during pregnancy and is adjusted with the care team.

“Insulin makes you gain weight”

Diabetes UK lists weight gain as a side effect of insulin for some people, and NIDDK includes it in the list of possible side effects of diabetes medicines. NIDDK says to ask your doctor about side effects. This does not happen to everyone, but it can. If you are worried about weight, discuss it with your doctor and a dietitian, and do not stop the medicine.

“Insulin can cause lows, so I will not take it”

NIDDK lists low blood sugar as the main side effect of insulin, especially when it is not matched with food and activity. But it also warns that fear of lows sometimes leads people to stop their medicine, and their glucose then rises. The solution is not stopping insulin. The solution is learning the signs of a low, carrying fast sugar, and talking with your doctor to adjust the plan. See the guide “Checking Glucose at Home and Recognizing Low Blood Sugar.”

“Other injectable medicines replace insulin”

NIDDK writes that injectable medicines in the GLP-1 group are not a substitute for insulin. Do not swap one for the other without your doctor’s opinion.

“Storing and injecting it is hard”

The American Diabetes Association and the NHS write simple principles:

• Keep unopened insulin in the refrigerator, away from the freezer. Insulin that has frozen must be thrown away.
• A vial or pen in use should stay at room temperature. The American Diabetes Association says about a month, and the NHS writes 4 or 6 weeks depending on the brand. Check the leaflet that comes with the medicine.
• Keep it away from direct sunlight and heat.
• Do not share a syringe or pen with anyone.

For more detail, plus travel and sick-day tips, see the guide “Insulin, Storage and Sick Days.”

Summary

Insulin is a serious medicine and it has side effects, but fear of it should not make you delay the treatment you need. If your doctor has suggested insulin, ask the reason, share your concerns, and ask the doctor to show you how to inject and store it. If you take insulin and feel unwell, check your glucose and ketones and see the guide “When should I call right away?”