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Overcoming Objections to Injections

Diabetes Injections -- Myth Versus Reality

Needle anxiety is often a learned response. One painful vaccination or shot in childhood can lead to a distrust of needles.

With today's new delivery systems -- which include spring-loaded syringes and pens -- the needle isn't nearly as daunting as many people imagine. "Years ago, when I first started in diabetes, the insulin injections were truly painful and difficult to administer," Henry says. "Now the needles have become so ultra thin and fine, and you almost can't feel them when they go in."

The higher the gauge is, the thinner the needle. The typical needle used to inject insulin is a 31-gauge, which Sisson says is about the width of a tiny speaker wire.

Another element to the fear is misperception -- believing that having to take insulin injections is a sign that you've failed at controlling your diabetes. "In the past when a type 2 diabetic went on insulin, it usually was when things got really bad. So people associate going on insulin with being in really bad shape," Henry says.

Some patients even think that insulin itself causes complications, an idea they've learned from watching friends and relatives with poorly controlled diabetes. Sisson has heard comments like, "If I start insulin, then that means I'm going to go blind, have to go on dialysis, and you're going to have to cut off my legs." In reality, insulin injections can help you control your diabetes so your blood sugar doesn't get high enough to cause these complications.

Making Injections Easier

Sisson and other diabetes educators guide patients through the process of giving an injection step by step to make it easier and less frightening. "We do a demonstration. I do a step -- and then the patient repeats that step with their own insulin syringe," he says. "What patients find is that this isn't as overwhelming as they thought it was."

To make the process easier and less painful, Sisson recommends injecting in the abdomen, where a layer of fat under the skin acts as a cushion. Insulin is also absorbed more quickly from the abdomen than from the arms or legs. Injecting there every time ensures that the insulin is delivered to the bloodstream at a consistent speed.

To minimize discomfort, Sisson advises patients to inject themselves at least two fingers'-length away from their bellybutton and pinch the skin on their stomach. "Just the process of pinching the skin up actually desensitizes the skin so you don't feel it," he says. Sisson also recommends alternating injection spots, because insulin can promote the growth of fat cells. Over time, if you keep injecting yourself in the same spot you could develop a fatty lump in that area.

Buffington has learned which areas on her abdomen cause her the least pain, and she's gotten used to the idea of injecting herself. "Once I did it a few times I realized, this isn't so bad after all," she says. "Most of the time I don't even feel it."

Her fear of diabetes complications also made it easier to overcome her fear of using needles. "I knew I had to do it. I knew how important it was," she says. "All I kept thinking about were the complications that could happen if I don't get this under control. Sticking a little needle in is nothing compared to losing your eyesight."

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Reviewed on March 28, 2011

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