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Tammy Williams was no stranger to diabetes. The North Carolina children’s librarian, now on disability, had originally been diagnosed with Type II diabetes in her mid-20s. For years, she had been managing her diabetes through diet modification and oral medications. But about six years ago, she entered a new area in the world of diabetes: insulin therapy.

“First I developed bronchitis, and I had to go on steroids, which was going to mess up my blood sugars,” recalls Williams, now 45. So her doctor prescribed insulin as a temporary measure. But once she stopped taking the insulin after her bronchitis resolved, her glucose levels kept getting worse. “I was having more and more trouble controlling things and my diet wasn’t working as well, so I went back on the insulin for good.”

Her first reaction: “Oh no, it’s going to hurt to give myself a shot every day!” This is one of many common fears among people with Type II diabetes who have to start taking insulin, says Nora Saul, RD, a nutrition manager with the Joslin Diabetes Centers in Boston. But as mysterious and frightening as the world of insulin therapy may seem, with a few insights from experts, it can be much easier to manage.

Here are six tips to remember when beginning insulin treatment for diabetes:

Taking insulin doesn’t mean you’ve failed at managing your diabetes.

Once or twice a week, Saul manages an “insulin start” for a patient who has been newly prescribed insulin. She commonly hears people say, “I lost weight. I’m eating better and more healthfully. So why am I being put on insulin?”

The natural progression of Type II diabetes often means that, over time, your pancreas will produce less and less insulin. So eventually you will need to receive it through injections. “That doesn’t mean it’s your fault,” says Saul. “By about 10 or 15 years of living with diabetes, most people are tending toward insulin. This is a way that you can get your blood sugars back under control and reduce the possibility of complications. It’ll give you more control than oral agents can, and you will probably feel better, with more energy.”

Insulin doesn’t lead to complications.

You may have seen family members or friends start taking insulin for their diabetes, only to experience complications, or even die. This might worry you. You may wonder if insulin actually poses a risk to your health.

No, says Saul. “People used to develop complications shortly after going on insulin in the past, because in those days patients were put on insulin as a last resort. The time to start is when your sugars are still in reasonable control. Insulin does not cause complications, and if used appropriately and in time, it will prevent complications.”

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