A New Way to Deliver the Insulin I Need

Editor’s Note: People who take insulin require consistently affordable and predictable sources of insulin at all times. If you or a loved one are struggling to afford or access insulin, you can build custom plans based on your personal circumstances through our tool, GetInsulin.org.

I spent much of my life observing, measuring, recording and analyzing equipment data. So it’s natural that in my retirement that I would apply those same skills to keep an eye on my blood glucose levels, food, medication, exercise and insulins. It’s part of the journey of living with type 2 diabetes. 

A major part of my journey has been learning how to integrate insulin into my routine. I’m sure my experience is relatable to so many others with type 2. For this part of my life with it, I’ll be sharing what it’s like going from using a syringe to an insulin pen. 

When I was diagnosed with type 2 diabetes nearly 30 years ago, I was initially prescribed glyburide, a sulfonylurea (SFU)and met with a diabetes care and education specialist (DCES) and a dietitian. From the start, I started exercising regularly and following a low-carb, high-fat diet. Unfortunately, along with my SFU, my routine was causing me to experience hypoglycemia (low blood sugar) and my doctor weaned me off of it. 

For a decade, I was able to maintain normal blood glucose levels with diet and exercise. Over time, I noticed my blood glucose levels starting to rise. I decided to cut my carbs to nearly zero grams per day and upped my bike riding routine, but it wasn’t working. It wasn’t until my doctor explained that type 2 diabetes is progressive and I may need extra help to keep my blood glucose numbers under control. They prescribed me metformin and it worked well for at least the first few years. After that period of time, she prescribed me a long-acting insulin. I wasn’t nervous about using needles, specifically a syringe and a vial; I spent a lot of my career using them to medicate and vaccinate livestock. I teased my DCES at the time that I was sure it’d be easier giving myself a shot than a restrained animal. 

My new routine of taking my long-acting was working well until the last quarter of 2020 when I noticed my fasting blood glucose levels and postprandial blood glucose levels were rising higher than normal. In late December of 2020, I got an A1C that was a full percentage point higher than the previous one. My doctor decided to prescribe me a fast-acting insulin used for meals, and a continuous glucose monitor (CGM) to help me keep better track of my blood sugar. In addition to that, I received info on how to use a sliding scale for insulin based on pre-meal blood glucose readings and info on how to set up insulin-to-carb ratios. 

At the time, I was taking both insulins using vials and syringes. I can only recall one time when I mixed up my vials and accidentally injected rapid-acting instead of long-acting which ended up being a much higher bolus than I intended. I realized my error almost immediately but decided it was a great time to start carb loading and indulge in some delicious banana nut bread. I had to determine how to separate my insulins to prevent another mistake like this. But it turns out, I didn’t have to do this for long because I ended up switching to insulin pens shortly after. Unfortunately, I started having trouble getting syringes in my preferred needle length and gauge from my local pharmacy. I’m not sure if it was a supply chain issue due to COVID-19. 

I’ve never had an issue using needles, including a syringe, to manage my diabetes, but I did notice some differences between using syringes and vials compared to insulin pens. Here’s what I noticed when I switched to pens. 

• I didn’t need to have a separate vial to draw from. 
• Less waste of my insulin. 
• I can inject with ½ unit doses. 
• Pens are easier to carry and I have a case that holds 2 pens and a cool pack if needed. 
• Pens are too heavy and unwieldy for me to inject into my upper arm. 

I’ve learned over the last year or so about smartpens. The ones I looked into seem to use insulin cartridges. They seem like good devices, but unfortunately, it would require another change in my prescription for both the pen and the cartridge. There’s a product I’m interested in that attaches to the dosing dial, but it’s not approved in the U.S. 

At the end of the day, despite the way I had to switch the way I deliver insulin, I’m glad I made the change. I’ve always been someone who stays on top of my diabetes through bike-riding for exercise, using apps to make sure I’m tracking my insulin correctly, monitoring my blood glucose on my CGM and now taking advantage of a new way to make sure I’m accurately getting the insulin I need. 

This content was made possible with support from Lilly Diabetes, a Founding Partner of Beyond Type 2.