Health And Wellness Center: Overcoming Objections to Injections

Does the thought of giving yourself an injection make you squeamish? It can take some getting used to, but you may find it’s not as bad as you thought it would be.

“I always tell patients that having a fear of needles is normal and natural,” says Evan Sisson, PharmD, a diabetes educator and assistant professor at the Virginia Commonwealth University School of Pharmacy. He helps people with diabetes get over their fear of shots so it doesn’t become an obstacle to controlling their blood sugar.

Why Injections Are Important

Everyone with type 1 diabetes must take insulin injections, because their body doesn’t make this hormone. People with type 2 diabetes take injected insulin or other prescription injectables if pills and lifestyle changes aren’t lowering their blood glucose enough.

Skipping insulin injections is very dangerous for people with type 1 diabetes. If glucose isn’t available for energy, your body starts burning fat instead. As a result, ketones can build up to unhealthy levels, which could make your blood too acidic, a state called ketoacidosis.

With type 2 diabetes, the risk of skipping medications or injections isn’t as immediate. But over time, unstable blood sugar levels can damage organs like the eyes, kidneys, and heart. Research shows that people who are afraid of their insulin injections are more likely to have poorly controlled blood sugar. They also have more diabetes-related complications. Getting comfortable giving yourself an injection is one of the keys to preventing these complications.

Debunking Your Fear

With today’s delivery systems, which include pens and smaller and thinner needles, 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,” says Robert R. Henry, MD, an endocrinology professor at the University of California, San Diego. “Now the needles have become so ultra-thin and fine, and you almost can’t feel them when they go in.”

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

You may also mistakenly think that having to take insulin injections is a sign that you’ve failed at controlling your diabetes. “In the past when a type 2 [diabetes patient] 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 people even think that insulin itself causes complications, an idea they’ve learned from watching friends and relatives with poorly controlled diabetes. That’s just not true. Insulin injections 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 people 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.”