2019-02-01_Diabetic_Living

Talk: INSULIN

My doctor wants to put

me on insulin. Does

this mean I’ve failed at

managing my diabetes?

—R esistant to Insulin

Dear Resistant,

Starting insulin therapy is not

a sign of failure. It is simply

employing the best medica-

tion to manage blood sugar

levels at this time for you.

Type 2 diabetes is progres-

sive. Over time, even with the

best management, the pan-

creas can become unable to

produce enough insulin. Plus,

individuals respond diff er-

ently to diff erent medications.

Th at’s why adjustments in the

dose or type of medication

to manage type 2 diabetes

are very common. Evidence

shows that earlier and more

aggressive management of

blood sugar, along with con-

trol of cholesterol and blood

pressure, can be helpful in

preventing complications.

What can you do? Dis-

cuss any fears, concerns, and

questions with your doctor or

diabetes educator, or tap into

a peer support group (online

or in person).

Bott om line: Keep your

eye on the prize. Th e addition

of insulin to your diabetes

management regimen may

help keep your blood sugar

levels closer to target, so you

can feel your best in spite of

your diabetes.

TOBY SMITHSON, M.S.,

RDN, CDE, is a registered

dietitian and diabetes ed-

ucator who has lived with

type 1 diabetesand used

insulinfor over 50 years.

She recently moved fr om the

busy suburbs to an island in

pursuit of living every day

like it’s a (much deserved!)

vacation day.

INSULIN BASICS

WHAT IS INSULIN?

Insulin is a hormone created by

the pancreas that helps move

sugar from your blood into

your body tissues where it is

used for energy.

WHAT IS INSULIN

THERAPY? When the

pancreas is unable to make

insulin, or the body cannot

use insulin effi ciently, insulin

therapy is used to help the

body turn food into usable

nutrients and energy.

WHAT TYPES ARE

AVAILABLE? There are many

on the market and each diff ers

in how quickly it begins to

work and for how long it helps

manage blood sugar. Some

forms, called basal insulins,

are long-acting, while others

(mealtime or bolus insulins)

are rapid-acting. Collaborate

with your health care team to

fi nd the right regimen for you.

As of November 2018, the Federal

Motor Carrier Safety Administration

(FMCSA) will allow drivers on a stable

insulin regimen (approved yearly by a

certifi ed medical examiner) to operate

commercial vehicles like trucks and

buses. Th is replaces the original rule,

which banned people requiring insulin

from driving interstate commerce trucks

unless they were granted an exemption

from FMCSAan application process

that took months, caused loss of wages,

and needed costly annual renewal.

10 DI A BETIC LI V ING / SPR ING 2019

Ask Toby

Fair Opportunities

for Truck Drivers

Stand Up for Affordable Insulin

Between 2002 and 2013, the average list price

of insulin nearly tripled, affecting almost 7.

million PWDs on insulin therapyespecially

those without insurance or on high-deductible

plans. Yet a complicated pricing systemwhich

involves drug companies, insurance companies,

pharmacies, and intermediariesmakes it nearly

impossible to pinpoint the causes of this steep

price increase or to fully understand who is ben-

efiting from it the most.

The American Diabetes Association is cir-

culating a petition that calls for increased trans-

parency and affordability in the insulin supply

chain, and that urges Congress to take action.

Whether you are on insulin therapy or not, your

signature is a reminder that there are over 30

million people living with diabetes in this coun-

try who deserve access to affordable care. To

sign, visit makeinsulinaffordable.org.

Life-saving medications like insulin

shouldn’t be fi nancially crippling, and

patients deserve to understand why

their medicines cost what they do.

MINT IMAGES / OFFSET.COM; COURTESY OF TOBY SMITHSON (INSET)