Fellow diabetics, what concerns do you have when you are advised by your doctor to use insulin? Are you worried about addiction, pain, gaining weight or cost? As a clinician, we have to face a series of similar questions from patients almost every day. it goes without saying that type 1 diabetic patients need to use insulin for life, while most type 2 diabetic patients still have a lot of misconceptions about insulin. The questions that patients have will be answered one by one. Long-term use of insulin is not addictive. “Drug addiction” refers to patients who, after applying certain drugs, have an uncontrollable desire to obtain and continuously use them, with the aim of obtaining pleasure, which is a kind of psychological dependence. Insulin is not a drug in the strictest sense, but a physiological hormone secreted by the human body itself that is needed by anyone, and it is the only hormone that can lower blood sugar. Even if it is applied for a long period of time, it is needed to maintain metabolism and sustain life, so insulin does not have the problem of addiction. Discontinuation of insulin varies from person to person Some patients with shorter disease duration or younger age, the use of insulin can not only have the effect of lowering sugar, but also, through insulin replacement therapy, can make the patient’s own islet cells get sufficient rest and protect the residual islet cells, thus restoring their own physiological functions to some extent. Through lifestyle changes and recovery of islet function, it is very possible for these patients to stop taking insulin and switch to oral medication or even no medication at all. For some patients with long duration and severe disease, it may not be possible to stop. On the one hand, they have already missed the best treatment period and have lost all the islet cells, and it is quite difficult to regenerate the apoptotic islet cells, so even if they use insulin, it is difficult for the islet cells to restore their functions on their own; on the other hand, some patients have serious complications or comorbidities, and long-term use of insulin is also recommended due to their conditions. Oral hypoglycemic drugs and insulin do not conflict with each other. As the disease progresses, the function of pancreatic islets decreases at a rate of 5% per year, and even if oral hypoglycemic drugs are prescribed, most patients will eventually need insulin therapy. Moreover, the insulin-promoting drugs in the oral medication keep the islet cells in a state of high load, thus accelerating the decline of islet function. When the islet cells are completely apoptotic, these pro-secretory agents become completely ineffective because there are no target cells for them to act on. Non-insulin secretagogues such as acarbose can control blood sugar to some extent, but when there is no insulin in the body, you will find it impossible to control blood sugar with these drugs alone. Both insulin and glucose-lowering drugs can have side effects The common side effects of insulin are hypoglycemia and discomfort at the injection site. The former can be completely avoided by regular diet, increased exercise, and fine adjustment of dosage, while the latter can be reduced by improved injection techniques and rotation of injection sites. Oral hypoglycemia can also occur, and the process of drug metabolism is more or less stressful to liver and kidney function. With insulin, there is no such concern. Weight gain is not the cause of insulin itself. Many diabetic patients have experienced weight gain after insulin application, which has caused many of them to be afraid of it. In fact, weight gain is mainly due to the reduction of energy lost with urine after the patient’s blood glucose is controlled, and the patient does not control the diet, or thinks that there is no need to control the diet after using insulin, or some patients are afraid of the occurrence of hypoglycemia and intentionally eat more food. At the same time, these patients do not do enough exercise to burn the extra energy, which leads to weight gain. In fact, they can completely achieve a balance between diet and exercise through a good lifestyle to avoid weight gain. Insulin injection is easy and convenient Insulin injection is very easy, and the average person can learn to operate it skillfully in 5 minutes. Moreover, some insulin products nowadays do not require a pre-meal wait, and you can eat as soon as the injection is administered. Insulin pens are easy to carry around, and after the refill (insulin) is installed, it does not need to be placed in the refrigerator or refrigerated, but at room temperature and avoiding high temperatures and sunlight. In addition, the needle tip on the insulin injection device is short and thin, which is just a “drizzle” compared to that of measuring blood sugar at the fingertips, so there is no need to worry about the pain. Early insulin costs are higher In the early stages of insulin use, a higher frequency of blood glucose monitoring is required in order to find the right dose, thus incurring some costs. After that, most of the cost is simply the cost of the insulin refill. The current reality is that many glucose patients are taking two or even three or four oral medications, and the total cost will only be higher than insulin, not to mention whether the blood glucose will meet the standard. Moreover, if long-term blood sugar is not up to standard and complications arise, it will be more expensive to treat the complications while lowering sugar at this time.