When people hear the word insulin, the image that comes to mind is often a giant needle and the hypoglycemia that occurs in insulin users. FoxNews.com has a summary of some of the misconceptions and facts about the process of using insulin to treat type 2 diabetes. Myth 1: People with diabetes always need insulin Not always. people with type 1 diabetes (about 5-10% of all people with diabetes) do need insulin to control their condition. However, according to the Centers for Disease Control and Prevention, for adults with diabetes, only 14% use insulin, 13% of patients use both insulin and oral medications, 57% take only oral medications, and 16% control their blood sugar levels through diet and exercise. Myth #2: Using insulin means patients are failing to control their sugar Jill Klander, professor of clinical medicine and director of the Division of Diabetes Clinical Trials at Albert Einstein College of Medicine in New York City. Dr. Crandall says, “A significant percentage of people with type 2 diabetes will eventually need insulin, but the medical community does not consider this a failure.” In fact, type 2 diabetes is a progressive disease, and a sensible diet and consistent exercise are both important for sugar control, but medication needs will change. Myth #3: Insulin injections can be painful Dr. Crandall says, “The small, delicate needles used today will make insulin injections close to painless, although not absolutely painless.” In fact, most patients will find the finger prick used to measure blood glucose levels more painful than insulin injections. In addition, choosing a tiny needle is usually not as intensely painful. Myth #4: Insulin can cause dangerous hypoglycemia It is possible, but not necessarily, that people with type 2 diabetes are at lower risk of hypoglycemia than people with type 1 diabetes. Most people with type 2 diabetes easily recognize the symptoms of hypoglycemia, including anxiety, trembling hands, sweating and a desire to eat. At this point, a little sugar, diluted juice or glucose tablets can quickly relieve the symptoms of hypoglycemia. Myth #5: Insulin must be used all the time Not necessarily. Some people with type 2 diabetes may need insulin temporarily, such as those who happen to develop diabetes after being diagnosed or during pregnancy; while others will need insulin indefinitely. Patients with diabetes who have lost a lot of weight (either naturally or with the help of bariatric surgery) may find that they no longer need insulin, while others who have lost weight still need insulin. The need for insulin depends greatly on how much damage diabetes has done to the insulin-producing cells of the pancreas. Dr. Crandall says, “So, whether to use insulin or not is not always a one-way decision process.” Myth #6: The process of injecting insulin is difficult Gone are the days when injecting insulin required a lot of bulky, obvious medical instruments and was difficult to handle. Nowadays, insulin can be made in the form of pen syringes, which are easy to carry around and do not require refrigeration, and are inconspicuous to use, and usually only need to be injected once a day; it is much more convenient than before. Myth 7: Oral medications are more effective than insulin When it comes to lowering blood sugar levels, oral medications for diabetes are quite effective. Many patients have been taking oral medications for years with safe efficacy, such as metformin. However, oral medications are not suitable for all diabetics. Crandall says, “For some patients, insulin is the easiest and best way to administer the medication because it always works; while some patients only respond to oral medications.” Not all oral medications have a proven track record of reliable and safe administration. Ventia, for example, is restricted by the U.S. Food and Drug Administration because studies show it raises the risk of heart attack. Myth #8: Insulin use can lead to weight gain There is some truth to this. Some people with type 2 diabetes experience weight gain when they begin insulin therapy. However, insulin therapy itself does not include the side effect of weight gain. This is because: if a diabetes treatment regimen works, the body will begin to handle blood sugar more normally, which may result in weight gain. This is one of the reasons why unexplained weight loss can be one of the early symptoms of diabetes. The good news is that as insulin therapy continues, the tendency to gain weight will gradually stabilize; therefore, weight gain is only a transient phenomenon. Myth #9: Type 2 diabetics cannot produce insulin This is a misconception. type 2 diabetics may actually produce higher than normal levels of insulin in the early stages of the disease. This is because type 2 diabetes is caused by insulin resistance, a disease in which the body loses the ability to respond normally to the hormone insulin. Insulin injections help overcome insulin resistance and it replaces the natural process of insulin production, which degrades over time. Myth #10: Using insulin requires multiple daily injections This is not always the case. Patients can try long-acting insulin injected once a night, when it is at its lowest level in the body. This long-acting insulin is sufficient to keep blood sugar levels under control or in combination with oral medications. If the patient’s postprandial blood sugar is still too high, insulin will need to be injected before each meal.