Discussing Mealtime Insulin With Your Doctor

If you are taking a long-acting (basal) insulin and are not meeting your PPG (after-meal blood sugar) and A1C goals, it may be time to add a bolus, or mealtime, insulin like NovoLog®. If so, you may want to consider bringing it up with your diabetes care team. 

Letting your health care provider know that you are willing to consider starting mealtime insulin can lead to a helpful conversation. Some health care providers may delay having conversations about starting insulin, or adding mealtime insulin, because feel that their patients may be reluctant or unwilling to try it. And, some people with type 2 diabetes do have a hard time accepting insulin therapy. In a recent study of patients in the United States with type 2 diabetes, more than 17% stated that they would be unwilling to start insulin therapy.   

Starting basal-bolus insulin therapy can seem like a big step at first, but what you need to do becomes routine with practice. You will have to match the insulin you take to the food you eat.  And you may need to take insulin more often than you are used to doing. However, because basal-bolus therapy closely mimics the body's insulin patterns, it may offer the additional blood sugar control that many people with type 2 diabetes need. 

Sometimes people feel overwhelmed when starting insulin therapy, or adding mealtime insulin to their treatment plan. If that’s how you feel, it’s normal. However, it may be helpful to think about where your concerns are coming from and discuss them with your health care provider. You may have even heard negative things about taking insulin that are based on poor information, myths, or outdated ways of using insulin. In the past, insulin was often started only after serious diabetes-related health problems began to happen. This mistakenly led people to believe that insulin was causing these diabetes-related problems. If you are still unsure about starting insulin, you may want to read the Insulin Myths article on this website to get updated facts about today’s insulin therapy. 

Remember, type 2 diabetes changes over time. If your blood sugar is starting to rise, your pancreas may be making less insulin than it once did. Or maybe it is releasing it too slowly. Or perhaps your body is no longer responding to the insulin it does make properly (called insulin resistance). In fact, all of these things could be happening. So, while your body is still producing insulin, basal insulin treatment may be enough. However, as your pancreas slows down its production of insulin, or stops producing insulin in response to meals, mealtime insulin may need to be added. 

There are many things you can do to help manage your diabetes as it changes. One of them may be starting a mealtime insulin like NovoLog®. In fact, NovoLog® may give you the additional help you need to control blood sugar spikes that happen when you eat. So don’t be afraid to be the one to start the insulin conversation with your diabetes care team. If you need help with this, you might want to use our Doctor Discussion Guide. 

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