This can be facilitated with some pointed questions, she added. “You can ask if they have ever missed a shot, and why. Many people miss a shot occasionally, but if they're under poor control, that might make me pursue it further.”
For patients with type 2 disease who are used to oral medications but are no longer in good glycemic control, the idea of injections may at first seem daunting. “They'll just say flat out, 'I'm not taking insulin.' They are terrified of giving themselves an injection.” However, this is often remedied with a simple practice session in the office, where they self-inject either with insulin (if indicated) or saline, Dr. Korytkowski said.
“For the majority of people, once they've given [themselves] that first injection and seen what's involved, they see it's not as bad as they had thought, and they realize they can do it.”
Both Dr. Korytkowski and Dr. Chase believe there are many layers to needle anxiety—pain and fear sometimes being separate issues, and sometimes occurring with more general phobic or depressive symptoms.
Although addressing this is usually time consuming, and may require additional help from specialists or nurse educators, it can result in improved glycemic control and frequently improves patients' quality of life.
'I've had kids [who were] ready to go to college, and the parents were still giving the shot.' DR. CHASE