Insulin and Type 2 Diabetes: Not One Size Fits All

Phyllisa Deroze wishes more people viewed insulin in neutral terms for people with Type 2 diabetes and doctors didn’t view it as a last resort.
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Insulin and Type 2 Diabetes: Misconceptions Abound
The relationship between insulin and people living with Type 2 diabetes is very often misunderstood. Many people view insulin injections as evidence of having a “bad” or “worsening” case of diabetes. Recently while I was at a conference, a woman asked me if I was on insulin. When I replied that I wasn’t, she responded by saying, “well that’s good.” I chuckled slightly and said, “So you say. But I am looking at the sugar cookie on your plate wishing I could enjoy it as much as you. Because I am not on insulin and my blood sugar is elevated I can’t indulge unless I go run on the treadmill for an hour. And, to tell you the truth, I did think about doing that, but I’m not in the mood tonight.” She gave me a puzzled and amused look, and replied “well, I never thought about it that way.”

What the woman didn’t know was that I had asked my endocrinologist for insulin the week before that conference. My fasting blood sugar was elevated, my post-meal readings were higher than they should have been, and I had a cold. I wanted to be on insulin, meanwhile my doctor was happy that I wasn’t using insulin therapy. To me, the elevated blood sugar was evidence that my body was fighting as best as it could, but it needed help. My endocrinologist, however, suggested that I increase my oral meds and wait it out. Her exact response to my request for insulin was “Nooooo, Phyllisa. You don’t need insulin.” In that moment, I felt that she, too, believed that insulin was a last resort for people with Type 2 diabetes.

My Routine Changes, So Should My Diabetes Management
I don’t feel that way. Insulin is one of many management regimes available for Type 2 diabetes and I should be free to select the style that’s best for me at a particular moment. When I was pregnant, insulin therapy worked well. When I was newly diagnosed, insulin worked well. Months after being diagnosed and for almost three consecutive years, diet and exercise worked well. When I needed help with portion control and losing weight, a GLP-1 injection, similar to this one, worked well. During the holidays and other seasonal transitions, oral meds work well. My experiences fluctuate, so naturally my diabetes management will vary.

The Healing Power of Insulin
I could never view insulin negatively because it was the life-saving nectar that rescued me from the diabetic coma I was falling into 2011 when I was first diagnosed. I know the healing power of insulin. I know how the right amount of the hormone can restore my vision, can stop the tingling in my feet, can reduce the extreme thirst, and can clear up a chronic yeast infection. I know that without insulin, I wouldn’t be alive to tell my story.

Insulin: Last Resort or Equal Alternative?
I wish more people viewed insulin in neutral terms for people with Type 2 diabetes and not as proof that we’re “uncontrolled.” The effects of this misconception can be damaging. I’ve been walking around for two months with elevated blood sugars waiting on oral meds to kick in because insulin is seen as a last resort rather than a choice that is equal to all the other options. I hope this changes, because as soon as it does, people may not avoid insulin to their own detriment or feel shameful or guilty about taking it.

I resist the idea that insulin is evil — because the true evil that I am most concerned about is hyperglycemia. It nearly killed me in 2011 when I was diagnosed, and I’ll do anything to avoid going back there again. Everything that helps keep my blood sugar regulated is equally appreciated, applauded, and accepted.


  1. Well written, Phyllisa … and love your motto!!! I’ll be following you to see further posts … I’m also a blogger … but a T1D one … having lived as an insulin junkie for the past 52 years … and still going strong … so #DiangosedNOTDefeated is now going to be ringing in my ears!

  2. Thanks Phyllisa for giving voice to type 2. Insulin is not the bad guy, it’s a tool that we can use to replace the function that our bodies have lost. It’s medicine, like other medicines that replace what is missing. If we keep voicing this we can help change the perception and correct the myth. Thank you.

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