Family, Friends, and Initiating Insulin Ask the Experts about Insulin Therapy in Type 2 Diabetes Family, Friends, and Initiating Insulin Posted 05/22/2008 Teresa L. Pearson, MS, RN, CDE Author Information Question How can family members and friends help type 2 diabetes patients who are making the transition to insulin therapy? Response from Teresa L. Pearson, MS, RN, CDE Director, Diabetes Care, Fairview Health Services, Minneapolis, Minnesota Note: I have written my response to this interesting question as if I were addressing a family member or friend of the diabetes patient. It has been said that when someone is diagnosed with diabetes, the whole family is diagnosed with diabetes. Diabetes is truly a family disease, and how family and friends respond can have a major impact on how well the person with diabetes copes with the demands of managing the disease. It seems that the transition to insulin elevates the perception of diabetes as a serious disease. Fears that may have been repressed surface, including fears about hypoglycemia, fears that the diabetes is getting worse, or fears that the patient now has the "bad kind of diabetes." The Diabetes Attitudes, Wishes, and Dreams study showed that patients with type 2 diabetes often believe that they have failed. This is especially true if they have continually been told that "if you do all these things, we can keep you off insulin." As a friend or family member of a person with diabetes, your support is needed now more than ever. You can offer that support by listening to and respecting your loved one's decisions. However, this may be difficult. Both the person with diabetes and friends and family come with their own perceptions of what the transition to insulin therapy means. The needs of the person with diabetes will vary depending on age as well as the dynamics of the relationships with friends and family. Children and adolescents with type 2 diabetes will require not only your emotional support, but may also require you to participate in the supervision of blood glucose levels, medication-taking, food intake, and activity levels. It is a big job, but how you handle it will serve as a lifelong lesson in how to face challenges. There are other issues if your loved one with diabetes is an adult. You can't make decisions for this person, but you can offer support. Ask how you can help, but whatever you do, do not become the diabetes police. If you see your loved one doing something that you think is harmful -- eating a piece of apple pie à la mode, for example -- talk about it, but don't nag. Nagging will only cause friction. Most people with diabetes already feel guilty; they don't need to hear about how they should be taking better care of themselves. Look at this as the beginning of a new way of life. Ask how you can help. Alleviate your own fears by offering to attend classes so you will better understand this disease. Ask questions. Tell your loved one that you are genuinely interested in learning more about diabetes so that you can be more supportive. Get involved. Something as simple as walking in the patient's shoes for a few days can go a long way toward showing your support. You may even ask your loved one's healthcare provider about testing your own blood glucose for a few days or injecting yourself with an insulin syringe. It is also important to talk about how initiating insulin affects both of you. Insulin is often viewed as an anchor that requires a strict schedule for food, medication, and activity, and people fear that all spontaneity will be lost. Learn more about how the new insulin analogs can provide more flexibility and less hypoglycemia, especially at night. Talk about your hopes and dreams. If you had planned to hike the Grand Canyon or tour Europe or take a road trip across the United States, talk about how you can still do that despite insulin. Talk to your loved one's diabetes care team for help. Show that your concern is based on your affection for this person and the life that you have together. It is the patient's diabetes and you need to respect the patient's choices, but if these choices scare you or you don't understand them, talk about it -- and listen. Diabetes happens to the family. This activity is supported by an independent educational grant from Novo Nordisk.