disease, diabetes and Enroll in the Heart Of Diabetes. Thrivers program by filling out and mailing of people with diabetes are overweight …
Session Nine
Fear of the Needle
session nine: feAr of the neeDLe
Session Nine
Fear of the Needle
The NDEP strongly encourages inviting a medical person health care provider or certified diabetes educator to participate in any sessions that you conduct to provide support for the discussion and to answer any specific medical questions that may arise
Background
Many people with diabetes use insulin to help keep their blood sugar blood glucose under control There are many myths about insulin use Some people think that a person has a worse kind of diabetes if he or she uses insulin Insulin is the fastest, most effective way for someone with very high blood sugar to get it down to a normal range Insulin alone or in combination with pills may be the best choice for many people with diabetes Yet many people are afraid to use insulin Why?
Objectives
1 To discuss what fears people have of using insulin 2 To discuss insulin myths versus realities 3 To describe what diabetes self-management means in terms of checking blood sugar, giving insulin, and problem solving
Time needed for discussion: 30 to 45 minutes without the optional section on glucose monitoring; 45 to 60 minutes if
discussion of self-monitoring of blood glucose is included
Materials
For instructions on borrowing The Debilitator film, see page 4 of this guide
DVD of the film The Debilitator DVD player/TV monitor
new Beginnings: A DisCussion guiDe for Living weLL with DiABetes
The handouts Myths and Facts About Insulin and What You Might Know About Diabetes: Myths and Facts can be found at the end of this session after page 72
Handouts: Myths and Facts About Insulin and What You Might Know About Diabetes: Myths and Facts the handouts are included in this discussion guide kit; make at least one copy for each participant Optional: Flipchart or blackboard for writing down key words from discussion
Method
Conduct a facilitated discussion group discussion with a leader asking stimulation questions Play the film, or select scenes from the film as needed
1 Tell the group: Think about the scene in which Calvin is in the doctors office [You may want to replay the scene to refresh participants memories ] Consider using the following questions to guide the discussion: Ask: What is Calvins attitude in general in the doctors office? Examples of his attitude might include: Suspicion He
asks the nurse, How long have you been doing this? Reluctance He is not initially interested in a support group, saying Let me think about it He reluctantly agrees to return for a follow-up appointment with the doctor Concern and maybe some disbelief He asks about his blood pressure reading: Is that high?
Tell the group: Think about Calvins reaction when he is told that he needs to use insulin What does Calvin say to the doctor? Possible responses include: Youre putting me on insulin? Thats using the needle, right?
session nine: feAr of the neeDLe
Ask: Is Calvin perhaps expressing disbelief, shock, dismay, or other emotions? I cant believe I have to take insulin Ask: What is Calvin feeling? Disappointment or disgust? Shock? Denial? Other emotions? Ask: What are some other common reactions that people have when they are advised that they need to use insulin? Possible responses include: Fear of the needle Feeling more out of control or overwhelmed Feeling that insulin is the end of the road– that if they are using insulin, their diabetes is more serious Fatalism–feeling that if they are on insulin, theres no use watching what they eat anymore Worry about whether being
on insulin will change important things in their lives, such as whether they can still hold the same job This concern about keeping a job can be a serious one for some people–those who have a commercial drivers license, for example Fear of what others might think, or fear that people will think that they are skin popping or abusing drugs Others?
Ask: Is there anyone here who uses insulin and is willing to tell us what it is like? [If anyone volunteers, ask:] How did you feel when you first started using insulin?
new Beginnings: A DisCussion guiDe for Living weLL with DiABetes
You may wish to bring out the following points in the discussion: Using the needle may sound awful, but the needle is very small–smaller than the one used to draw blood or even the one used to give children their baby shots There are a lot more kinds of insulin and ways to give it than there used to be, so you and your doctor can find a system that works for you It may be scary to take insulin when you first start, but most people adjust and dont find it hard to do over time Some people do have a difficult time accepting the use of insulin Dont be afraid to talk to your doctor if you are afraid
or are having a hard time with it Some people just refuse to use insulin, but such a refusal may mean that their blood sugar stays out of control and that they are risking complications Some people are embarrassed about using insulin and try to hide their use, but there is nothing to be ashamed of–no more than if you were taking any other kind of medicine Think whether you would feel this way if you had to take medicine for arthritis pain or acid indigestion It can be a hassle to have to take insulin at specific times each day, or to have to match up your insulin dosage with the amount of food that you eat But doing so is just trying to get as close as possible to what your body would do naturally if you didnt have diabetes Some people complain that using insulin causes them to gain weight Although insulin can stimulate appetite, it is overeating that causes weight gain Choose vegetables or low calorie foods when you are hungry
session nine: feAr of the neeDLe
2 Tell the group: Lets talk about some facts about insulin 3 Ask: What is the doctors response when Calvin says, I cant believe I have to take insulin? Response: Insulin is really the best thing for you
now
4 Ask: Why does the doctor say this to Calvin? Make sure that the following points are brought out in discussion: Insulin can bring down a high blood sugar level faster than any other medication Calvins blood sugar is so high 400 that insulin will work better than other medications It is dangerous to leave Calvins blood sugar so high He and his doctor need to take action Using insulin will give Calvins pancreas a rest Calvin may be able to control his blood sugar without insulin later
5 Tell the group: The doctor also says, The needle is so small you really cant feel it How true do you think this statement is? Make sure that the following points are brought out in discussion: The needle is small, but it is still a needle It takes time to get used to the idea of injecting insulin For many people, the issue is not so much the pain of the needle, but fear about what it means to use insulin Using a needle may seem scary in part because it is a different way of taking medicine Most people take medicine in the form of pills But insulin is not the only medicine that is taken by injection Other medicines may also be injected because they work
new Beginnings: A DisCussion
guiDe for Living weLL with DiABetes
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faster or more reliably when taken this way Some people give themselves injections of medicine to stop a migraine headache If they can do this to stop a headache, you can do this to control your blood 
sugar and stop the complications of diabetes
Brainstorming Exercise
Ask the group to think about Calvins reaction to starting insulin and about the things that you have talked about in your discussion of insulin Then ask participants what advice they would have for themselves, or for someone starting insulin, to help calm fears and other emotions
Discussion of Self-Monitoring of Blood Sugar
1 Tell the group: The nurse checked Calvins blood sugar, but no one in the film talked about self-monitoring–checking your own blood glucose at home with a glucose meter Note: The purpose of this discussion session is to share experiences and talk about emotions related to diabetes care, not to provide details of home glucose monitoring A session on home glucose monitoring and how to use the results is best taught by a certified diabetes educator or health care provider 2 Ask: Why do you think no one in the film talked about self-monitoring? Make sure that
the discussion brings out the following points: There may not have been enough time in the film to discuss everything about diabetes care There is only so much that Calvin can take in about diabetes at one time
session nine: feAr of the neeDLe
Dr Goodson says that she will set up a session for Calvin with a diabetes educator That is probably when he will learn about self-monitoring Self-monitoring is very important, even though it isnt covered in the film
Note: A participant may comment that he or she finds that doing a fingerstick for self-monitoring hurts more than injecting insulin If so, you can acknowledge that many people feel this way You can encourage participants to talk to their doctor or diabetes educator about this issue Explain that new lancets are available that may make it easier and less painful for them to check their blood sugar
Homework Exercise
Give each participant a copy of the two handouts: Myths and Facts About Insulin and What You Might Know About Diabetes: Myths and Facts Ask participants to review these handouts at home and to think of any questions that are not covered Tell them to use the two handouts to help them come up with questions to
take to their next doctors appointment
The brochure Tips for Helping a Person with Diabetes can be found behind the Handouts tab at the end of this guide
Participants may also be interested in the NDEP brochure Tips for Helping a Person with Diabetes, available from http://wwwndepnihgov/diabetes/pubs/ KnowNumbers_Engpdf
72
hAnDout for session nine: myths AnD fACts ABout insuLin
Handout for Session Nine
Myths and Facts About Insulin
Myth: Using insulin means that your diabetes is really bad FACT: Diabetes is a serious condition whether you use insulin, pills, or both It is still serious even if it is controlled by food planning and physical activity alone Myth: You are at the end of the road if you are using insulin FACT: Insulin may be used at any time to help control diabetes Some health care providers prescribe insulin when diabetes is first diagnosed, just as Dr Goodson did for Calvin Dixon Using insulin doesnt mean that you have a worse kind of diabetes than others who dont use insulin Myth: Insulin makes you fat FACT: Some people complain that using insulin causes them to gain weight Although insulin can stimulate the appetite, it is overeating that causes weight gain
Choose vegetables or low calorie foods when you are hungry Myth: Some people cant give themselves insulin FACT: Special devices are now available that help people with disabilities to give themselves insulin Even blind people can measure insulin and give it to themselves accurately If you have trouble seeing the amount of insulin to be drawn up into the syringe, or if you have any difficulty dealing with the syringe, talk to your doctor or diabetes educator about your needs Myth: Insulin is dangerous FACT: Any medicine can have side effects It is important to know what the side effects are and how to avoid them so that you can learn to use insulin safely Myth: Once you start insulin, you must always stay on insulin FACT: There are many treatments for people with diabetes Some people start on insulin injections and later switch to other medications taken as pills Some are able to decrease the amount of medication they take once their diabetes is under control Some even can stop certain medications IF they are able to lose enough weight
Write Down Your Questions
Do you have a question about insulin? Are you unsure whether something is a myth or fact? Write it here or on the reverse
side of this page and take it to your next doctors appointment
hAnDout for session nine: whAt you might know ABout DiABetes
Handout for Session Nine
What You Might Know About Diabetes
Myths and Facts
I have a touch of sugar There is no such thing as a touch of sugar You cannot have a touch of sugar, just as a person cannot be a touch pregnant Having a touch of sugar means having diabetes–plain and simple I am only borderline CAUTION: Diabetes Ahead There is no borderline with diabetes–you either have the disease or not The term borderline only serves as an excuse for people who dont want to think about the reality of living with diabetes You cant prevent diabetes Yes, you can Studies show that people with prediabetes blood sugar higher than normal but not in the diabetes range can prevent or delay diabetes If your doctor tells you that you have a touch of sugar, ask him if you have prediabetes or diabetes Theres a big difference For more information, visit http://wwwndepnih gov/diabetes/prev/preventionhtm By drinking water, I can wash away the extra sugar in my blood and cure diabetes Although you can wash away spilled sugar from a table, the bodys own sugar, glucose, cannot
be washed away by drinking water However, you can control your diabetes by eating a healthy diet, staying physically active, losing weight if you are overweight, seeing your doctor regularly, taking any medications as prescribed, and monitoring your blood sugar regularly I have sugar in my eye Uncontrolled diabetes can cause problems with vision, including blindness Controlling the disease can prevent or delay complications with eyesight Insulin is a cure for diabetes Insulin is not a cure for diabetes At this point, there is no cure for diabetes–only medicine and behaviors that help to control it Insulin helps to control diabetes by keeping the bodys sugar, glucose, from building up in the bloodstream If Im not taking medicines for diabetes, it must not be serious Not everyone who has diabetes needs to take insulin, but diabetes is always serious If the body can produce insulin, other steps can be taken to help keep the insulin working effectively These steps include regular physical activity, a healthy diet, oral medications pills, and regular doctors visits
new Beginnings: A DisCussion guiDe for Living weLL with DiABetes
I have diabetes and Ive seen its effect on family
members I know there is nothing I can do about it Remember, diabetes is serious, common, and costly but controllable There are many actions that people with diabetes can take to live a full life, while preventing or delaying complications Taking care of yourself by making healthy lifestyle changes, such as regular physical activity and a healthy diet, is the key to living well, even with diabetes
Source:goredforwomen.org
