Overcoming the Fear of Injections for Diabetes
Do you have an objection to injections? If you have type 2 diabetes, you may be afraid you’ll eventually need to give yourself insulin injections, or maybe your doctor has mentioned non-insulin injections might be in your future.
Treating diabetes with injections does not mean you have failed or did not follow your doctor’s instructions. Many diabetics will need insulin shots over time, and non-insulin injections are just a newer form of diabetes medication. However, you do need to overcome your fear and resistance if you want to get your diabetes under control. In order to do this, it’s important to determine the root of your anxiety, and identifying the problem can help you find solutions.
While there have been attempts at developing an inhaled insulin, injections are currently the most common form of delivery with the technology available today. And non-insulin injectables can be an effective and lower-maintenance treatment option. A small fear of needles is normal, especially if you are newly diagnosed or have managed your diabetes with oral medication, diet, exercise, and lifestyle modifications for many years. This means you need to overcome the fear of needles if you want to successfully manage your diabetes. Educate yourself and keep the following in mind to help alleviate your hesitations:
Needles are smaller than in the past. Most needles for injections you’ve probably had in the past (e.g. vaccines or antibiotics) are bigger than a diabetic needle. Insulin and diabetes medication only needs to get into the fat and subcutaneous tissue, while vaccinations and antibiotics need to go deep into muscle. This difference allows needles used by diabetics to be much smaller and cause less pain.
Injection pens make injections much simpler. Not only do injection pens for insulin and other medications allow you to dial up the dose you need, but they also keep the needle out of sight, which can decrease anxiety and fear.
Numbing the area reduces pain. Rubbing an ice cube on the area you’re going to inject will numb it so you feel less (or no) pain. There are also topical medications (both prescription and over the counter) that contain lidocaine, a pain reliever that can help ease the pain of injections.
Diabetes educators are great resources. Certified diabetes educators can help you through the anxiety of starting injections by demonstrating the technique or just talking you through the experience.
A small number of people develop a significant fear or anxiety of shots referred to as needle phobia. You may experience the following when faced with a shot if you have needle phobia:
Feeling sick to your stomach
Feeling faint, dizzy or light-headed
Developing a rapid heart rate, palpitations, and quick breathing
Breaking out into a cold sweat
If these symptoms prevent you from giving yourself injections, you can ease your anxiety by trying stress-relief techniques.
Before starting injections, make sure you talk with your doctor and ask any questions you have. It’s likely you’ve had injections in the past. Be sure you utilize any strategies that have worked before. You can also apply the following strategies:
Prevent fainting by applying tension. With this technique, you’re simply raising your blood pressure before the injection to decrease the chance of fainting. After sitting down in a comfortable position, tense your arms, legs, and shoulders for 15 seconds and then relax for 30 seconds. Repeat this activity five times. For best results, repeat this activity three times daily for a week.
Lower your heart rate with breathing exercises. After sitting down in a comfortable position with your shoulders and jaw relaxed, breathe deeply in through the nose and out through the mouth. If you place your hand on your belly, you should feel it moving up and down. Do this five times in a row. Practice this technique three times a day for a week.
Tackle your fears by working through a hierarchy or fear ladder. A fear ladder is a list of all the situations in which you feel anxiety over injections. For example, most people find the actual injection to be the most frightening. But even touching a needle, watching someone else get an injection, watching a video of an injection, or thinking about an injection could all provoke anxiety. On your ladder, rate each scenario from 1 to 10 and place them in order. Then, place yourself in each scenario and practice either breathing exercises or applied tension until the anxiety and stress has decreased.
If you still don’t think you can give yourself a shot, you may need to seek specific treatment such as cognitive behavioral therapy that includes relaxation training (a process like mediation that can help decrease anxiety), guided imagery (a visualization process where you imagine yourself giving the injection), graded exposure (gradual exposure to injections that allows you to control fear at each step), behavioral rehearsal (you rehearse your feelings and behaviors related to an injection), modeling (where a therapist handles needles or injects themselves to demonstrate irrational fear), reinforcement (process of pairing injection with something pleasurable like a desired snack), and incentive scheduling (providing specific rewards as you get closer and closer to giving yourself an injection).
Diabetes is a complicated disease. Just because your doctor may recommend insulin or other shots does not mean you are a failure. Like many other chronic illnesses, diabetes tends to worsen over time. Don’t fixate on the fact that you now need shots; instead focus on how you are going to manage your diabetes and continue to live life to the fullest.