Insulin dramatically increases the life expectancy of persons with type 1 diabetes. Those with type 2 diabetes have also benefited from modern insulins. However, about a third of those with type 2 diabetes are unwilling to take insulin. Here’s a few of the reasons that we hear for “psychological insulin resistance”:

• Guilt — Beginning insulin therapy may make individuals feel that they have failed at managing their diabetes.
• Needle phobia.
• Insulin injections would restrict their lifestyle.
• Insulin causes weight gain.
• Fear their diabetes is now serious.
• Fear of getting low blood sugars.
• In western society, insulin is viewed as a last resort.
• Association of insulin therapy and complications in close relatives.

Due to the progressive loss of beta cell function in type 2 diabetes, most of those with type 2 will likely require insulin at some point.

Complications of uncontrolled type 2 diabetes are well documented. Type 2 diabetes is falsely perceived as mild.

Beginning insulin therapy indicates to some people that their diabetes is now more serious. People with type 2 diabetes often feel fine and may wonder why they should start insulin. The greatest barrier to starting insulin is the fear of gaining weight, but with lifestyle counseling the weight gain overall is modest.

Healthcare providers are also reluctant to initiate insulin therapy even when a person has a high A1C. The provider’s attitude has a significant impact on the patient’s attitudes and beliefs regarding insulin. Often, insulin therapy is used as a threat to force people to make lifestyle changes. Or, clinicians can use it as a scare tactic — a threat if the person with diabetes does not comply with prescribed oral agents. Labeling insulin therapy negatively makes people with diabetes feel like they’ve failed.

Recently, I had a patient tell me she didn’t ever want to go on insulin. She wasn’t starting on it, but when she repeated the statement I asked her why. She said she didn’t want the hassle of having to give herself injections. I mentioned that when a person with type 2 diabetes needs to start insulin, they are often started on a once-daily long acting insulin injection. She was surprised, relieved and said that wouldn’t be bad at all.

Source: Mayo clinic Blog

Consider your treatment options

A number of erectile dysfunction treatments are available. Ask your doctor if one of these may be a good choice for you:

• Oral medications. Erectile dysfunction medications include sildenafil (Viagra, Revatio), tadalafil (Cialis, Adcirca) or vardenafil (Levitra, Staxyn). These pills can help ease blood flow to your penis, making it easier to get and keep an erection. Check with your doctor to see whether one of these medications is a safe choice for you.
• Other medications. If pills aren’t a good option for you, your doctor may recommend a tiny suppository you insert into the tip of your penis before sex. Another possibility is medication you inject into the base of your penis. Like oral medications, these drugs increase blood flow that helps you get and maintain an erection.
• Vacuum-constriction device. If medications aren’t effective, you may try a penis vacuum-constriction device. Also called a penis pump or a vacuum pump, this device is a hollow tube you put over your penis. It uses a pump to draw blood into your penis to create an erection. This hand- or battery-powered device is simple to operate and has a low risk of problems. If a vacuum-constriction device is a good treatment choice for you, your doctor may recommend or prescribe a specific model. That way you can be sure it is approved by the Food and Drug Administration, suits your needs and is made by a reputable manufacturer. Vacuum-constriction devices available in magazines and sex ads may not be safe or effective.
• Penile implants. In cases where medications or a penis pump won’t work, a surgical penis implant may be an option. Semirigid or inflatable penile implants are a safe and effective treatment for many men with erectile dysfunction.

Make good lifestyle choices

Don’t underestimate the difference a few changes can make. Try these approaches to improve erectile dysfunction and your overall health:

• Stop smoking. Tobacco use, including smoking, narrows your blood vessels, which can lead to or worsen erectile dysfunction. Smoking can also decrease levels of the chemical nitric oxide, which signals your body to allow blood flow to your penis. If you’ve tried to quit on your own but couldn’t, don’t give up — ask for help. There are a number of strategies to help you quit, including medications.
• Limit how much alcohol you drink. Drinking too much alcohol — more than two drinks a day — can damage your blood vessels and worsen erectile dysfunction.
• Lower your stress level. Stress can reduce your erections. To keep stress under control, evaluate and prioritize your tasks. Set realistic expectations for yourself and ask for help when you need it. Try relaxation techniques such as meditation or yoga.
• Get regular exercise. Regular exercise can increase blood flow, improve your mood and energy levels, and reduce stress. If you haven’t exercised for a while, start with something easy, such as a daily walk.
• Fight fatigue. If you’re well rested, you’re less likely to struggle with erectile dysfunction. Make sure you’re not overdoing it and that you’re getting plenty of sleep.

Source: Mayo Clinic