More diabetes myths   (August 12, 2008)

After hearing a comment from a friend that his blood glucose was running on the high side, I suggested he adjust his dose of insulin to fix things. He demurred, saying that he would have to contact his physician for permission to change his dose. Later, I realized I had found another myth about diabetes care:

1) Patients with diabetes must get approval from their physicians to change their insulin doses. This sort of thinking is true for many disorders, but people with diabetes should be taught to adjust insulin doses based on BG levels and other factors (such as food intake, exercise, and sometimes even time of day). If your physician insists on you calling for advice on changing your dose, either your doc is obsessive-compulsive, or you haven't yet learned the tricks of the trade.

Some other diabetes myths that I consider amongst my favorites:

2) You must change lancets after every finger poke.

3) You must change needles after every insulin shot.

Both of these are based on manufacturers' reluctance to do testing of multiple uses, and not on any medical logic. Many or most people with diabetes reuse their equipment several times. I'd suggest changing if the lancet or needle touches anything except your skin, or if it seems dull, or maybe simply change once a day if doing multiple sticks per day.

4) You can't inject through clothing. Yes, you can; it's really no big deal. See my previous discussion, Injecting through clothing.

5) Sugar is bad for people with diabetes. Well, maybe -- eat enough, and you'll gain weight. And you might risk tooth decay. But sugar is simply another form of carb, and is fine in moderation. Also, if you're hypoglycemic, sugar is actually GOOD for you!

6) You should cleanse the skin with an alcohol before fingerpokes or shots. Not really; and if you do, be sure to let the alcohol dry thoroughly before poking through the area. But washing with soap and water is plenty sufficient. And many folks don't even bother with this (see "injecting through clothing", above).

7) Once you start taking diabetes pills or insulin for type 2 diabetes, you can never get off them. Not always. Sometimes, there are temporary circumstances that cause elevated sugar levels. With passage of time, and the resolution of a temporary stress, plus continued emphasis on meal planning and exercise, some people who had been started on diabetes pills and/or insulin may find that they can control their blood sugar without medications.