Diabetes Health Center

Overcoming Objections to Injections

There was a time when doctors couldn't get anywhere near Sherri Buffington with a needle. "I was deathly afraid of needles," recalls the 44-year-old senior legal secretary from Sicklerville, N.J. "I've been petrified of needles since I was a little kid."

Then in 2004, Buffington was diagnosed with diabetes. When oral medications didn't control her disease, her doctor prescribed an injectable prescription medication along with insulin. Taking these drugs meant she would have to inject herself, sometimes three times a day. "I was apprehensive," she says. "But I felt that if this was going to help me, I'd have to grin and bear it and just do it."

Buffington is far from the only diabetes patient with needle anxiety. More than a third of people with diabetes approach their injections with a sense of dread, and nearly as many feel that injections are the hardest part of managing their condition. The fear can be severe enough to prevent some diabetes patients from taking the medicines they need to control their blood sugar. In fact, one survey found that more than half of patients skipped insulin injections from time to time, often because they feared the pain.

"I always tell patients that having a fear of needles is normal and natural," says Evan Sisson, PharmD, a diabetes educator and assistant professor in the Department of Pharmacotherapy and Outcomes Science at the Virginia Commonwealth University School of Pharmacy. Sisson and other diabetes educators help diabetes patients overcome their fear of shots, so it doesn't become an obstacle to controlling their blood sugar.

Why Injections Are Important

Everyone with type 1 diabetes must take insulin injections, because their body doesn't produce this hormone. People with type 2 diabetes take injected insulin or other prescription injectables when pills and lifestyle changes aren't lowering their blood glucose enough.

Why injections? “Injections are the most effective," says Robert R. Henry, MD, professor of medicine in the Division of Endocrinology and Metabolism at the University of California, San Diego and president of Medicine & Science at the American Diabetes Association.

Skipping insulin injections can be extremely dangerous for people with type 1 diabetes. When glucose isn't available for energy, the body starts burning fat instead. That can lead to a state called ketoacidosis, in which acids called ketones build up and poison the body.

With type 2 diabetes, the risk of skipping medications or injections isn't as immediate. But over time, fluctuating blood sugar levels can damage organs like the eyes, kidneys, and heart. Research has found that people who are afraid of their insulin injections have poorly controlled blood sugar and experience more diabetes-related complications. Overcoming needle anxiety can be a key element to preventing these complications.