Starting on Insulin (Type 2 Diabetes)
Type 2 diabetes is a progressive condition in which the body tends to produce less and less insulin over time. There may come the time when medications for type 2 diabetes just don’t cut the mustard in terms of keeping blood glucose levels in check. This is a sign that your body is no longer able to produce enough insulin and there is no alternative to keep you healthy other than starting on insulin injections.
There is often reluctance on the part of both the person with type 2 diabetes and the health professional to start insulin injections. This might be due to concerns about weight gain, fear of injections, pain associated with injections and self‐monitoring of blood glucose, or fears around hypoglycaemia.
But timely initiation of insulin therapy, if HbA1c levels are persistently above target, will undoubtedly improve health outcomes – as long as these kinds of concerns can be overcome.
Firstly, remember that this is in no way a reflection of failure, nor of ‘worsening’ of the diabetes. It is simply the natural progression of the condition.
Depending on the duration of diabetes, and your individual circumstances you may not need to stay on insulin ‘forever’. Sometimes insulin is needed temporarily to help people with type 2 diabetes through a period of illness, infection, or surgery. Sometimes, attention to food choices, significant weight loss and increased regular physical activity can reduce the need for additional insulin to be injected, but this is only if your body is still able to make sufficient to keep your blood glucose levels within target.
The possibility of weight gain when starting on insulin is a real and valid concern… especially if no other changes are made to your food intake or lifestyle. On the plus side though, starting on insulin will likely give you more energy, and should bring your overall blood glucose levels down. And if you feel better within yourself then perhaps you might be better placed to consider how you might feel better about yourself.
Starting insulin – meeting your body where it is right now
Starting insulin doesn’t mean you’ve failed or that your diabetes has suddenly “got worse”.
It means that at this stage in your journey, your body is no longer making enough insulin to keep glucose levels in a healthy range on its own. Injecting insulin is simply a way of replacing what your body can’t make enough of right now.
For many people with type 2 diabetes, this is a natural turning point — a moment where treatment needs to change to match what’s happening inside the body.
You’re still in control. Insulin is a support, not a punishment.
Why insulin is needed at this point
Type 2 diabetes is progressive for many people. Over time:
- the pancreas may produce less insulin
- insulin resistance may increase
- tablets alone may no longer be enough to keep your blood glucose levels in a healthy range
Needing insulin doesn’t erase any efforts you’ve already made. It reflects where your body is today, not your worth or commitment.
Remember, at another point in your journey, your treatment may change again.
The practical side of starting insulin
Storing insulin
Insulin replaces what your body isn’t making enough of — and it needs to be stored properly to work well.
- Unopened insulin belongs in the fridge
- In-use insulin can usually be kept at room temperature for up to a month
- Room-temperature insulin is often more comfortable to inject
Needles and injections
Modern insulin needles are short and fine. They’re designed to deliver insulin into the fatty layer just under the skin.
Changing needles regularly helps insulin be absorbed properly and keeps injection sites healthy.
Rotating injection sites
Because insulin is standing in for your body’s own supply, it needs to be absorbed consistently. Rotating sites helps ensure insulin works as predictably as possible.
Common worries & myths
“Starting insulin means my diabetes has got really bad”
More accurately, it means your body isn’t producing enough insulin at this stage of your journey. Treatment has changed to match that reality — not because you’ve failed.
“Once I start insulin, I’ll be on it forever”
Not necessarily. Insulin use reflects what your body needs now. For some people, those needs change again later.
“Insulin will make me gain weight”
Some people do gain weight, especially early on, as insulin allows the body to use glucose more effectively again. But weight gain isn’t inevitable, and insulin can be used carefully alongside other strategies.
If weight matters to you (and for many people it does), it’s an important part of the conversation — not something to ignore or feel awkward about.
Low blood glucose – understanding the balance
Because insulin is replacing something your body usually regulates on its own, finding the right dose takes time.
This is why insulin is started low and adjusted gradually — to support your body without tipping things too far the other way.
Learning to recognise and manage low blood glucose is part of this stage of the journey, not a sign that something has gone wrong.
Titrating insulin – adjusting as your needs change
Your insulin dose is not a verdict. It’s a work in progress.
As your body’s needs change, insulin doses can be:
- increased
- reduced
- sometimes stopped
This is normal and expected. Remember that you can potentially influence how your needs might change…
Coming off insulin
– another possible crossroads you might reach depending on your journey thus far…
For some people with type 2 diabetes, needing to inject additional insulin is temporary.
As blood glucose levels improve — through lifestyle changes, weight loss (where appropriate), or other medications — the body may recover it’s ability to produce insulin, or to respond more efficiently to the insulin that is produced. The upshot of this is the need for less injected insulin, or possibly none at all.
Coming off insulin is also about whether your body can meet its insulin needs again at a later stage of the journey.
Do remember that If insulin remains part of your diabetes treatment long term, it’s because it continues to support your health — it’s replacing something that is missing – and not because you’ve failed…
You’re at a crossroads
Starting on insulin is definitely what I call a crossroads moment! By this I’m meaning a point in your life that you ‘notice’ something is amiss or needs attention – and perhaps acknowledge this internally- even if you don’t actually ‘do’ anything about it.
It’s a point where:
- the body’s needs have changed
- treatment adapts
- new choices and possibilities open up
You can simply take insulin as prescribed — or you can also use this moment to pause, reflect, and decide how you want diabetes to fit into your life from here.
Read more: Crossroads & Choices – making sense of change in your diabetes journey
Also see:
Page updated: January 2026
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