I was diagnosed with type 2 diabetes about 25 years ago, and it’s been a long journey. Every diabetic has their own story about diabetes and their own way of managing it. For me, mealtime insulin has helped a great deal. I’ve been taking oral medication to control my blood glucose (blood sugar) for more than two decades now. I also take insulin, which works alongside the pills. Initially, I started with long-acting insulin at bedtime, and now I also take mealtime insulin three times a day. I know I have to be aggressive with my diabetes. I can’t just sit back and watch the disease progress; I have to fight. I’m on this journey for the long haul. No one likes hearing they have diabetes, but I’ve got my “big three” on my side: a great healthcare team, good diabetes education, and a steadfast commitment to my treatment plan. It hasn’t always been easy or pleasant, and I’ve hit some detours along the way, but today, I’m happy and proud to say I’ve got my diabetes under control. Time for a Change One way I know how well I’m managing my diabetes is by monitoring my A1C levels. A1C is a blood test that measures the average amount of glucose in my blood over the past 3 months. When my A1C is not properly controlled, I know I have to act. A few years ago, my A1C was close to 10%. My doctor explained that an A1C level above 7% in people who have diabetes can lead to an increased risk of developing complications like eye disease, nerve damage, or even heart or kidney disease. That A1C level told us my current medications weren’t enough to keep my blood sugar under control anymore. That’s what happens on this journey: every now and then, you have to stop and plan a new course of action. At that point, my doctor recommended I go on mealtime insulin because it’s helpful in bringing down A1C levels; it keeps blood sugar from getting too high after eating. I met with my certified diabetes educator (CDE), too. She told me insulin can be kinder to my body than some of the oral medications, because it has fewer side effects. After talking it over with my doctor and CDE, adding mealtime insulin seemed like a reasonable step. I also went on a more aggressive low-carb diet and added more exercise to my day. All in all, moving to mealtime insulin was a pretty easy transition for me. I really wasn’t fazed by it. I think that’s because I knew a lot about diabetes by the time I needed mealtime insulin; I’ve learned a lot on this journey. Now, using mealtime insulin is just a part of my life. I have to be very careful because the insulin can make me hypoglycemic (when blood sugar gets dangerously low). If I know I’m going to be walking a lot or exercising and I only had a salad for lunch, then I need to take my non-insulin oral medications. But if I’m just sitting at my desk working and not moving around, then I know I need to take my mealtime insulin before I eat. I check my blood glucose levels before I eat so I know how much insulin to measure out and give myself. I also have to consider factors like the amount of carbs I’m going to eat. It was a little tricky at first, but with some practice and good education from my healthcare team, I got the hang of it pretty quickly. Stick With It Patient education is important. So is working and communicating with my healthcare team. Endocrinologists, diabetes educators, and pharmacists have all played a role in my mealtime insulin journey. With their guidance, I know how much insulin my body needs in different situations. The other big key to diabetes control is compliance—following my doctor’s directions, sticking with my mealtime insulin treatment, and refilling my prescriptions. I know I won’t get the best results if I don’t keep up with my doctor’s instructions. Another thing I’ve learned is that if something isn’t going well or doesn’t feel right to me, I need to get in touch with my doctor immediately. One time I was struggling with a new pen for injecting medication and I spilled a whole vial because I wasn’t using it correctly. After I spoke with my doctor, I was able to understand what I was doing incorrectly, and I didn’t have any problems moving forward. I’ve learned since then that most problems I come up against can be easily fixed by talking with my doctor. I also find it helpful to have my wife come with me to my doctor’s appointments. Very often, diabetes is a family issue, where everyone needs to be involved. In my family, we’re all eating healthier and making positive changes to stay healthy. Today, my A1C is 6.7%—four whole points lower than what it was two years ago—and mealtime insulin plays a huge role in keeping that A1C number controlled. I still have a little more work to do, but I’m happy to say my numbers are the best they’ve been in a long time. I now know managing diabetes is something I have to stay on top of, but I also know it’s very doable. It’s a journey, but I’m not on this journey alone, and I’ve been given the knowledge to successfully navigate it.