I get lumps and bumps where I inject insulin. Is there something wrong?

The lumps you describe are fat deposits that may occur when insulin is injected into the same general area on a repeated basis.

These lumps can delay the absorption of insulin and cause unwanted glucose fluctuations that trigger low blood sugar, or hypoglycemia.

You should point these areas out to your doctor. In the meantime, you should avoid those areas for injecting to allow time for them to heal.

You should change injection sites to other areas.

Always keep 2 to 5 cm distance between old and new injection site. Something that could be helpful are “injection site templates”.

One easy way to remember to rotate injection sites is to inject on the right side (of the arm, leg, or belly) for any morning and lunch insulin, and on the left side (of the arm, leg, or belly) for the dinner and bedtime insulin.

Since I have been taking insulin, I have the feeling that I am gaining weight. Is that possible?

Weight gain is a common side effect for people who take insulin — a hormone that regulates the absorption of sugar (glucose) by cells. However, controlling your weight is not only possible but also an important part of your overall diabetes management plan.

When you take insulin, glucose is able to enter your cells, and glucose levels in your blood drop. This is the desired therapeutic goal. However, if the number of calories you take in and your activity level result in more calories than you need to maintain a healthy weight, your cells will get more glucose than they need. Glucose that your cells don’t use accumulates as fat.

Weight gain may also be related to other complex functions of insulin in the body related to how cells use fats and proteins.

Eating healthy foods and staying physically active every day can help you prevent unwanted weight gain. The following tips can help you keep the pounds off:

  • Count calories. Eating and drinking fewer calories helps you prevent weight gain. Stock the refrigerator and pantry with fruits, vegetables and whole grains. Plan for every meal to have the right mix of starches, fruits and vegetables, proteins, and fats. Trim your portion sizes, skip second helpings and drink water instead of high-calorie drinks. Talk to your doctor, nurse or a dietitian about meal-planning strategies and resources.
  • Don’t skip meals. Don’t try to cut calories by skipping meals. When you skip a meal, your body is less efficient at using energy, and you’re more likely to make poor diet choices at the next mealtime because you’re too hungry. Skipping meals also causes large fluctuations in blood sugar levels. Three modest meals a day with healthy snacks in between can result in better control of weight and blood glucose levels.
  • Be physically active. Physical activity burns calories. A reasonable goal for most adults is a minimum of 150 minutes per week of moderately intense aerobic activity — such as walking, bicycling, water aerobics, dancing or gardening — plus muscle-strengthening exercises at least two times per week. Talk with your doctor about activities and exercises that are appropriate for you.
  • Ask your doctor about other diabetes medications. Some diabetes medications that help regulate blood glucose levels — including metformin (Fortamet, Glucophage, others), exenatide (Byetta), liraglutide (Victoza) and pramlintide (Symlin) — may promote weight loss and enable you to reduce your insulin dosage. Ask your doctor if these or other medications would be an appropriate part of your diabetes treatment plan.
  • Take your insulin only as directed. Don’t skip or reduce your insulin dosages to ward off weight gain. Although you might shed pounds if you take less insulin than prescribed, the risks are serious. Without enough insulin, your blood sugar level will rise — and so will your risk of diabetes complications.

I found a blister on my foot, what should I do?

Diabetes complications include nerve damage and poor blood circulation. These problems make the feet vulnerable to skin sores (ulcers) that can worsen quickly and are difficult to treat. Proper diabetes management and careful foot care can help prevent foot ulcers.

When foot ulcers do develop, it’s important to get prompt care. An ulcer that won’t heal causes severe damage to tissues and bone and may require surgical removal (amputation) of a toe, foot or part of a leg.

Here’s what you need to know to keep your feet healthy, and what happens if amputation is necessary. (Hyperlink)