Reality check. If you live with diabetes, you’ll probably take insulin at some point. It could be 20 years from now, or one year post-diagnosis. When beginning insulin therapy, know that it’s not a punishment, and warrants no shame. “It’s the nature of Type 2 diabetes. The body’s ability to manufacture insulin diminishes over time,” says Ann Williams, research associate at Case Western University’s Frances Payne Bolton School of Nursing. She’s been educating 20-plus years on insulin safety and lives with diabetes herself.

Ask about prescription insulin pens. Measuring insulin amounts is easier with them (you’ll hear and feel clicks as each unit dials) than eyeballing syringe lines and they’re more discreet. Set the dose by turning a knob, then deliver insulin by attaching a needle, pushing it through skin, and pressing a button. Studies show that, while more costly up front, pens result in fewer emergency-room visits due to wrong dosage.

Know signs of hypoglycemia (low blood sugar), which can happen when using insulin. Learn the symptoms, how it feels, and how to treat it with rapidly absorbed carbohydrates. Always carry a carb source (such as glucose tablets, juice boxes, hard candies, or dried fruit). Hypoylcemia occurs for various reasons including wrong insulin dosage, insufficient carbs, exercise increases, and/or stress.

Panic if you realize you administered the wrong insulin dosage. If you’ve taken too much, eat rapidly absorbed carbs (anything you’d eat for hypoglycemia) and call your doctor immediately. If unsuccessful, call your diabetes educator, pharmacist, or emergency room and explain what happened. Two to four extra units of a long-acting insulin may cause a mild low-blood-glucose response (Action plan: Monitor blood glucose more frequently to determine carbohydrate needs). Mistakenly taking 40 to 60 units of rapid insulin may result, if untreated, in unconsciousness, seizures, even death (Action plan: get to the hospital–but do not drive–to be observed and possibly treated for severe low blood sugar.)

Know safe methods for accurately measuring, properly injecting, and safely storing insulin. Ask your doctor to refer you to a diabetes educator who can explain step-by-step insulin instructions. Most but not all insurance policies cover an insulin-initiation session. Pharmacists also provide excellent free information.

Store insulin in overly hot or cold temperatures. Store unopened vials and pens is in the refrigerator. Once opened, keep at room temperature (up to one month for vials; two-to-four weeks for pens). Don’t put insulin in fridge where it could freeze. The butter compartment is a good option.

How would You feel starting insulin therapy? Or if You’ve started, how’s it going?