Dear Arianna,

Type 1 Diabetes, sometimes referred to as Juvenile Diabetes or Childhood Diabetes, is a condition where the person’s body does not produce insulin. People with Type 1 Diabetes must take insulin to live. Type 2 Diabetes usually occurs in individuals who have been in poor physical condition and overweight for some period of time.

You might be surprised to learn that it is common for patients, particularly with Type 2 Diabetes, to be resistant to taking insulin shots even though their doctors’ insist upon it. Some studies show that as many as 72 percent of patients are reluctant to use insulin at first (British Medical Journal, 1995). There are several reasons that patients give for not wanting to take their insulin shots, including fear of needles and a resistance to accepting the diagnosis of diabetes.

Consider asking your friend why she is unwilling to take her insulin. If she doesn’t believe that she has diabetes, offer to go with her to her doctor so that she can discuss it further. If she’s afraid of needles, it might be necessary for her to return to her doctor for additional training until she is more comfortable with it. If she’s still too afraid, she can work with a mental health professional trained in Systematic Desensitization, a behavioral technique that helps patients get over fears that interfere with their functioning. Most importantly, let her know how much you care about her and that you will help support her in addressing this challenge.

If she refuses after all of your efforts, consider speaking to her parent(s) who may not be aware that she is not taking her insulin. Even though this can be difficult to do, your friend’s health will be at risk if she doesn’t take proper care of herself. Sometimes being a true friend means doing what’s necessary even if it’s not easy.