Insulin timing

A situation I experienced tonight made me decide to post the following:

If you take mealtime insulin, avoid taking it too far ahead of a meal. This type of insulin is meant to “cover” or compensate for the meal you are about to eat. Because it works fast, if you take it too soon, there is a risk of going low (hypoglycemia).

Humalog, Novolog, and Apidra (usually called “rapid-acting”) start working in approximately 10 minutes and their peak action happens in about 90 minutes. Within just a few hours, they are gone (although how long they last can vary from person to person). So if you are at home preparing your own meal, it makes sense to take it shortly before you start eating. That way, the insulin has a chance to get started and is working when the food you eat turns to glucose in your blood stream.

I try to take my rapid-acting (mealtime) insulin about ten to fifteen minutes before I start eating. If my blood glucose is low prior to a meal, I take my insulin and eat immediately – or even treat the low by eating some sort of carbohydrate food first and then take the insulin. If my blood glucose is high, I take my insulin about 20 minutes before I start eating. This way it really has a chance to get to work lowering my blood glucose before I go and raise it again with food.

Tonight I had supper at a barbecue-type event. I took insulin inside the building and then went out to get my food. It turned out that I did not eat as much carb as I had planned and I ended up low afterward. This reminded me of an important message: it’s very – very – important never to take rapid-acting insulin before leaving home if you are eating out (at a restaurant or someone else’s house). Wait until you are seated, have ordered, and there is food in front of you. In other words, wait to take your mealtime insulin if you don’t know how long it will be or how much food you will eat. Better safe than sorry!

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6 Responses to Insulin timing

  1. Kathleen Graham says:

    Parents with young children may also want to wait until they are actually going to eat before taking meal time insulin! I used insulin during both pregnancies and there were times I got too low because I had taken my insulin and got so busy helping my oldest son (who was about 2 at the time) with his meal that I didn’t get to feed myself for a while!

    • jane k says:

      Great point, Kat! Thanks for chiming in. Self-care definitely takes a back seat when young kids are in the house!! Parents of kids with diabetes often wait to administer insulin until they see what the kids actually eat. Sometimes I take part of my dose right away and wait on the rest until I know how much I ate. I wish I had done that tonight!

  2. Cathy DeVreeze says:

    I learned this the hard way myself. It took much longer to prepare a meal than I thought, as I was not the one doing the prep and I ended up going low before I actually got to eat. Now, if I am not the one doing the cooking, I wait until the food is in front of me. When I am at a family gathering, where I am doing most of the cooking, I still wait. It seems I am always the last one to sit down. Ahh, I never get to eat my food when it is hot at these dinners!

    • jane k says:

      I feel your pain, Cathy! I can never get the food temperature thing right, and we are hosting Christmas this year. Yikes!!

  3. Leonard Auter says:

    i usually do real good at home with my insulin and my meals. when i was in Fort Collins for the bike ride and eating out with the exception of breakfast i would wait until the meal was in front of me and still not really being able to tell the exact amount of carbs because of their special sauces and hidden sugar, i was still guessing somewhat, but with the pump i would do a square wave bolus and ended up working out great. we ate at the Olive Garden the first night, i’d never been to one and pretty much all pasta so i asked for an extra plate and separated out the meal into portion size, and only ate the portion, that really helped with pasta too, i usually don’t do well with that, and that worked out great too.

    • jane k says:

      Nice job, Leonard! I like the extra plate idea. Square wave/dual wave and extended boluses are wonderful features of the awesome pumps we have these days. I do not wear a pump, so I my version of an extended bolus is to take part of my mealtime insulin before I eat and the rest about an hour after I eat. This helps with coverage for an especially high fat meal.

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