Your A1c…and How Long You Wait After Taking Your Insulin (before Eating!)
There’s nothing quite so fun in life as the pursuit of that “perfect” A1C…oh, wait…that’s not fun at all! What is it about A1C percentages that leave you feeling so unsatisfied even when you hit your goal? It seems as if the day after a great A1C result is always filled with high blood sugars. Some kind of diabetic irony. Anyways, if you’re struggling to reach your A1C goals or you’re just working hard and want to work harder…there’s a little thing we all know but easily forget that has a major impact on blood sugar: …how long you wait after taking your insulin injection before you begin to eat. The reason this is recommended is because it takes approximately 10 to 20 minutes for insulin actually start doing its job in your bloodstream! This is also known as the pre-bolus. Oh that dreaded word. It sounds so damn simple and yet, it’s a lot harder than you think to actually know exactly what you’re going to eat, when you’re going to eat it, and of course, you might have wanted to start eating right now, like with the rest of your family or friends, but waiting 15 minutes while twiddling your thumbs does not equal a great time or a great meal. So, the pre-bolus…does it really make a difference? Really? Is it really possible to keep your blood sugar under 160 or even 140 mg/dL after a meal just by pre-bolusing your insulin dose? The Power of the Pre-Bolus & Your A1C: 1. Yes: whether you’re struggling with your A1C or you’re trying to make another leap of progress in your continued hard work on your A1C, what your blood sugar does after you eat has a tremendous impact on your A1C! Imagine, each time you eat, if your blood sugar is rising up to 180 or 200 mg/dL or higher and hanging out there for at least an hour before the insulin starts to Continue reading >>
7 Techniques To Reduce Post-meal Spikes During Pregnancy
“Gary, I think I need more insulin at breakfast.” “Why do you say that, Julianne?” “Because I’m always having high readings right afterwards, and my obstetrician said I shouldn’t spike after I eat.” “And what happens after the spike?” “It usually comes down to normal before lunch. So do you think I should take more insulin?” After-meal blood sugar spikes can create quite a quandary for anyone with diabetes, particularly during pregnancy. Research has shown that fetal macrosomia (overgrowth of the baby) becomes more common when post-meal blood sugars exceed 120 mg/dl (6.7 mmol). With post-meal readings above 140 mg/dl (7.8 mmol), the risk more than doubles from baseline. Fetal macrosomia can cause many problems during pregnancy. When the baby grows and develops too rapidly, it can lead to a premature and more complicated birth. It may also cause injuries to occur to the baby during delivery. Why do after-meal blood sugars have such a major influence on the baby’s growth? Nobody knows for certain. Perhaps, when the mother’s blood sugar “spikes” suddenly after meals, the baby is fed more sugar than its pancreas can “cover” with insulin, and high fetal blood sugar results. And because the baby’s kidneys spill almost all excess sugar from the baby’s bloodstream back into the amniotic fluid, the baby then drinks in the extra glucose and winds up growing more than it should. Suffice to say that post-meal blood sugar spikes are something to avoid during pregnancy. But how do we do it? Getting back to Julianne’s question, if she takes more insulin, she’ll probably wind up hypoglycemic before lunch. Luckily, we have some excellent techniques for preventing the after-meal highs without having to take more mealtime insulin. What Causes Sp Continue reading >>
Exercising With Diabetes: Is It Better To Eat Before Or After Your Workout?
Whether it’s best to eat before or after a workout has been debated for decades, and the decision becomes even more complicated if you have diabetes. “For someone with diabetes, they not only have to think about fuel for exercise, but they also have to think about glycemic control,” says Monet S. Bland, a clinical exercise physiologist and diabetes educator with Joslin Diabetes Center in Boston. Exercise impacts your blood sugar, so you need to make sure your levels aren’t too high when you start exercising, but also not so low that they’ll plummet during your workout. So while a study published in November 2010 in the Journal of Physiology found that not eating before exercise helped people burn fat, people with diabetes need to maintain blood sugar levels, and should plan to eat before, after, and sometimes even during exercise, Bland says. That’s the general recommendation, but it’s not a one-size-fits-all approach. You need to keep an eye on how your body responds, since “some people are more sensitive to the effects of exercise versus others,” Bland says. Not sure where to start? Bland recommends working with an endocrinologist or an exercise physiologist to establish blood glucose targets and an exercise plan that’s safe for you. No matter what, you’ll want to check your blood sugar before working out so you know how to fuel up. Your goal is a level greater than 100 milligrams per deciliter (mg/dL) — but always skip the workout if your blood sugar is at or higher than 250 mg/dL and ketosis is present, or greater than 300 mg/dL without ketosis. Be sure to talk to your doctor about your blood glucose targets before and after exercise. The Best Pre-Workout Snacks Your best bet is eating a balanced meal an hour to an hour and a half before your Continue reading >>
Faqs On Taking Insulin With Meals
Many people with type 1 and type 2 diabetes take mealtime insulin. But that doesn’t mean you’ve failed at managing your condition. Mealtime insulin is simply another way to help control your blood sugar and prevent diabetes complications. Check out the answers to some commonly asked questions about mealtime insulin. How is mealtime insulin different from other insulin? All types of insulin help your body control blood sugar. But some types of insulin work faster or last longer than others. When you take it before you eat, mealtime insulin works quickly to control the spike in blood sugar after a meal. The lean protein from this pan-roasted chicken can help stabilize your blood sugar levels. 2017 Healthgrades Operating Company, Inc. All rights reserved. May not be reproduced or reprinted without permission from Healthgrades Operating Company, Inc. Use of this information is governed by the Healthgrades User Agreement. How do I make sure to take the right dose? Your doctor will tell you what dose to start with, but you’ll need to adjust how much you take based on your blood sugar readings. A few hours after you give yourself mealtime insulin and eat, check your blood sugar. If your blood sugar is high, take more insulin before that meal the next day. If your blood sugar is low, take less mealtime insulin. The Endocrine Society offers online charts show how much you should adjust your dose based on your blood sugar reading. Keep in mind that these are general guidelines. Ask your doctor what he or she recommends for you. I don’t like carrying around vials and syringes. Do I have any other options to take my mealtime insulin? Yes. Alternatives to syringes include insulin pens, insulin pumps, and inhalable insulin. Insulin pens are either prefilled with insulin or ha Continue reading >>
Insulin Treatment
Insulin is a hormone made in your pancreas, which lies just behind your stomach. It helps our bodies use glucose for energy. Everyone with Type 1 diabetes and some people with Type 2 diabetes need to take insulin – either by injection or a pump – to control their blood glucose levels (also called blood sugar levels). Injecting insulin Insulin is injected using a syringe and needle, or an insulin pen or needle. The needles used are very small as the insulin only needs to be injected under the skin (subcutaneously) – not into a muscle or vein. Once it's been injected, it soaks into small blood vessels and is taken into the bloodstream. As your confidence grows and you become more relaxed, injections will get easier and soon become second nature. The most frequently used injection sites are the thighs, buttocks and abdomen. You may be able to inject into your upper arms, but check with your diabetes team first as this isn't always suitable. As all these areas cover a wide skin area, you should inject at different sites within each of them. It is important to rotate injection sites, as injecting into the same place can cause a build up of lumps under the skin (also known as lipohypertrophy), which make it harder for your body to absorb and use the insulin properly. The three groups of insulin There are three groups of insulin – animal, human (not from humans but produced synthetically to match human insulin) and analogues (the insulin molecule is like a string of beads; scientists have managed to alter the position of some of these beads to create 'analogues' of insulin). Nowadays, most people use human insulin and insulin analogues, although a small number of people still use animal insulin because they have some evidence that they otherwise lose their awareness of Continue reading >>
- Relative effectiveness of insulin pump treatment over multiple daily injections and structured education during flexible intensive insulin treatment for type 1 diabetes: cluster randomised trial (REPOSE)
- New diabetes treatment could eliminate need for insulin injections
- Diabetes treatment: THIS new drug could be biggest development since discovery of insulin
Missing Insulin Injections
Tweet Missed insulin injections are much more of a pain than the injections themselves and can cause a headache as to what effect a late injection will have and what dose should be administered. We look at this common problem and provide some guidance. Always remember that if you are at all unsure what to do, you should contact your health team for advice rather than risk making a mistake. In this article, when it says contact your health team, note that you may need to contact your out of hours service if your health team is not available. Common causes of missed injections Commonly cited reasons for missed injections include: Forgetting to take insulin Oversleeping Not having your injection kit with you Running out of insulin Having a fear of needles Deliberately missing insulin If you have problems with forgetting injections, see our forgetting injections guide dedicated to help prevent problems with forgetting to inject and if you forget whether you have injected or not. What to do if an insulin injection is missed There is not a set rule of what to do if an injection is missed as it can depend on how long ago the injection was meant to be administered and what type of insulin was to be taken. We provide some general tips but if you are in doubt, it is best to consult your health team and follow their advice. If long term/basal insulin was forgotten If you forget to take your long term insulin (basal insulin) and you realise relatively soon, it should usually be fine to inject your usual dose if the dose is given within 2 hours of when it should have been done. In this case, you’ll need to be aware that the injection was taken later and so the insulin will also be active in your body later than it would usually be. In some cases this could increase the chance of h Continue reading >>
- Exosomes are the Missing Link to Insulin Resistance in Diabetes
- Relative effectiveness of insulin pump treatment over multiple daily injections and structured education during flexible intensive insulin treatment for type 1 diabetes: cluster randomised trial (REPOSE)
- 10 Silent Diabetes Symptoms You Might Be Missing
Is Mealtime Insulin Right For Me?
Diabetes & Insulin In diabetes, your body does not make enough insulin or use it properly. This causes your blood sugar to go too high. Oral medications, like metformin, may help your body to use insulin more efficiently. Other oral medications can help your body make more insulin. However, these medicines often work for only a few years. When the oral medications stop working, you will need to give yourself background and/or mealtime insulin shots to help control your blood sugar. If you need insulin, it does not mean that you have failed. It is just a part of diabetes. Background insulin can help control your blood sugar when you are not eating. However, it does not cover the carbs that you eat at meals. If the dose of background insulin is raised to cover spikes in blood sugars that happen after you eat, your body will have too much insulin in between your meals and while you sleep. This can cause your blood sugar to go too low. This is called hypoglycemia. If you have high blood sugars after meals, this can cause tiredness, irritability, blurry vision, more frequent urination and thirst. Over time, high blood sugars can damage your feet, hands, and eyes. By adding mealtime insulin you can better match the insulin to what your body would produce if you did not have diabetes. This will help prevent both low and high blood sugars so that you feel better and get less damage from the diabetes. What is Insulin? Natural insulin is made from the pancreas to match what the body needs so your blood sugar stays in a normal range. The pancreas makes some amount of insulin all the time, called background or basal insulin. Background insulin helps to supply fuel to your muscles and controls the glucose that is released from your liver. Every time you eat, the pancreas releases a Continue reading >>
Sometimes I Forget To Take My Insulin Before I Eat. Should I Go Ahead And Take My Shot After I Eat?
A: You can take your insulin after your meal, but the dose may need to be adjusted depending on how much time has elapsed betweem your meal and the time you remembered to take the insulin. If little time has passed and you remember to take the insulin right after you have eaten, it is usually safe to take your pre-meal dose. If, however, you remember 1 to 2 hours after your meal, the dose will usually need to be adjusted to a lower amount to protect you from unwanted low blood glucose levels 3 to 4 hours after the meal. How much of an adjustment you make is something that should be discussed with your primary care provider, your endocrinologist or your diabetes educator. Continue reading >>
About Fast-acting Mealtime Insulin
What is mealtime insulin? Mealtime insulins are fast-acting insulins that are taken immediately before or after meals. As you eat, your blood sugar naturally goes up, or “spikes.” Humalog® (a fast-acting insulin) works to manage those blood sugar spikes and may help keep your sugar levels in balance. Humalog should be taken within 15 minutes before eating or right after eating a meal. People who take Humalog will usually continue to take longer-acting insulin to help manage blood sugar levels at night and between meals. Taking mealtime insulin in addition to longer-acting insulin may help to control blood sugar levels throughout the day. Low blood sugar (hypoglycemia) is the most common side effect of Humalog that may be severe and cause unconsciousness (passing out), seizures, and death. Test your blood sugar levels as your doctor instructs. Talk to your doctor about low blood sugar symptoms and treatment. The orange area shows how blood sugar levels typically rise after meals. The pattern of insulin action may vary in different individuals or within the same individual. Comparing types of insulin Take a look at our overview below to find out about the different types of insulin. You’ll notice that there are differences in when the types of insulin reach your bloodstream, when they “peak” in your body, and how long they can last (length of time the insulin keeps lowering your blood sugar). Fast-acting insulin (also called rapid-acting) is absorbed quickly and starts working in about 15 minutes to lower blood sugar after meals. Humalog fast-acting insulin should be taken 15 minutes before eating or right after eating a meal. Depending on the type of diabetes you have, you may need to take Humalog with a longer-acting insulin or oral anti-diabetes medication. Continue reading >>
- Fiasp, a new, ultra-fast acting mealtime insulin is available for the treatment of diabetes in adults
- Relative effectiveness of insulin pump treatment over multiple daily injections and structured education during flexible intensive insulin treatment for type 1 diabetes: cluster randomised trial (REPOSE)
- Calculating Insulin Dose
Why Do You Administer Insulin Before Meals & Not After?
Your doctor prescribes medicinal insulin to replace or supplement your body's naturally occurring insulin. The goal with medicinal insulin is to mimic the normal patterns of insulin secretion as closely as possible. Depending on what type of insulin you take, administration may occur before or after meals, or at other times during the day. Always follow your doctor's instructions about when to administer your insulin to prevent extreme highs and lows in your blood sugar level. Video of the Day Your pancreas normally secretes a background amount of insulin throughout the day and greater amounts after meals in response to increasing blood sugar. Different types of medicinal insulin mimic either background or post-meal insulin secretion. Background, or basal, insulins are intermediate- or long-acting and include glargine, detemir and NPH. Mealtime insulins are rapid- or short-acting and include regular, lispro, glulisine and aspart. The timing of administration of the different types of insulin depends on how quickly the drug enters your bloodstream, when the peak levels occurs and how long the medication remains active in your body. Rapid-Acting Insulin Insulin glulisine, lispro and aspart are rapid-acting, mealtime insulins. These drugs begin working within 15 minutes of administration and mimic the insulin increase that occurs when you eat. You typically take insulin glulisine within 15 minutes before a meal or within 20 minutes after you begin eating. With insulin lispro, you administer your injection within 15 minutes before a meal or immediately afterward. If you take insulin aspart, your doctor will likely advise you to take the drug 5 to 10 minutes before meals. Administering rapid-acting insulin close to mealtime ideally means the drug enters your bloodstream at r Continue reading >>
Diabetes Patients Can Eat Immediately After Taking Insulin
People with type 2 diabetes no longer have to wait to eat after taking insulin…. People with type 2 diabetes are sometimes told to wait after using insulin for the drug to work its way into the body before they can begin eating, but a new study from Germany indicates that it is not necessary to wait. In a group of about 100 diabetics, researchers found that blood sugar levels remained steady regardless of whether or not participants left a 20 to 30-minute gap between using insulin and eating a meal. The diabetics overwhelmingly preferred being able to eat right away, too. The result of the study can lead to better adherence and satisfaction. Injectable insulin is available for diabetics in a newer fast-acting form, but it’s expensive and many still use human insulin, which takes some time to become active in the body. So doctors often recommend waiting to eat after using human insulin to prevent blood sugar spikes. Not all experts think waiting is necessary, though, according to the researchers led by Nicolle Mueller of Universitätsklinikum Jena. To see what difference it makes, Mueller and her colleagues randomized type 2 diabetics into two groups. For four weeks, one group of 49 people waited 20 minutes to eat after using human insulin. Then they switched to eating immediately after injecting insulin for another four weeks. A second group of 48 diabetics did the same in reverse order, eating immediately after injection for the first four weeks, then observing a waiting period for the next four. Using a blood test that measures average glucose levels over time, the researchers found that all the participants had generally higher than ideal blood sugar levels but the difference in those levels between periods when they waited or didn’t wait to eat after insulin i Continue reading >>
Pre And Post Meal Testing
Tweet Blood glucose testing is one part of managing your diabetes successfully. Testing your blood glucose both before and after a meal allows you to see how that meal affects your blood glucose levels and helps you to understand which meals may be best for your blood glucose control. Page 1: Pre and Post Meal Testing [You are here] Page 2: Patient perspectives and forum threads The most powerful influence on blood glucose levels comes from food. Whether you have type 1 or type 2 diabetes, the peak blood glucose levels are often likely to occur around two hours after meals. What is pre and post meal blood glucose testing? Pre and post meal testing allows you to see how your meal and, where relevant, your medication for that meal affects your blood glucose levels. Tweet Type 2 diabetes mellitus is a metabolic disorder that results in hyperglycemia (high blood glucose levels) due to the body: Being ineffective at using the insulin it has produced; also known as insulin resistance and/or Being unable to produce enough insulin Type 2 diabetes is characterised by the body being unable to metabolise glucose (a simple sugar). This leads to high levels of blood glucose which over time may damage the organs of the body. From this, it can be understood that for someone with diabetes something that is food for ordinary people can become a sort of metabolic poison. This is why people with diabetes are advised to avoid sources of dietary sugar. The good news is for very many people with type 2 diabetes this is all they have to do to stay well. If you can keep your blood sugar lower by avoiding dietary sugar, likely you will never need long-term medication. Type 2 diabetes was formerly known as non-insulin-dependent or adult-onset diabetes due to its occurrence mainly in people over Continue reading >>
Diabetes: How To Use Insulin
Please note: This information was current at the time of publication. But medical information is always changing, and some information given here may be out of date. For regularly updated information on a variety of health topics, please visit familydoctor.org, the AAFP patient education website. What is insulin, and why do I need it? Insulin is a hormone that controls the level of blood sugar (also called glucose) in your body. People with diabetes may not have enough insulin or may not be able to use it properly. The sugar builds up in the blood and overflows into the urine, passing out of your body unused. Over time, high blood sugar levels can cause serious health problems. All people with type 1 diabetes, and some people with type 2 diabetes, need to take insulin to help control their blood sugar levels. (The box below lists the different types of insulin.) The goal in treating diabetes is to keep the blood sugar level within a normal range. Do I need to monitor my blood sugar level? Yes. You need to check your blood sugar level regularly using a blood glucose monitor. Your doctor or the office staff can teach you how to use the monitor. You'll need to write down each measurement and show this record to your doctor, so your doctor can tell you how much insulin to take. How often will I need to take insulin? Your doctor will give you a schedule. Most people with diabetes need at least 2 insulin shots a day. Some people need 3 or 4 shots for good blood sugar control. When should I take insulin? If you take Regular insulin or a longer-acting insulin, you should generally take it 15 to 30 minutes before a meal. If you take insulin lispro (brand name: Humalog), which works very quickly, you should generally take it less than 15 minutes before you eat. What is different Continue reading >>
Do I Take Insulin Before Or After A Meal?
Question Originally asked by Community Member elainenakamura Do I Take Insulin Before Or After A Meal? How soon after a meal should I take insulin? I don’t know whether I should take it before or after, actually. Can anyone help? Answer Elaine- Hello! What kind of insulin are you taking? You should find out from your physician when the best time for you to take your insulin would be. When I was taking shots (insulin) I would give myself a shot before breakfast, before lunch, before dinner and I would give myself lantus before bed. We all have different requirements. Your physician would be able to answer this questions a lot better than I could. You can read more about how insulin works, and other useful information at this link. Cherise Community Moderator You should know Answers to your question are meant to provide general health information but should not replace medical advice you receive from a doctor. No answers should be viewed as a diagnosis or recommended treatment for a condition. Answered By: Cherise Nicole Continue reading >>
Insulin Therapy
Why do I need to take insulin? When you digest food, your body changes most of the food you eat into glucose (a form of sugar). Insulin allows this glucose to enter all the cells of your body and be used as energy. When you have diabetes, your body doesn’t make enough insulin or can’t use it properly, so the glucose builds up in your blood instead of moving into the cells. Too much glucose in the blood can lead to serious health problems. All people who have type 1 diabetes and some people who have type 2 diabetes need to take insulin to help control their blood sugar levels. The goal of taking insulin is to keep your blood sugar level in a normal range as much as possible so you’ll stay healthy. Insulin can’t be taken by mouth. It is usually taken with injections (shots). It can also be taken with an insulin pen or an insulin pump. How often will I need to take insulin? You and your doctor will develop a schedule that is right for you. Most people who have diabetes and take insulin need at least 2 insulin shots a day for good blood sugar control. Some people need 3 or 4 shots a day. Do I need to monitor my blood sugar level? Yes. Monitoring and controlling your blood sugar is key to preventing the complications of diabetes. If you don’t already monitor your blood sugar level, you will need to learn how. Checking your blood sugar involves pricking your finger to get a small drop of blood that you put on a test strip. You can read the results yourself or insert the strip into a machine called an electronic glucose meter. The results will tell you whether or not your blood sugar is in a healthy range. Your doctor will give you additional information about monitoring your blood sugar. When should I take insulin? You and your doctor should discuss when and how you Continue reading >>
