Diabetes Self-Management Articles

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Fast-Acting Insulin

by Hope Warshaw, MMSc, RD, BC-ADM, CDE

To prevent hypoglycemia from unused insulin, get in the habit of thinking about when you took your last bolus dose and how much (if any) action is still left before taking another bolus to “correct” high blood glucose.

The latest generation of insulin pumps, which some people call “smart pumps,” has a built-in feature that keeps track of how much of a previous bolus dose is still active. If the user attempts to administer a bolus dose while a previous bolus is still active, the pump will suggest subtracting the amount of insulin still “on board” from the requested amount.

How are you doing?
Measuring and observing your postmeal (postprandial) blood glucose values will help you to determine how well you are timing your rapid-acting insulin and figuring your doses. Walsh suggests that “much of the postprandial high blood glucose values observed are because people aren’t giving rapid-acting insulin long enough before a meal to act in tandem with their food. Most foods affect the blood glucose within two hours, while most of the effect of rapid-acting insulin is seen over five hours.”

The American Diabetes Association advises that postprandial blood glucose shouldn’t exceed 180 mg/dl (plasma value) at two hours after the start of a meal. Other associations and experts believe the two-hour postmeal goal should be less than 140 mg/dl. Occasionally checking your blood glucose after a meal at hours one, two, and three can help you determine when your blood glucose level peaks and starts to come down again. According to Scheiner, “Research shows that it is common for people to have elevated blood glucose levels after meals.” One key to controlling these highs is better timing of rapid-acting insulin.

Because responses to insulin and carbohydrate can vary (because of, say, activity level or meal composition), some people find it helpful to record their experiences for future reference in a notebook, computer file, or logbook. Chart the foods you eat and the amounts, the amount of insulin you take to cover the food, your blood glucose levels before and after you eat, when you exercise and how vigorously, and any lessons you learn. Although perfect control is impossible, your personal database can help you obtain a better understanding of your blood glucose readings and how to fine-tune your diabetes control.

The right time
Delivering rapid-acting insulin at the proper time can help you to achieve optimal blood glucose control. It’s not easy, but by learning when it’s best for you to take your insulin and putting a few tips into practice, you can increase your chances of hitting your blood glucose targets more regularly. For more information about insulin, click here.

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Also in this article:
Insulin Resources
Normal Insulin Release for Food



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