Evidence From Clinical Studies
Conflicting literature exists on optimal prandial bolus timing in clinical practice. Two studies in particular favour injection of prandial insulin 1520;min before eating. Cobry et;al. carried out a crossover study in 23 young people with Type;1 diabetes on insulin pump therapy. The trial had three treatment arms: delivering an insulin glulisine bolus by insulin pump 20;min prior to a meal , immediately before the meal or 20;min after meal initiation . At 60;min, the 20;min arm showed significantly lower glycaemic excursions than both the 0;min arm and the +20;min arm . At 120;min after meal initiation, the 20;min arm likewise showed significantly lower BG values than both the 0;min and +20;min arms . Peak BG levels were also significantly lower in the 20;min arm compared with the 0;min arm and in the +20;min arm compared with the 0;min arm and the +20;min arm . No difference in BG readings was observed when insulin was administered immediately prior to the meal compared with 20;min postmeal. Hypoglycaemic episodes recorded were highest in the +20;min arm compared with the 0;min and 20;min arms , respectively .
Mean blood glucose levels after meal initiation in three treatment arms: Pre: delivering an insulin glulisine bolus by insulin pump 20;min prior to a meal ; Start: immediately before the meal ; and Post: 20;min after meal initiation . Figure;reproduced from Cobry et;al. Diabetes Technol Ther 2010; 12: 173137 .
What Type Of Insulin Is Best For My Diabetes
- How you respond to insulin.
- Lifestyle choices. The type of food you eat, how much alcohol you drink, or how much exercise you get will all affect how your body uses insulin.
- Your willingness to give yourself multiple injections per day
- Your age
- Your goals for managing your blood sugar
Your doctor may prescribe more than one type. You might need to take insulin more than once daily, to space your doses throughout the day, or to add other medicines.
Afrezza, a rapid-acting inhaled insulin, is FDA-approved for use before meals for both type 1 and type 2 diabetes. The drug peaks in your blood in about 15-20 minutes and it clears your body in 2-3 hours. It must be used along with long-acting insulin in people with type 1 diabetes.
The chart below lists the types of injectable insulin with details about onset , peak and duration . These three things may vary. The final column offers some insight into the “coverage” provided by the different insulin types in relation to mealtime.
|Type of Insulin & Brand Names||Onset|
|30 min.-2 1/2 hours||16-20 hours|
|*Premixed insulins combine specific amounts of intermediate-acting and short-acting insulin in one bottle or insulin pen.|
How Should I Use Humalog
Use Humalog exactly as it was prescribed for you. Follow all directions on your prescription label and read all medication guides or instruction sheets.
Humalog is injected under the skin using a syringe and needle, an injection pen, or with an infusion pump. A healthcare provider will teach you how to properly use this medicine by yourself.
Read and carefully follow any Instructions for Use provided with your medicine. Ask your doctor or pharmacist if you do not understand these instructions.
Prepare your injection only when you are ready to give it. Do not use if the medicine looks cloudy, has changed colors or has particles in it. Call your pharmacist for new medicine.
Humalog is to be used within 15 minutes before a meal, or right after eating.
Your healthcare provider will show you where on your body to inject insulin lispro. Use a different place each time you give an injection. Do not inject into the same place two times in a row. Do not inject into skin that is damaged, tender, bruised, pitted, thickened, scaly, or has a scar or hard lump.
Concentrated Humalog must not be given with an insulin pump, or mixed with other insulins. Do not transfer insulin lispro from an injection pen to a syringe or a severe overdose could occur.
Never share an injection pen, cartridge, or syringe with another person, even if the needle has been changed. Sharing these devices can allow infections or disease to pass from one person to another.
Storing unopened insulin lispro:
Don’t Miss: Type 2 Diabetes And Bananas
What Is Different About Insulin Lispro
Insulin lispro is a new type of insulin. It starts working sooner than other insulin types. It also reaches peak activity faster and goes away sooner. Insulin lispro helps keep your blood sugar level from going too high after you eat. To keep your blood sugar level steady, your doctor will probably prescribe either a longer-acting insulin or another drug for you to take each day in addition to the insulin lispro.
If you need to mix insulin lispro with a longer-acting insulin, it’s best that you mix insulin lispro only with Humulin U or Humulin N, which are brand names for certain longer-acting insulins. Insulin lispro should always be drawn into the syringe first. This will keep the longer-acting insulin from getting into the insulin lispro bottle.
Types of insulin
Each type of insulin works at a different speed and lasts for a different length of time.
Quick-acting, such as insulin lispro , begins to work very quickly and lasts for 3 to 4 hours.
Short-acting, such as Regular insulin, starts working within 30 minutes and lasts about 5 to 8 hours.
Intermediate-acting, such as NPH or Lente insulin, starts working in 1 to 3 hours and lasts 16 to 24 hours.
Long-acting, such as Ultralente insulin, doesn’t start to work for 4 to 6 hours, but lasts 24 to 28 hours.
NPH and Regular insulin mixture, two types of insulin mixed together in 1 bottle, starts working in 30 minutes and lasts 16 to 24 hours.
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 dont 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 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 NicoleContinue reading >>
Recommended Reading: High Blood Sugar At Night
What Is Insulin Lispro
Insulin is a hormone that works by lowering levels of glucose in the blood. Insulin lispro is a fast-acting insulin that starts to work about 15 minutes after injection, peaks in about 1 hour, and keeps working for 2 to 4 hours.
Lyumjev is not approved for use by anyone younger than 18 years old.
Insulin lispro may also be used for purposes not listed in this medication guide.
Taking Humalog With Other Drugs
You may need to take other medications together with Humalog to manage your blood sugar levels.
If youre taking insulin such as Humalog, your doctor may decrease the dosage of, or have you stop taking, other diabetes drugs that increase your insulin level. Doing so helps prevent your blood sugar levels from dropping too low.
Examples of other diabetes medications that may be used with Humalog include:
- insulin products other than Humalog
If youd like to know more about taking other drugs with Humalog, talk with your doctor.
Also Check: How To Tell If Your Blood Sugar Is Low
Too Much Insulin Or Not Enough
High morning blood sugar levels before breakfast can be a puzzle. If you haven’t eaten, why did your blood sugar level go up? There are two common reasons for high before-breakfast blood sugar levels. One relates to hormones that are released in the early part of sleep . The other is from taking too little insulin in the evening. To see which one is the cause, set your alarm to self-monitor around 2 or 3 a.m. for several nights and discuss the results with your health care provider.
How I Rotate My Insulin Injection Sites
While I use my abdomen and arms for my rapid-acting injections, I use my glutes and lower back for all of my basal injections.;
I have a very home-made but also very effective way of keeping track of my injections so I remember to rotate them.
To make sure that I do proper injection rotation, I have a piece of paper where I note down my injections . I usually switch from right to left side daily and will start with injecting right above the bikini line, then switch to below the bikini line, and lastly inject alongside the bikini line.
This rotation pattern takes me about a month to get through before I start all over again. So far, that has worked really well for me. I have no lumps and my insulin absorption is still really good after 20 years with diabetes.
You May Like: How Does Diabetes Affect The Digestive System
What Are The Side Effects Of Humalog
With any medication, there are risks and benefits. Even if the medication is working, you may experience some unwanted side effects.
Contact your doctor immediately if you experience any of the following:
- Severe hypoglycemia – If not treated, severe hypoglycemia can lead to unconsciousness, seizures, and even death
- Severe allergic reactions
- Dangerously low levels of potassium
The following side effects may get better over time as your body gets used to the medication. Let your doctor know immediately if you continue to experience these symptoms or if they worsen over time.
Getting The Right Dosage
Even for those on Lantus® for a while, it may take a little time to get to the right dose of insulin. Your doctor may change your Lantus® dose several times in the first few weeks. This is to be expected. For best results, keep taking your Lantus® as prescribed, and keep talking to your doctor. What if You Miss a Dose? Your doctor will guide you on when to take Lantus®. Ask him or her what to do if you forget to take your insulin, so you can be prepared in advance in case it ever happens. Here are a few ways to remember to take your Lantus® once-a-day: 3 Helpful Tips Make yourself a reminder If you take your Lantus® at night, it might also be a good idea to leave yourself a note on your nightstand as a way to remember. If you take it in the morning, put your supplies where you can’t miss themnext to your toothbrush, for example. Keep out of reach of children. Add it to your other daily “to dos” Many people take Lantus® right after brushing their teeth in the evening or while making breakfast in the morning. Set an Alarm Some people set alarms on their wristwatches or mobile devices to remind them when to take their Lantus®. We changed doses a couple of times when I started on Lantus®, until we found the right amount for me.Continue reading >>
You May Like: How To Lower Blood Sugar Overnight
Dosage Adjustment Due To Drug Interactions
- Dosage adjustment may be needed when HUMALOG is coadministered with certain drugs .
- Dosage adjustment may be needed when switching from another insulin to HUMALOG .
- Instructions for Mixing with Other Insulins
|HUMALOG U-100 subcutaneous injection route|
|HUMALOG U-100 continuous subcutaneous infusion route|
|HUMALOG U-200 subcutaneous injection route|
Humalog And Insulin Glargine Drug Interactions
Do not stop taking any medications without consulting your healthcare provider. Disclaimer: Every effort has been made to ensure that the information provided by Multum is accurate, up-to-date and complete, but no guarantee is made to that effect. In addition, the drug information contained herein may be time sensitive and should not be utilized as a reference resource beyond the date hereof. This material does not endorse drugs, diagnose patients, or recommend therapy. Multum’s information is a reference resource designed as supplement to, and not a substitute for, the expertise, skill, knowledge, and judgement of healthcare practitioners in patient care. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate that the drug or combination is safe, effective, or appropriate for any given patient. Multum Information Services, Inc. does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. Copyright 2000-2018 Multum Information Services, Inc. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse, or pharmacist. Some mixtures of medications can lead to serious and even fatal consequences.Continue reading >>
Also Check: What Is The Best Alcohol To Drink For A Diabetic
Check For Insulin Flow
How Do I Take It
Many people get insulin into their blood using a needle and syringe, a cartridge system, or pre-filled pen systems.
The place on the body where you give yourself the shot may matter. You’ll absorb insulin the most evenly when you inject it into your belly. The next best places to inject it are your arms, thighs, and buttocks. Make it a habit to inject insulin at the same general area of your body, but change up the exact injection spot. This helps lessen scarring under the skin.
Inhaled insulin, insulin pumps, and a quick-acting insulin device are also available.
Recommended Reading: What Does A Diabetes Rash Look Like
What Happens If I Overdose
Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. Insulin overdose can cause life-threatening hypoglycemia. Symptoms include drowsiness, confusion, blurred vision, numbness or tingling in your mouth, trouble speaking, muscle weakness, clumsy or jerky movements, seizure , or loss of consciousness.
What Should Be Done In Case Of Overdose
Dont take more Humalog than your doctor prescribes. Using more than this can lead to serious side effects.
If you take too much Humalog, your blood sugar may drop too low, causing hypoglycemia . A severe overdose of Humalog can cause your blood sugar to drop very low, which can be life threatening.
You May Like: What Is A Unit Of Insulin
How Long Does It Take For Humalog To Kick In
about 15 minutesabout 1 hour
Rapid-acting insulin starts to work within 30 minutes after injection. Its effects only last 2 to 3 hours. Regular- or short-acting insulin takes about 30 minutes to work and lasts for about 3 to 6 hours. Intermediate-acting insulin takes up to 4 hours to work fully.
Additionally, how much Humalog do I take? For safety, I initially have patients replace the 1500 Rule for Regular with an “1800 Rule” for Humalog. Someone on 30 total units a day would now divide 30 into 1800 to find their blood sugar is likely to drop 60 mg/dl on each unit of Humalog, rather than the 50 mg/dl drop seen with each unit of Regular.
Subsequently, question is, how much does 1 unit of insulin bring down blood sugar?
Generally, to correct a high blood sugar, one unit of insulin is needed to drop the blood glucose by 50 mg/dl. This drop in blood sugar can range from 30-100 mg/dl or more, depending on individual insulin sensitivities, and other circumstances.
Is regular insulin fast acting?
Regular Human Insulin which has an onset of action of 1/2 hour to 1 hour, peak effect in 2 to 4 hours, and duration of action of 6 to 8 hours. The larger the dose of regular the faster the onset of action, but the longer the time to peak effect and the longer the duration of the effect.