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Can you jab twice?

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Tom1982

Tom1982

Well-Known Member
Relationship to Diabetes
Parent of person with diabetes
Daft question.
If you had a snack i.e a cake (that needed a jab) at say 3 o’clock, would you have to wait until 5 for dinner?
 
Do you mean wait until 5 for the cake or the jab?
If you are carb counting then it is perfectly OK to eat a cake at 3 and inject for it and then have your tea at 5, as long as you (or your daughter!) don’t mind the extra injection.
The only thing to be careful of is that at 5 the blood sugar might still be a bit high from the cake so you don’t want to do a correction that soon because the insulin you injected for the cake hasn’t finished working yet and will continue to drop the blood sugar, so if you correct you will have injected two lots of insulin for the same blood sugar rise and will end up going low. If that makes sense!
 
No. You can rejab less than 4 hours after your last jab.
It is often frowned upon because you risk "stacking" and having too much insulin. Therefore, you need to take into consideration "insulin on board" (IOB) when calculating the second dose.
The advice is to assume a straight line graph. So, if a bolus dose lasts 4 hours, half of it will be used after 2 hours. So when calculating the second dose, subtract the IOB.
 
Ah I see. So Jo had a cake today at about 3. Had the 3.5 jab to cover it. We then waited until 5 to have dinner with the jab to cover it and so on. Was that too soon?
 
That should be fine provided that you only inject for her tea and not any correction for a high BG reading at tea time as the earlier insulin will still be working.
 
If you’re using a meter or app that calculates the insulin dose for you, it should take into account any earlier meals and injections, so that you can bolus for snacks in between meals.
 
Tom1982 said:
Ah I see. So Jo had a cake today at about 3. Had the 3.5 jab to cover it. We then waited until 5 to have dinner with the jab to cover it and so on. Was that too soon?
Click to expand...

No it wasn’t too soon. As an example, at a buffet I might have 2 units for a piece of quiche and salad, then 20 minutes later have another 2 units for something else, etc. As long as you remember what you’re doing, it’s fine. You can bolus for a snack, then eat a meal an hour later if she wants, or you can bolus for a main meal, then 30 minutes later bolus for dessert.
 
Thanks again everyone for the help. Cleared that one up. I’m sure I’ll have another daft one by the end of today
 
Everyone’s answered the specific question but some more info to help you make decisions. Fast insulin has a peak about an hour after injecting then insulin works its way out over the next few hours. For novorapid the peak is one hour after injecting and it will be out of the system 4-5 hours after injecting. Different brands of fast insulin will have slightly different curves but along the same idea. Generally speaking for kids it’s good to have some periods of the days where there isn’t a lot of active fast insulin circulating so allowing the full cycle of 4-5 hours to play out between meals is a good idea instead of having big meals close together. But snacks are totally to be expected and whilst to begin with we tried to keep them to around 10-20g of carbs so only a little bit of insulin was needed sometimes they would be bigger than that. With things like cake we tended to keep them to with meals (and he would have dessert with every meal so there was less feeling of deprivation of certain foods). And even with the best planning sometimes meals are closer together than every 4 hours anyway. As previous posters have said the biggest problem with giving injections close together is the risk of stacking which can lead to a hypo. Knowing the curve of the insulin will help you in judging if you need to give less insulin if giving jabs close together. The meter will usually have a display of active insulin as part of the onscreen info if you’re getting more bolus advice but it only count this as the first hour or so after a jab so if in doubt you can adjust the recommended dose downwards. The meter is doing the maths for you but it doesn’t know everything you know so it’s fine to either use one of the exercise adjustments to reduce the bolus or take 10g off the carb count or just take 0.5 off the recommended dosing amount if you know you’re giving two lots of insulin close together. Especially during the honeymoon period and with smaller kids there can be more sensitivity to insulin so a little less insulin is often safer than a little too much. (My kid is now adult sized, going through puberty which means more insulin resistance and out of the honeymoon period so much less sensitive to insulin and so we have fewer problems with doses close together but in the first year it did cause some issues if we didn’t adjust downwards.)

No question is too daft. If your team is like ours they will repeat info every few weeks then every few months and now at the annual review so no one expects you to know everything and it’s good to go over things often. We have to juggle so much info and it’s a lot to take in.
 
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