Injecting after meals

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sue63

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J is new to MDI and yesterday it went a bit all over the place!

He is injecting after meals as our nurse said he could. Ate breakfast late and injected (probably a good 30 mins later!!) then we had family round and a buffet lunch, J injected again straight after the meal and then went low.

He didn't feel right really all day until the late evening. I presume he injected far too late after breakfast and them he struggled calculating the carbs at the buffet. He is on such tiny amounts of insulin half units make a big difference.

It feel like 2 injections a day were easier than this MDI but it's early days!

Do people generally inject before meals to get the insulin working straight away?

Thank you again🙂
 
I think with MDI and your quick acting insulins they say inject before the meal as it takes 5-10 mins to start working...........but its all about experimenting, if there are lots of slowly released carbs in the meal then injecting after the meal or even a good few minutes after it is OK.......

The timings matter as well........quick acting novo rapid is done after 4-5 hours roughly, so ideally you want to leave that amount of time between injecting again or there could be an overlapping effect, this together with being unsure of exactly what carbs were consumed at the buffet MIGHT have been the cause......

Test, test, test................🙂
 
Hi Sue,

I guess it might depend exactly which insulin a person is on... I'm on lispro & tend to inject just before I eat (baby & toddler permitting!). I find it also depends on the food type too - fattier / lower GI foods seem to absorb more slowly so I can sometimes get away with injecting a little bit later, ie part way through or straight away afterwards... like everything with diabetes, it seems quite variable though! 🙄
 
Hi Sue, I've always injected immediately prior to eating (I use novorapid). I'm surprised at the advice to inject after, although I know some people do - as has been said normally you want the insulin to start working before or as you eat. Injecting after does have the advantage of knowing exactly what you have eaten - sometimes I inkect before and then either change my mind over what I want to eat or don't eat as much as I had planned, which might mean I then have too much or too little insulin. Recently I have been experimenting with injecting 15 mins before to try and avoid 'spikes', but not convinced that it's making much difference to me. I've only injected after a meal a couple of times, and on one of those occasions completely forgot until about two hours after, but which time my levels were scarily high 😱
 
Injecting 30 mins after a meal is way to late and would undoubtedly lead to a post meal spike in his blood glucose. Mostly it is better to inject immediately before eating, but occasionally there are exceptions, for example one with a high fat content would mean a injection after eating would work best due to the fat delaying the breaking down process of the carbs, likewise with a low gi meal too. On the other hand a meal of say mashed potato would instantly start to raise blood glucose and its is then advisable to inject immediately before eating to counteract a spike, I found learning about the gi value of foods is a useful tool in stabilising blood glucose.

His after lunch hypo could have been the result of his late breakfast insulin still being active, just be careful with overlapping insulin's, and be sure the previous dose has faded out before injecting again, I try to leave at least 4-5 hours to allow for this. Its very hard to calculate buffet style meals with insulin, but on these occasions if they not to frequent, I prefer to underestimate if unsure, this way you avoid the dreaded hypo's, and you can always include a correction dose later at your next meal. Toby.
 
Ever since C moved onto MDI, she always injected after the meal or between the meal and dessert. That way, if she doesn't eat it all, it doesn't matter. of course she'll always eat all her dessert 😉. I don't know anything about spikes, as we were never told to test after 2 hours.
 
Thanks everyone....we will check out this advice about injecting after meals..I wasn't sure. We need to learn lots about fat contents of foods etc

I suspected J had overlapped his insulin. I am not sure about our team..they are not that clear...especially the dietician and we are having to do a lot of learning ourselves!
 
This place might even be better than you clinic for learning............:D
 
I have moved onto MDI recently, (within the last 2 months) and we started working on carb counting at the last dieticians appointment. She is very good indeed, and says the two hour after test is less important than the before the next meal test, as it's only once 4-5 hours have gone past that you know how the injection that you gave with the first meal has dealt with the first meal. The two hour test ideally should be within 2mmol/l of where you started, but she was less concerned by that than arriving at a sensible base before the next meal.

Of course, this may change once we have worked out the ratios that I need to inject on, and is always assuming that the basal dose is correct...

R
x
 
I will generally inject before meals as I was told that novorapid will start entering the system after about 20 mins which is the same as food.

The only time I inject after is if I have a hypo just before I am due to eat in which case I have some oJ, have my meal and wait 1/2 an hour. I would generally slightly reduce the amount of insulin I would take as part of the food is needed for the hypo treatment.
 
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