Insulin Mistakes You Need To Avoid
Amy Hess Fischl, MS, RDN, LDN, BC-ADM, CDE
If you use insulin to keep your blood sugar in check, these five common mistakes could lead to dangerous lows or highs. What you need to know:
1. Wrong dose, wrong insulin. There are four basic types of insulin: Rapid- and short-acting insulins are injected before a meal to cover the rise in blood sugar from the food youre about to eat; intermediate- and long-acting insulins control blood sugar for up to 24 hours, covering periods of time when shorter-acting types have stopped working. People with type 1 diabetes often take a combination of shorter-and longer-acting insulins and thats where mix-ups can happen. Among the most common: Taking a too-high dose of a rapid-acting insulin because youve mistaken it for a longer-acting type, according to a report in the journal Clinical Diabetes. The danger: Low blood sugar.
The fix: If this happens to you, eat enough carbohydrates to cover the extra insulin, keep monitoring your blood sugar, watch for signs of and call your doctor right away if you have any concerns. To prevent it from happening again, make sure you know which insulin is which and what the right dose is. In a 2014 in the journal Prescrire International, experts note that sometimes, doctors and pharmacies abbreviate the word units to U, which can look like an extra zero, leading people to take insulin doses ten times higher than prescribed. Ask your doctor or pharmacist if youre unsure of the right dose.
If Long Term/basal Insulin Was Forgotten
If you forget to take your long term 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, youll 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 hypoglycaemia so speak to your health team if you have any doubts.
If it has been longer than 2 hours since your injection should have been taken and you are not sure what to do, speak to your health team who will be able to advise you. It is important not to delay getting advice as your blood glucose levels may begin rising to dangerous levels
If your blood glucose levels are high when you notice you have missed a dose, you may need to take short acting or rapid acting insulin to lower your blood glucose levels. If you are at all unsure of what dose to take, seek advice from your healthcare team.
Monitoring Your Blood Glucose And Ketone Levels
If you have missed an injection, it is important that you monitor your blood glucose levels more regularly than usual over the next 24 hours to prevent blood glucose levels from going either too high or too low.
If you have type 1 diabetes , or have type 2 diabetes and produce very little of your own insulin, be prepared to test your blood or urine for ketones if your blood glucose levels rise above 15 mmol/l.
When Should One Normally Take Insulin In A Day
Insulin must be taken before meals, as when you are eating, the blood sugar levels in your body tend to rise naturally. Injecting insulin before this spike in blood sugar can happen helps to manage the rise in sugar levels.
Mealtime Insulins are the ones that are taken immediately before a meal and are fast-acting ones.
Regular insulin should be injected before 15 to 30 minutes of a meal. There are various insulin injections available whose time intervals depend on the strength of it. Various brands are made to work comparatively quickly. These insulin injections must be taken less than 15 minutes before a meal.
It is generally advised and recommended by to administer insulin in the body before meals.
What to do if you forgot your daily insulin before food? Can it be taken afterward?
Now, lets say, you missed to take your insulin before your food, it is not very late to correct this mishap. Suppose insulin is introduced to the body within specified time limits after meals. In that case, it can still work the same way and protect your metabolism and blood sugar levels from adverse situations.
Thus, the question arises, that if you have not taken your daily insulin before a meal, can it be taken after you have had your food?
Let us divide the way insulin can be taken post-meal, depending on the varieties of insulin available and might be the ones you use.
How To Prevent An Insulin Overdose
There are things you can do to prevent an overdose:
Keep a consistent schedule. Itâll make it much easier for you to stay on track.
Eat something at every mealtime. Even if you’re not hungry, have some bread, a glass of skim milk, or a small serving of fruit. Never skip meals when you’ve taken insulin.
Be prepared. Expect that you’ll have insulin complications at some point. Pack hard candies in your bag and your partner’s. Keep some in the car and in your travel bag, too.
Make sure friends and family know the way you react to hypoglycemia. Itâll help them take action if your low blood sugar levels make you confused.
Wear a medical alert bracelet. Make sure it says you use insulin.
What Will Happen If I Stop Taking Insulin
Guest over a year ago
I am worried that insulin is actually doing my body more harm than good. What will happen if I decide to stop taking insulin? I think I should be able to control my blood sugar with diet and exercise. Has anyone ever tried this? Have you stopped taking insulin for good? I’m hoping for some positive stories here because I don’t want to take insulin any longer than I have to.
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over a year ago
Hi Guest,
Untreated, your diabetes will cause more harm than good. Insulin occurs naturally in the body, created by the pancreas.
In some cases, by losing weight you may be able to get off of insulin. It depends upon a number of factors including how much weight you lose.
Discuss this with your doctor. They are familiar with your specific case. Do NOT just stop taking it.
Good luck.
GloriaAttarRNBSN310575 over a year ago
Have you spoken to your doctor about your fears? Some diabetics are eventually able to go off of insulin and treat their diabetes naturally with diet and exercise, but that is something that must be learned over time. I completely understand your fears about putting something artificial into your body. Are you on a synthetic insulin or a natural insulin?
Guest over a year ago
Susan Ardizzoni310772 over a year ago
Forgetting Blood Sugar Checks
Checking your blood sugar levels regularly helps you stay tuned in to how your body responds to your medications, food, and lifestyle habits, Dr. Port says. It can help you and your doctor determine the right amount of basal and bolus insulin to take. Fasting blood sugar levels reflect how basal insulin is working in the background, whereas pre-meal and evening blood sugar levels are a better barometer of how the bolus insulin dosing is matching up with your food and intake. “Many people stop checking their blood sugar because they dont feel badly,” Port says. Or, despite having symptoms of high or low blood sugar, they simply ignore the fact that their diabetes may be out of control, she adds.
Smart strategies to stay on top of your blood sugar testing routine include choosing a glucose meter that works for your lifestyle, keeping the meter where its easy to get to and use, and finding ways to remind yourself to do the checks. It can be a note on your refrigerator, an alarm on your phone, or some other device that prompts you to use it whatever works for you. You might also be eligible to use a continuous glucose monitor, a special device placed just under the skin that tracks blood sugar readings continuously and sends this information to a reader or to a phone app. Most devices require minimal or no calibration with finger stick blood glucose readings and can typically be worn for up to 7 to 14 days, depending on the brand.
Avoiding Injection Bruises And Lumps
Bruising can happen when you catch a tiny capillary under the skin where you have injected. It is quite normal for this to happen occasionally when you are injecting regularly and youre not doing anything wrong.
If you are concerned, you could make an appointment with your diabetes specialist nurse who will be able to do a review of your injection technique. In some cases, bleeding and bruising can be reduced by something as simple as using a different sized needle or changing your needle after each injection.
Some people notice hard lumps that can form if you inject in the same place too often. This might be lipohypertrophy , or could be something called cutaneous amyloidosis. These lumps can stop the insulin from working properly, so make sure you rotate where you inject and choose a different spot each time. If you notice any lumps, especially if they’re not going away, speak to your healthcare professional for more advice.
Other side effects from injecting a lot can be itching, rashes and other skin irritations. Changing where you inject helps with this too. You can also get treatments from your local pharmacy that can will help with the irritation.
Also Watch For High Blood Sugar
If youre not eating due to an acute illness like the flu or an infection, its also common for your blood sugars to rise.
When you have diabetes and are acutely ill, you should check your blood sugars up to four times per day, drink plenty of fluids and contact your doctor if your blood sugars are consistently over 250, Garvey says.
When Should I Take Insulin
You and your doctor should discuss when and how you will take your insulin. Each persons treatment is different. Some people who use regular insulin take it 30 to 60 minutes before a meal. Some people who use rapid-acting insulin take it just before they eat.
Types of insulin:
- Rapid-acting insulin starts working in about 15 minutes. It lasts for 3 to 5 hours.
- Short-acting insulin starts working in 30 to 60 minutes and lasts 5 to 8 hours.
- Intermediate-acting insulin starts working in 1 to 3 hours and lasts 12 to 16 hours.
- Long-acting insulin starts working in about 1 hour and lasts 20 to 26 hours.
- Premixed insulin is a combination of 2 types of insulin .
Controlling Diabetes When Youre Not Hungry
If you find that youre eating less due to an illness or other factors, your medications may need adjusting, so its important to talk to your doctor. Meanwhile, here are some general guidelines:
- Mealtime insulin: For mealtime insulin, if you skip the meal, you should also forego the mealtime insulin.
- Long-acting insulin: The dosage for long-acting insulin is not usually based on food intake, so your doctor will not likely recommend a dose reduction.
- Other medications: There are some diabetes medications that will lower your blood sugar when high, but wont normally cause hypoglycemia. They may or may not need adjustment, depending on how much youre eating. These medications include metformin, SGLT-2 inhibitors and DPP4 inhibitors.
How Is Hypoglycemia Diagnosed
A doctor who thinks a person might have hypoglycemia will ask about the patient’s medical history and diet, in particular about the timing of the symptoms, whether they tend to happen after eating high-sugar meals, and if the symptoms go away quickly with eating sugar.
The only way to tell for sure whether someone’s symptoms are related to hypoglycemia is to test the blood sugar while the person is having the symptoms. If the test shows that the blood sugar is truly low, the doctor may do other tests to diagnose specific diseases that can cause hypoglycemia.
What Happens If You Avoid Taking Your Insulin
If you have type 1 diabetes, taking insulin is essential and you cannot live without it. If you avoid taking it, your blood sugar levels can become too high and you risk developing diabetic ketoacidosis . If left untreated, DKA could be life-threatening. Thats why its important to make sure you take your insulin.
If you have type 2 diabetes and use insulin to treat your condition, you should continue to take it as prescribed. If you avoid taking it, your blood sugar levels could become too high and you may become ill. Please speak to your healthcare professional if you have any questions or concerns about taking your insulin.
Insulin is a treatment that helps manage blood sugars, so this also reduces the risk of serious long-term complications as well a shorter-term consequences. Its still important to keep going to your appointments and manage your condition with healthy lifestyle choices. Staying active and eating a healthy diet will reduce the risk of complications from your diabetes, but insulin is also an important part of your treatment.
High Calorie Foods May Or May Not Cause The Blood Sugar Level To Rise
Many people think that all high-calorie foods raise blood sugar level, but this is not always the case.
In general, foods that cause blood sugar level to rise the most are those that are high in carbohydrates, which are quickly converted into energy, such as rice, bread, fruits and sugar. Next are foods high in protein, such as meats, fish eggs, milk and dairy products, and oily foods. However, even though carbohydrates affect blood sugar levels, if you don’t eat them your diet will be unbalanced and you won’t feel satisfied after your meal, which can lead to excessive consumption of foods rich in protein and fat.
Food containing three major nutrients
| Carbohydrates |
|---|
What Happens If Taking Insulin After Food
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Fast-acting insulin 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. When used in a pump, do not mix Humalog with any other insulin or liquid.
Subsequently, question is, can I take insulin 2 hours after eating? Don’t wait more than 15 minutes to eat after taking a mealtime insulin. As the name suggests, rapid-acting insulin starts to work rapidly in the bloodstream. If you wait too long to eat, your blood sugar can actually end up getting too low. This puts you at risk for hypoglycemia.
Just so, how long should you wait to take insulin after eating?
Remember, you should not wait more than 15 minutes to eat after you take this insulin shot. Rapid-acting insulin can be more convenient to take than regular insulin. With regular insulin, you inject the insulin and then wait 30 to 60 minutes before eating.
How does insulin work after a meal?
After you eat food and your blood sugar level rises, cells in your pancreas are signaled to release insulin into your bloodstream. Therefore, insulin helps balance out blood sugar levels and keeps them in a normal range. As blood sugar levels rise, the pancreas secretes more insulin.
Cautions With Other Medicines
Some medicines interfere with the way glimepiride works. Your doctor may need to adjust your dose of glimepiride. They may also recommend checking your blood sugar levels more often.
Tell your doctor if you’re taking any of these medicines before starting on glimepiride:
- steroid tablets such as
- some medicines used to treat heart problems, high blood pressure and high cholesterol
- medicines to treat bacterial or fungal infections such as , co-trimoxazole, miconazole or fluconazole
- rifampicin, a medicine used to treat tuberculosis
- other diabetes medicines
Some women may need to adjust their dose of glimepiride after starting contraceptive pills. In rare cases contraceptive pills can increase blood sugar levels.
Who Needs To Take Insulin
Diabetes impairs insulin production by the pancreas and use of this essential hormone by the body. The condition causes high blood sugar levels.
However, not every person with type 2 diabetes will need to take insulin. People with type 1, on the other hand, will have to supplement their insulin supply for the rest of their lives.
There are three main types of diabetes:
- Type 1 diabetes: Typically starts in childhood when a person does not produce enough insulin. Usually results from the bodys immune system attacking an otherwise healthy pancreas.
- Type 2 diabetes: Can develop at any age but 45 years is the average age of onset. Either the pancreas does not produce enough insulin, or the bodys cells become resistant to its actions.
- Gestational diabetes: Occurs during pregnancy and makes it harder for a womans body to respond to insulin. Typically stops after childbirth but increases a womans risk of developing type 2 diabetes.
Type 1 and type 2 diabetes are usually lifelong conditions. According to the Centers for Disease Control and Prevention , more than 30 million people in the United States have diabetes. Type 2 diabetes is the most common, accounting for
Urgent Advice: Contact Your Doctor Straight Away If You Take Too Much Glimepiride
Taking too many glimepiride tablets can give you low blood sugar.
Early warning signs of low blood sugar include:
- feeling hungry
- feeling confused
- having problems concentrating
If you think you have low blood sugar, have some food or drink that quickly gets sugar into your bloodstream such as sugar cubes or fruit juice.
Throwing Away Your Needles And Lancets
Sharps bins and needle clippers are the safest way of disposing of your insulin needles and your lancets. A needle clipper removes the needle from your insulin pen, and is useful when youre out and about. How you get rid of your sharps bin depends on where you live. Your healthcare team should have information to help you get rid of your bin.
If Short Term/rapid/bolus Insulin Was Forgotten
If you forgot to take your meal time insulin and you realise relatively soon, it will usually be fine to inject the dose you would have given yourself if the dose is given within 2 hours of when it should have been done.
You will need to be aware that because the injection was taken later, the insulin will be working within your body later than it would have done had you injected on time.
insulin duration chart
Be aware of any signs of high or low blood glucose levels, monitor your blood glucose levels more regularly than usual and contact your health team if you have any questions or worries.
If you forgot to take your meal time injection more than 2 hours ago, it can be more complicated as you may have another meal or bed time due.
If you are unsure of how much insulin to take, contact your health team who will be able to advise you. In this case it is important not to delay getting advice as your blood glucose levels can quickly rise to dangerous levels.
Background Or Basal Insulin Replacement
- Controls glucose overnight and between meals by keeping fat in fat tissue and curbing glucose production from the liver.
- Provides a low, continuous level of insulin.
- Can be a long-acting insulin, which you inject once or twice daily such as the insulin analogs, insulin glargine, insulin detemir and .
- Or can be a rapid-acting insulin continuously infused under the skin, if you are using an insulin pump.
- Represents about 50% or half of the bodys daily insulin requirements.
Time To Strike High Blood Glucose
Given the many short- and long-term benefits of post-meal blood glucose control, it is certainly worth the effort to start measuring and evaluating your after-meal control. If your blood glucose levels are higher than they should be, talk with your healthcare team about new or different medical treatments that might help. And take a look at your personal choices in terms of food and activity. Even without a perfectly functioning pancreas, there is still a multitude of options for tackling those high blood glucose spikes!
Disclaimer Statements: Statements and opinions expressed on this Web site are those of the authors and not necessarily those of the publishers or advertisers. The information provided on this Web site should not be construed as medical instruction. Consult appropriate health-care professionals before taking action based on this information.
Taking Insulin Without Eating
Guest over a year ago
Hi, I have a question. Is it okay taking insulin without eating? Does insulin have an effect if I haven’t eaten anything? I’m not sure how this works. Can some explain this to me. I have on occasion taken my insulin and then forgot to eat. I didn’t feel very well after that. I was very tired. I had to lay down and take a nap. One of my friends suggested that I should have at least had some juice but that was after the fact. Has anyone taken their insulin and not eaten? What happened to you? I’d like to hear your story if you’re willing to share. Thanks.
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Susan Ardizzoni310772 over a year ago
Time Your Bolus Insulin Properly
For people who take rapid-acting insulin at mealtimes, the timing of the bolus can have a huge impact on after-meal blood glucose levels. Boluses given too late to match the entry of glucose from dietary carbohydrates into the bloodstream can produce significant blood glucose spikes soon after eating. A properly timed bolus, on the other hand, can result in excellent after-meal control.
Unless you have , it is best to give bolus insulin doses before eating. How long before? It depends mainly on what you are eating and on your pre-meal blood glucose level.
Figuring out the pre-meal blood glucose part is fairly straightforward: the higher your blood glucose, the earlier the bolus should be given. If your pre-meal blood glucose is well above your target, it is best to give the bolus and then wait at least 30 minutes before eating. Near your target blood glucose? Wait 15 minutes. Below target? Either take the bolus and eat right away, or take the bolus after eating to manage high blood glucose.
Does earlier bolusing make a difference? Absolutely. Research has shown that simply giving mealtime boluses before eating rather than after eating can reduce the post-meal spike by about 45 mg/dl.
Benefits And Dangers Of An Insulin Response
The rise in insulin after eating helps move sugar into body tissues, and therefore keeps your blood sugar from getting too high.
Note from Luke: Think of insulin as a traffic cop. It tells the blood sugar where to go. In normal and healthy individuals the glucose fuels your nervous system, red blood cells, brain and muscle tissue. With optimal amounts and good insulin sensitivity, glucose fuels your nervous system and is burned off as energy. With too much or poor insulin sensitivity your muscle don’t readily grab the glucose and it goes to where it’s always welcome: fat stores.
But the release of insulin can have negative effects. Too much insulin, for instance, can stress the pancreatic cells that secrete insulin. And this added stress might cause the exhausted cells to stop releasing insulin normally or, in the worst cases, to die. These outcomes are particularly dangerous, as your body needs insulin to maintain normal blood sugar levels.
A diet high in refined carbohydrates, low in fiber and protein can lead to insulin resistance and diabetes. When you are constantly stimulating insulin and causing huge blood sugar swings, eventually your muscles become less sensitive to it’s effects. So to get the muscle to absorb the glucose you need more insulin, then more and then more. Pretty soon the muscle doesn’t really respond to insulin and much of the glucose is stored as bodyfat and even sometimes in the liver, leading to fatty liver disease.