Is Mealtime Insulin Right for You?

By

Amy Rushlow

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If you’ve been having trouble keeping your blood sugar under control, mealtime insulin might help.

Research shows that adding mealtime insulin to other diabetes treatments can improve blood sugar control in people with type 1 and type 2 diabetes. It may also prevent serious diabetes complications, such as damage to the eyes, kidneys and nerves.

But mealtime insulin isn’t right for everyone, considering factors such as your A1c level and your lifestyle. Discuss it with your doctor to learn whether it’s a good choice for you.

Insulin Basics

When you have diabetes, your body doesn’t produce enough of the hormone insulin or can’t use it well. As a result, your blood sugar (blood glucose) goes up.

Medications can help, but they usually only work for a few years. When medicine isn’t enough to control your blood sugar, your doctor may recommend taking insulin.

There are two main types of insulin: background insulin and mealtime insulin. You take mealtime insulin before you eat to help control the rise in blood sugar that occurs after you eat. Background insulin helps manage your blood sugar in between meals. Most people start with background insulin and add mealtime insulin for additional blood sugar control.

How Mealtime Insulin Works

In people who don’t have diabetes, eating triggers the release of insulin in proportion to the amount of carbohydrates consumed. For people with diabetes, mealtime insulin mimics the body’s normal release of insulin in response to food. This helps prevent high blood sugar after meals.

You might think that you could simply increase your background insulin to control these blood sugar spikes. But that would make your blood sugar too low between meals.

There are two types of mealtime insulin: rapid-acting and short-acting. Rapid-acting insulin starts working very quickly and lasts a few hours. Short-acting, or regular, insulin takes about 30 minutes to kick in and lasts six hours or more. Your doctor might recommend premixed insulin, which combines a rapid-acting and intermediate-acting insulin.

Pros and Cons of Mealtime Insulin

The right insulin regimen for you depends on how your body responds to the hormone, your age, and whether you have type 1 or type 2 diabetes. In general, your doctor may consider mealtime insulin if:

  • You’re taking a high dose of background insulin

  • Your hemoglobin A1c level is higher than the goal your doctor has set for you

  • Your post-meal blood sugar is often high

Your lifestyle and personal preferences also matter. Mealtime insulin may be a good fit for you if:

  • You don’t always eat at the same time

  • You typically eat one big meal a day

  • You don’t mind giving yourself multiple daily injections and checking your blood sugar several times a day

  • You don’t find it difficult to give yourself shots before meals

  • You follow a healthy diet and count carbohydrates

Talk with your doctor about your treatment. He or she can help you find an insulin plan that will control your blood sugar and work with your lifestyle.

Key Takeaways

  • Mealtime insulin mimics the body’s normal release of insulin in response to food. This helps prevent high blood sugar after meals.

  • Adding mealtime insulin to other diabetes treatments can improve blood sugar control and prevent complications in people with type 1 and type 2 diabetes.

  • Your doctor may consider mealtime insulin if you’re taking a high dose of background insulin, your hemoglobin A1c level is higher than it should be, or your post-meal blood sugar is often high.

  • Your lifestyle and personal preferences also matter. Mealtime insulin may be a good fit if you don’t always eat at the same time and you don’t mind giving yourself multiple daily injections.

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Medical Reviewers: William C. Lloyd III, MD, FACS Last Review Date: Dec 22, 2016

© 2016 Healthgrades Operating Company, Inc. All rights reserved. May not be reproduced or reprinted without permission from Healthgrades Operating Company, Inc. Use of this information is governed by the Healthgrades User Agreement.

View Sources

Medical References

  1. Curtis B and Lange MJ. Glycemic control among patients with type 2 diabetes who initiate basal insulin: a retrospective cohort study. Journal of Medical Economics. 2014;17(1):21-31.
  2. Heller S, Buse J, Fisher M, et al. Insulin degludec, an ultra-longacting basal insulin, versus insulin glargine in basal-bolus treatment with mealtime insulin aspart in type 1 diabetes (begin basal-bolus type 1). The Lancet. 2012;379(9825):1489-97.
  3. Spollett GR. Improved disposable insulin pen devices provide an alternative to vials and syringes for insulin administration. Diabetes Spectrum. 2012;25(2):117-22. http://spectrum.diabetesjournals.org/content/25/2/117.full.pdf+html
  4. Deciding whether to transition your patient to mealtime insulin. Endocrine Society. Accessed November 27, 2014. http://www.accurateinsulin.org/for-doctors/deciding-whether-to-transition-your-patient-to-mealtime-i...
  5. Is mealtime insulin right for me? Endocrine Society. Accessed November 27, 2014. http://www.accurateinsulin.org/for-patients/is-mealtime-insulin-right-for-me
  6. Starting mealtime insulin. Endocrine Society. Accessed November 27, 2014. http://www.accurateinsulin.org/starting-mealtime-insulin
  7. Insulin pumps. American Diabetes Association. Accessed November 27, 2014. http://www.diabetes.org/living-with-diabetes/treatment-and-care/medication/insulin/insulin-pumps.htm...
  8. Insulin routines. American Diabetes Association. Accessed November 27, 2014. http://www.diabetes.org/living-with-diabetes/treatment-and-care/medication/insulin/insulin-routines....
  9. Fact sheet: diabetes and insulin. Endocrine Society. Accessed November 27, 2014. http://www.hormone.org/questions-and-answers/2012/diabetes-and-insulin
  10. Nathan DM, Zinman B, Cleary PA, et al. Modern-day clinical course of type 1 diabetes mellitus after 30 years’ duration. Archives of Internal Medicine. 2009;169(14):1307-16. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2866072

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