Newer rapid-acting insulins and long-acting insulins do not require consistent snacking. Older insulins such as Regular, NPH, Humulin L Lente, and Humulin U Ultralente, because of their pronounced peaks and duration in the body, require that you eat snacks in order to prevent hypoglycemia. Regular peaks between two and 4 hours after injecting and stays in your system for 6 to 8 hours.
That means it's still lowering your blood glucose long afterwards your meal has stopped raising it. NPH peaks about six hours after injecting and leaves your system in about sixteen, Lente peaks nearly eight to nine hours after injecting and exits in about twenty, and Ultralente® peaks about twelve hours after injecting and lasts almost twenty-four hours total. If you're using one of these insulins, you need to consume regularly timed snacks.
However, today's long-acting insulins and rapid-acting mealtime insulins, which came to market three to ten years ago, do not require eating snacks, and most patients on these insulins don't do so. Of course, based on how these insulins affect you and also your individual diabetes goals, your treatment plan may call for a snack in a particular time of day.
These insulins are known as "bolus" insulins and are used specifically to pay for the carbohydrates in meals and snacks. Their greatest advantage is when quickly they're going to work and how quickly they exit your body. They start working between five and fifteen minutes after injecting, peak in one to one . 5 hours, and clear out from the body within 3 to 4 hours.
The faster action and shorter duration of these insulins make them better match the "action time" of your meals; they often reach their peak when your blood sugar is at its highest, so they're lowering your blood sugar levels simultaneously food is raising it. Between three and four hours later, when any of these bolus insulins is leaving your system, your blood sugar is near to its starting place.
Because the composition of your meal determines how fast your blood sugar levels will rise, rapid-acting insulins allow you to achieve better pre- and post-meal blood sugar levels control. Foods that have a high glycemic index (GI), those that break down rapidly and release glucose quickly into the bloodstream, such as cold cereals, juice, and soda, are easier to cover with rapid-acting insulins.
When eating low-GI carbohydrates, those that digest slowly, such as brown rice or perhaps a bean burrito or eating meals with considerable fat in it, which slows an upswing of blood sugar levels, you can best match your blood sugar's rise by injecting during or after your meal or if you take half your dose before the meal and half your dose a couple of hours after consuming. To manage the "dawn phenomenon", I often take one-third of my breakfast bolus upon waking to blunt an upswing and also the other two-thirds just before or during my meal. They are general guidelines. Speak with your doctor to work out your personal plan.
Lantus and Levemir are known as "basal" insulins. They last between sixteen and twenty-four hours, are generally taken once or twice a day, and mimic a normally functioning pancreas by continuously delivering small quantities of insulin to maintain blood sugar at normal levels between meals.
These insulins are nearly peakless, providing the advantage of reduced hypoglycemic events using their flatter action. If you use Lantus or Levemir, your doctor will adjust your dose so that you do not need to snack. However, if you also take an oral medication that may cause hypoglycemia, you might need a bedtime snack.
If you are on large doses of basal insulin (70-100 units or more in one injection), it might work more effectively if you split your dose into two injections taken at the same time. For example, you might take 35-50 units in each of two separate injections. Because long-acting insulins vary in duration from about nineteen to twenty-four hours, your doctor may also prescribe that you use them once or twice a day. When my friend Ruth switched by using Lantus once each day to using it twice a day, her blood sugar control improved dramatically.
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