Thursday, June 28, 2007
“If you inject 10 units of short-acting insulin into obese subjects, there is not much difference in time to peak effect,” he said. “But the time is tripled with triple the dose – the kind of dose an obese person with diabetes is much more likely to need.”
This means that what we generally call rapid-acting insulin isn’t rapid at all. It may take as much as 45 minutes to go to work.
This could explain a lot of the control issues that I’ve seen among type 2s who use Humalog or Novolog. I know obese type 2s who take rapid-acting insulin immediately before eating and then wondered why the insulin didn’t match their food intake.
If you take large doses of one of the rapid-acting insulins and are seeing a mismatch, what can you do now? Certainly a few days of careful testing of your blood glucose levels before and after your meals at half-hour intervals will help. If you find that your glucose and insulin peaks aren’t matching well enough, you can discuss with your physician or diabetes nurse educator about injecting sooner - half an hour to 45 minutes before eating might work better.
(Read David Mendosa's full report from the American Diabetes Association conference here.)
