Other than glucose other food needs more than an hour to reach blood stream. So, what is the benefit of taking insulin before meal, rather some time it can cause serious hypoglycemia if patient miss to take meal after insulin dose.
Hyperglycemia has no immediate bad effect but hypoglycemia can cause death immediately. So, insulin should not be given before meal or breakfast . For prevention of insulin induced hypoglycemia it should be given after meal or breakfast. The dose will be adjusted according to the previous status and amount of the food taken. Some time patient may forget to take meal or refuse to take meal after taking insulin. In these cases serious hypoglycemia can cause death. Pt may be on diarrhoea or anorexic due to viral fever or other causes. Some time pt. may vomit after eating. In these cases pt will suffer serious hypoglycemia particularly during night when immediate glucose infusion will be difficult due to availability of medical person. Physician should advice to consider these situations to their patient on insulin therapy .
There is compulsory thing that if patients took insulin is to eat, taking insulin=time to eat. Also many food go to blood stream and raise blood sugar in 2 minutes. So mandatory or not it depends on the type of insulin. For example Novorapid may took before eating or after your meal. Others took before meal half an hour. To judge that you need to read the leaflet of insulin. Yes hypoglycemia may be fatal so patients with diabetes should keep sweet stuff with them, I would recommend honey, bananas, fruits if available if not sweet candies and may be glucose tablets in some situations. Patients should learn the signs of hypoglycemia and have ID define the patients as he/she have diabetes. Again Taking insulin means going to eat.
Best regards
Aly
Hi Mujibur
taking the insulin treatment before eating a meal poor in carbohydrates for a patient who is in hypoglycemia...what will be the consequences?
fred
Dear Mujibur, thank you very much for your thought provoking question. Two factors are important here. First one, type of insulin used and it's onset and duration of action. Second one glycemic index of the food and it's absorption time. Timing of insulin injection to be determined accordingly. You have rightly maintained, if somebody can not take the sufficient amount of food after inj insulin, Then patient should be closely monitored for hypoglycemia and should be managed promptly... Because hypoglycemia is very dangerous.. Following link might help you.. Thanks
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1415461/
These links may help you
http://www.diabetes.org/living-with-diabetes/treatment-and-care/medication/insulin/insulin-routines.html?referrer=https://www.google.com/
http://onlinelibrary.wiley.com/doi/10.1002/pdi.289/pdf
http://www.livestrong.com/article/470250-why-administer-insulin-before-meals-not-after-meals/
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Dear Dr Mujibur,
Your apprehensions about hypoglycemia occuring after taking insulin and not taking meal within the specified time, are real. But this situation is rare in adults unless there is a psychological issue. It commonly occurs in children who may refuse to eat after taking insulin, so the physician advises parents to give the insulin shot when the child has started eating. The younger the child, the commoner is this situation. The timings of insulin injection before meals are based on the peak insulin action and the peak rise in blood glucose after a meal depending on the glycemic index of the food taken.
You are right that the effects of hypoglycemia may be catastrophic but the each episode of hyperglycemia also leaves a memory, the reason why there is so much stress by diabetologists to minimise the postprandial glucose excursions in patients with diabetes.
Best wishes,
Devi Dayal
the best way to talk about risks at this topics is to be T1D, so am I...
hyperglycemia are better than hypoglycemia, damages are real for both but life have some limits.
fred
If you take Regular insulin or a longer-acting insulin, you should generally take it 15 to 30 minutes before a meal. If you take insulin lispro (brand name: Humalog), which works very quickly, you should generally take it less than 15 minutes before you eat.
@ Ban M. SSaeed what is the drawback of taking regular or long acting insulin after meal you think?
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