Mealtime insulin

Sometimes long-acting (basal, or background) insulin isn’t enough to keep your blood sugar levels at your target level. When you eat a meal, the amount of sugar in the blood goes up rapidly and these “spikes” may be too much for the long-acting insulin to control.

Diabetes changes with time and needing to add mealtime insulin simply means that your diabetes has progressed and you need more help to control it.

Mealtime insulin is a rapid- or fast-acting insulin, which is injected just before you eat. It helps to control the spikes in blood sugar. Mealtime insulin is given in addition to long-acting insulin, not instead of it. The two together are sometimes called “basal-bolus insulin”.

Insulin levels in your body (basal-bolus treatment)

When you first start mealtime insulin, you may only need one mealtime injection per day, which you’ll probably take with your biggest meal. You may need to add more injections as time goes on. Your doctor will advise you on this.

How do I know if I need mealtime insulin?

If you’re struggling to control your blood sugar levels with long-acting insulin alone, this might be a sign that mealtime insulin would be an option for you.

To find out if you need mealtime insulin, your doctor needs to know how your meals are affecting your blood sugar. You’ll be asked to test your blood sugar before and two hours after meals. This will help to understand where you might benefit from an injection of mealtime insulin. You will be asked to keep a diary of your blood sugars levels and how much you eat at each meal for a few days.

It does seem like a lot to do at first, but it’s only for a few days and is the best way to determine what would be the next best step to manage your diabetes.

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