Question:
It has been advocated that the interval between giving Regular insulin and
eating should vary depending on the preprandial glucose level to allow time
for the glucose to fall to normal levels before "adding" glucose with the
meal. I have seen no such recommendations with the use of lispro, but the
same logic would seem to hold. For example: if the preprandial glucose is
200, and one is using lispro, shouldn't one still wait some period of time
before eating to allow for the lispro to reduce the current level to the
recommended 70-130 range? Thanks.
Answer:
You are quite correct in what you say about timing the administration
of conventional Regular insulin, but the same rationale does not
apply to
lispro insulin [Humalog®].
The new substituted insulin usually begins to act within about
ten minutes so clearly there is a risk of hypoglycemia if eating is
delayed. The great advantage though is that Lispro can be given
immediately after the meal and in this way the dose can be adjusted both
for the pre-meal blood sugar level and for appetite.
DO'B
Original posting 29 Mar 97
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