Insulin injections – Before or after food?

timing of insulin injection in relation to food is something which patients are always confused about.  There is no uniformity regarding this since it depends on the type of insulin being taken…Insulin is injected into the fat below the skin and from there it has to reach its sites of action i,e.the liver,muscle and fat through the blood.  Short acting insulins are supposed to act immediately following intake of a meal.   Hence short acting insulins should be injected before a meal.  There are two types of short acting insulin – regular insulin and rapi acting insulins.

Regular insulins

• Human Actrapid,
• Human Insulin R,
• Insugen R
• Wosulin R
• Insuman rapid

These insulins are to be taken 20-30 minutes before a meal.  They are clear insulins and are usually marketed in bottles with yellow label

Rapid acting insulins

• Novorapid,
• Humalog,
• Apidra

These are also clear insulins and thse can be taken around 5 minutes before a meal or even after a meal since they act faster than regular insulins

Premixed insulins

These are mixtures of short acting and intermediate acting insulins.  The short acting insulins in thse premixed insulins can be either regular or rapidly acting.  Those containing regular insulin such as

• Human Mixtard,Human Insulin 30/70,
• Wosulin 30/70
• Insugen 30/70
• Insuman combo

should be taken 20-30 minutes before food.  Those with a rapid acting insulin eg Novomix,Humalog Mix should be taken 5 minutes before a meal

Long acting intermediate acting insulins

These insulins usually start acting only gradually and act for a long time.  Hence thse insulins need not be taken in relation to a meal.  NPH insulins can be taken once in 12 hours or 24 hours.  Glargine insulin is given once in 24 hours.  These are usually taken around 10pm at night and should be taken same time of the day everyday.  newest insulins like degludec insulin can be taken once in a day and the timing of insulin is also flexible

To know more

Insulin – Where to inject? Tips for injecting insulin

• Insulin – confusion and misconcepts
• Insulin – Where to inject?
• Tips for injecting insulin

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