Angelsongs

Q:

If I take my Novalog to cover my meal, but two hours later have a blood glucose of 300, do I need to take more insulin to cover for that?

Dr. William Sullivan

A:

You mention a situation that occurs frequently, when a rapid-acting insulin (such as Novolog) is taken before meals to control blood glucose after meals – but your blood glucose 2 hour after meals is still elevated at 300 mg%. In general, it is best to cover a meal with adequate meal insulin coverage so that after meal blood glucose is less than 180 mg%. As you know, Novolog is one of the rapid-acting insulins; the other options include Humalog and Apidra. All three of these rapid-acting insulins can be effective in controlling blood glucose after meals. If you are doing carbohydrate counting or using an insulin algorithm before meals – it may be best to adjust your premeal insulin dose so that blood glucose after a meal is under 180 mg%. If you have elevated blood glucose after a meal unexpectedly, taking additional rapid-acting insulin may be considered but should be discussed with your healthcare provider, as stacking insulin doses may lead to hypoglycemia. At times, it may be best to recheck blood glucose after 3 hours, as blood glucose occasionally drops significantly between 2-3 hours after a meal. It is important to review your meal rapid-acting insulin dosages with your healthcare provider to decide what is best for you.

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