5 Signs It's Time to Add Mealtime Insulin to Your Diabetes Treatment

Doctor William C Lloyd Healthgrades Medical Reviewer
Medically Reviewed By William C. Lloyd III, MD, FACS
Written By Evelyn Creekmore on September 18, 2022
  • Confident woman at her desk
    The goal is control.
    The goal of any diabetes treatment is to help you control blood glucose (also known as blood sugar) levels and prevent diabetes complications. There’s more than one way to get there. Mealtime insulin, which you take before eating, is one option. Examples of mealtime insulin include insulin aspart (NovoLog), insulin lispro (Humalog), and insulin glulisine (Apidra). If you’re adhering to your current treatment and consistently hitting your A1C goal, adding mealtime insulin is probably not necessary. If you’re not reaching your goal, your diabetes is harming you, whether or not you can feel it. Know how to pick up the signals that you may need to boost your treatment.
  • Pills in hand
    1. You’re not getting good control from your current diabetes treatment.
    Generally, the desired blood glucose level for those with diabetes is between 70 and 130 mg/dL before a meal and less than 180 mg/dL after a meal. Everyone is different, and your doctor determines your personal goal based on many factors. For some people, their goal can be met through dietary changes with glucose tablets as needed. Some people need background insulin that lasts for 24 hours. When these treatments don’t help you stabilize blood sugar levels, mealtime insulin can do the job.
  • woman checking blood sugar levels
    2. You have a pattern of low blood sugar.
    If you have a tendency toward low blood sugar (hypoglycemia), it’s important to tell your doctor. Research shows hypoglycemia can be the biggest barrier to good blood glucose control with insulin. Blood sugar tends to drop about four hours after meals and overnight. Background insulin taken once daily may not be enough to help balance out the highs of eating, the lows after eating, and overnight “fasting,” especially if your meals tend to be high in fat.
  • Doctor and patient speaking
    3. You’re ready to commit to mealtime insulin for diabetes.
    Mealtime insulin can be very effective, but adhering to mealtime insulin can require more effort than other diabetes treatments. Depending on your current habits, you may need to cut way back on dining out, drinking alcohol, and working through lunch. You may feel uncomfortable bringing your medication and monitoring devices with you on social occasions. Studies show significant lifestyle changes can lead to “psychological insulin resistance.” But they also show a collaborative doctor-patient partnership and newer technologies can help patients overcome the challenges. If your doctor thinks it’s time for mealtime insulin, with the right support system, you should feel confident in your ability to commit and control your diabetes.
  • woman eating breakfast and looking at journal
    4. You’re able to eat on a regular schedule as part of your diabetes treatment.
    Do you prefer grazing throughout the day to getting your “three squares”? That might have to change with mealtime insulin. The standard routine for those using mealtime insulin is three moderate meals a day, evenly spaced four to five hours apart. Some studies show eating six times a day raises blood glucose levels because there’s not enough time in between to clear the glucose. Skipping meals can also lead to serious problems.
  • woman in grocery store aisle checking nutrition facts
    5. You’re ready for serious carb counting.
    Carbohydrates are a part of life, whether or not you have diabetes. A more accurate accounting of carbs is needed, however, when you take mealtime insulin. That’s because the dose of insulin you take is intended to “cover” the number of carbs you eat. One unit of rapid-acting mealtime insulin equals about 12 to 15 grams of carbs. The range can vary widely, though, based on your insulin sensitivity. Be prepared to work with your doctor to get educated on the math.
Is It Time for Mealtime Insulin for Diabetes? | Diabetes Treatment

About The Author

Evelyn Creekmore has more than 15 years of experience writing online educational health content, including nearly 10 years full-time at WebMD, where she was the director of brand content. She holds an MPH in Applied Public Health Informatics from Emory University Rollins School of Public Health and an MA from the University of North Carolina at Charlotte.
  1. University of California, San Francisco. Goals of Treatment. https://dtc.ucsf.edu/types-of-diabetes/type2/treatment-of-type-2-diabetes/monitoring-diabetes/goals-of-treatment/
  2. Products for Treating Low Blood Glucose. American Diabetes Association. http://www.diabetesforecast.org/2009/jan/products-for-treating-low-blood-glucose.html
  3. EADSG Guidelines: Insulin Therapy in Diabetes. US National Library of Medicine National Institutes of Health. https://www.ncbi.nlm.nih.gov/pubmed/29508275
  4. Insulin Therapy and Hypoglycemia. US National Library of Medicine National Institutes of Health. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4265808/
  5. Psychological Insulin Resistance in Patients With Type 2 Diabetes. American Diabetes Association. http://care.diabetesjournals.org/content/28/10/2543
  6. Choosing What, How Much, and When to Eat. The American Diabetes Association. http://www.diabetes.org/living-with-diabetes/recently-diagnosed/where-do-i-begin/choosing-what-to-eat.html
  7. Dining on Time. American Diabetes Association. http://www.diabetes.org/food-and-fitness/food/what-can-i-eat/food-tips/eating-out/dining-on-time.html
  8. 11 Diabetes Dinner Mistakes to Avoid. The Diabetes Council. https://www.thediabetescouncil.com/11-diabetes-dinner-mistakes-to-avoid/
  9. Calculating Insulin Dose. University of California, San Francisco. https://dtc.ucsf.edu/types-of-diabetes/type1/treatment-of-type-1-diabetes/medications-and-therapies/type-1-insulin-therapy/calculating-insulin-dose/
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Last Review Date: 2022 Sep 18
THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.