PL is a 18 year old type 1 diabetic who uses regular human insulin (Humulin R) whenever he has a meal. He always injects 30 minutes prior to his meal and rotates his injection sites. The doctor recently switched his mealtime insulin to insulin lispro (Humalog). Lately, he has been getting hypoglycemic values prior to his first bite of the meal. Which of the following is the best recommendation for improving his glucose levels?
a) Inject at the same site every time. b) Move the timing of the injection closer to his meal. c) Eat smaller meals to reduce carbohydrate count. d) Move the timing of the injection to 1 hour prior to his meal.
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The answer is (B).
Humulin R (regular human insulin) is a fast acting insulin which is injected 30 minutes prior to a meal. In contrast, Humalog (insulin lispro) is a rapid acting insulin which has a faster onset of action and can be injected just prior to a meal.
a) Injecting into the same site can cause lipodystrophy, which can cause erratic absorption patterns.
b) Correct answer
c) Eating smaller meals may worsen the hypoglycemia he is experiencing due to reduced carbohydrate count. Also, it does not correct the timing of insulin action.
d) Humalog should be injected close to a meal, such that its effect will coincide with the spike in glucose. Injecting one hour prior to a meal will not be effective.
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