Managing Your Diabetes with Mealtime Insulin

If you and your doctor have decided that mealtime insulin is right for you, this interactive tool can help you determine when and how to adjust your insulin.

Starting and Adjusting Mealtime Insulin

Background & Rapid-acting Insulin

To start mealtime insulin, add four units to your background dose before your largest meal. What is your largest meal?

Breakfast
Lunch
Dinner

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Background & Rapid-acting Insulin > Breakfast

Check your blood sugar before lunch and choose the option below that matches your result.

  • Under 80

    If your blood sugar was under 80 when you tested it before lunch, subtract 2 units of mealtime insulin before breakfast the next day.
  • 80-130

    If your blood sugar was 80-130 when you tested it before lunch, do not change your mealtime insulin dose before breakfast the next day.
  • Over 130

    If your blood sugar was over 130 when you tested it before lunch, add 2 units of mealtime insulin before breakfast the next day.

If your blood sugar is under 70, drink ½ cup of juice or soda or eat something that contains sugar. You can also take glucose tablets to bring your blood sugar into normal range. Let your physician/care team know that you had low blood sugar.

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Background & Rapid-acting Insulin > Lunch

Check your blood sugar before dinner and choose the option below that matches your result.

  • Under 80

    If your blood sugar was under 80 when you tested it before dinner, subtract 2 units of mealtime insulin before lunch the next day.
  • 80-130

    If your blood sugar was 80-130 when you tested it before dinner, do not change your mealtime insulin dose before lunch the next day.
  • Over 130

    If your blood sugar was over 130 when you tested it before dinner, add 2 units of mealtime insulin before lunch the next day.

If your blood sugar is under 70, drink ½ cup of juice or soda or eat something that contains sugar. You can also take glucose tablets to bring your blood sugar into normal range. Let your physician/care team know that you had low blood sugar.

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Background & Rapid-acting Insulin > Dinner

Check your blood sugar before bed and choose the option below that matches your result.

  • Under 125

    If your blood sugar was under 125 when you tested it before bed, subtract 2 units of mealtime insulin before dinner the next day.
  • 125 - 150

    If your blood sugar was 125 - 150 when you tested it before bed, do not change your mealtime insulin dose before dinner the next day.
  • Over 150

    If your blood sugar was over 150 when you tested it before bed, add 2 units of mealtime insulin before dinner the next day.

If your blood sugar is under 70, drink ½ cup of juice or soda or eat something that contains sugar. You can also take glucose tablets to bring your blood sugar into normal range. Let your physician/care team know that you had low blood sugar.

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Premixed Insulin

To start premixed insulin, your first dose should be 10% of your body weight in pounds (i.e. 220lbs = 22 units) and take it once a day during breakfast or dinner. When are you taking your premixed insulin?

Breakfast
Dinner

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Premixed Insulin > Breakfast

Check your blood sugar before dinner and choose the option below that matches your result.

  • Under 80

    If your blood sugar was under 80 when you tested it before dinner, subtract 2 units every 3-5 days until your blood sugar is 80-130 before dinner.
  • 80-130

    If your blood sugar was 80-130 when you tested it before dinner, do not adjust your insulin dose.
  • Over 130

    If your blood sugar was over 130 when you tested it before dinner, add 2 units every 3-5 days until your blood sugar is 80-130 before dinner.

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Premixed Insulin > Dinner

Check your blood sugar before bed to make sure your blood sugar is not too low. If your blood sugar is 80-130 before bed, eat a small snack. For most people on premixed insulin, 130-180 is a good blood sugar goal to have in order to avoid hypoglycemia during the night.

Check your blood sugar again before breakfast and choose the option below that matches your result.

  • Under 80

    If your blood sugar was under 80 when you tested it before bed, subtract 2 units every 3-5 days until your blood sugar is 80-130 before breakfast.
  • 80-130

    If your blood sugar was 80-130 when you tested it before bed, do not adjust your insulin dose.
  • Over 130

    If your blood sugar was over 130 when you tested it before bed, add 2 units every 3-5 days until your blood sugar is 80-130 before breakfast.

If your blood sugar is under 70, drink ½ cup of juice or soda or eat something that contains sugar. You can also take glucose tablets to bring your blood sugar into normal range. Let your physician/care team know that you had low blood sugar.

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