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This article originally posted and appeared in  DietMedicationBG ControlType 2 DiabetesPractice MgmtIssue 663

Diabetes Patients Can Eat Immediately After Taking Insulin

People with type 2 diabetes no longer have to wait to eat after taking insulin....

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People with type 2 diabetes are sometimes told to wait after using insulin for the drug to work its way into the body before they can begin eating, but a new study from Germany indicates that it is not necessary to wait.

In a group of about 100 diabetics, researchers found that blood sugar levels remained steady regardless of whether or not participants left a 20 to 30-minute gap between using insulin and eating a meal. The diabetics overwhelmingly preferred being able to eat right away, too.

The result of the study can lead to better adherence and satisfaction.

Injectable insulin is available for diabetics in a newer fast-acting form, but it's expensive and many still use human insulin, which takes some time to become active in the body. So doctors often recommend waiting to eat after using human insulin to prevent blood sugar spikes.

Not all experts think waiting is necessary, though, according to the researchers led by Nicolle Mueller of Universitätsklinikum Jena. To see what difference it makes, Mueller and her colleagues randomized type 2 diabetics into two groups.

For four weeks, one group of 49 people waited 20 minutes to eat after using human insulin. Then they switched to eating immediately after injecting insulin for another four weeks. A second group of 48 diabetics did the same in reverse order, eating immediately after injection for the first four weeks, then observing a waiting period for the next four.

Using a blood test that measures average glucose levels over time, the researchers found that all the participants had generally higher than ideal blood sugar levels but the difference in those levels between periods when they waited or didn't wait to eat after insulin injections was a negligible 0.08 percent.

The participants also reported about the same number of high-blood sugar episodes between the two time periods, and about 87 percent of them said they "significantly preferred" doing away with the 20-minute wait altogether.

Dr. Aaron Cypess, a staff endocrinologist in the clinic of the Joslin Diabetes Center in Boston who was not involved in the study, said people should talk with their doctors before making any sort of change to their insulin routine.

"What would I do with a patient who is moderately adherent to what I recommend? I'd say give it a shot," he said, because it's better for people to eat closer to the time they use insulin. "This is really useful, because you get into a problem if people are supposed to take insulin so many minutes before. That's where adherence goes down."

These results may also allow some people to switch from the fast-acting insulin analogs to the less-expensive human insulin, said Cypess, but he added that more studies would be needed to compare the two.

Diabetes Care, online January 28, 2013. 

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This article originally posted 08 February, 2013 and appeared in  DietMedicationBG ControlType 2 DiabetesPractice MgmtIssue 663

Past five issues: Issue 797 | Diabetes Clinical Mastery Series Issue 256 | Issue 796 | Diabetes Clinical Mastery Series Issue 255 | Issue 795 |

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