Taking Insulin Late

[StewM]

So I had a brain fart and forgot to take my Insulin with dinner last night. My two hours post meal reading made me think I just needed correction. My three hour reading made it abundantly clear I hadn’t take any Insulin with dinner.

What’s the rough guidance on what to do in such a situation? Like I wouldn’t just take a correction dose (as I’ve found when I’ve miscounted my carbs “corrections” don’t correct like they would normally).

I took my full dose at hour 3 (minus the “correction” added at hour 2) but I found, perhaps unsurprisingly that the dose taken at that point was far too effective (with limited amounts of digestion still going on). Causing one mild hypo before bed and one hypo in the middle of the night.

Which suggests I should’ve taken a reduced dose, but reduced by how much?

 

[Ushthetaff]

Well as with everything with diabetes it’s difficult to say what would suit you as it’s so individual to the individual! However having done the same myself I tend not to take a reduced dose , I just take what I th8nk I would have taken and deal with the consequences , it means a tad more testing but I find it normally settles down given time an I can always treat a low quite easily , I think the secret is not to let it happen too often ,

 

[In Response]

For me, it would depend how long after eating that I remember.
If it is within a couple of hours, I would give myself the same dose as I would with/before the meal.
If it is more like 3 or 4 hours, I would correct the high.

In both cases, I would bear in mind that as my blood sugars get high (over about 12mmol/l for me) I become insulin resistant and may need more insulin than usual to correct.

As @Ushthetaff says, I would try to avoid this happening very often - understand why I forgot this time and maybe tweak my meal time regime so injecting is a major part of it or get my partner/family to remind me.

 

[sgm14]

I suspect this is probably something only you can tell based on your own experience.

I have found the opposite, in that I need more insulin to bring me down from a high than I would normally. Hence I tend to take an extra unit if that happens and also go for a long walk.

 

[StewM]

Well as with everything with diabetes it’s difficult to say what would suit you as it’s so individual to the individual! However having done the same myself I tend not to take a reduced dose , I just take what I th8nk I would have taken and deal with the consequences , it means a tad more testing but I find it normally settles down given time an I can always treat a low quite easily , I think the secret is not to let it happen too often ,

Yeah I mean avoiding it is obviously the best practice Let’s just underline that

Just it’s always useful to have “in your tool kit” what to do when something out of the ordinary does happen. Like it’s not so much I want to know so I can do it more, just want to handle it as well as possible if it ever does happen again.

 

[Ushthetaff]

Yeah I mean avoiding it is obviously the best practice Let’s just underline that

Just it’s always useful to have “in your tool kit” what to do when something out of the ordinary does happen. Like it’s not so much I want to know so I can do it more, just want to handle it as well as possible if it ever does happen again.

I need to stress I’m not trying to “ tell you off “ god knows I’m the last person to try and do that , suppose the best part of your tool kit in situations like that is definitely your blood testing kit, of course different meals and a miss3d injection result in different results, I know if I eat pasta I would take my injection 2 hours after , I can’t remember how many times I’ve missed an injection and I’ve had diabetes over 40 years .

 

[StewM]

I need to stress I’m not trying to “ tell you off “ god knows I’m the last person to try and do that , suppose the best part of your tool kit in situations like that is definitely your blood testing kit, of course different meals and a miss3d injection result in different results, I know if I eat pasta I would take my injection 2 hours after , I can’t remember how many times I’ve missed an injection and I’ve had diabetes over 40 years .

Didn't read that way, so don't worry

Yeah, all I meant was I'm not planning to do this, again. All things being equal it won't happen again. But, in the unlikely event, it does... that's where the information would be useful. Just to put everyone in the thread at ease.

*edited for additional clarity

 

[NicoleC1971]

Yeah, I just wanted to make clear I'm not planning to do this, again. All things being equal it won't happen again. But, in the unlikely event, it does... that's where the information would be useful. Just to put everyone in the thread at ease.

I do it all the time so no point in beating yourself up about it. If it happens again then consider the meal content e.g. if high fat /carb (e.g. pizza) you could split the usual dose in 2 to catch the slow rise. If high carb I'd put the whole dose in and not check my bg again (unless hypo) until I went to bed to avoid 'stacking' the doses and thus going hypo. The insulin peters out at 4 hours so if you aren't back in range by then you can consider another bolus. That of course is the theory but I do think the balance of your meal makes a difference.
Plan B for a high carb meal could be to take the dose then take a walk to blunt the spike and get the glucose being used up (this won't work on no insulin btw).

 

[searley]

i do this from time to time.. and ive often struggled with deciding what to take.. because the calculations often don't match.. ie if i had dosed with the meal then id need 10units, but a correction dose in theory would only want about 3 or 4 units

so i often work somewhere between the 2.. erring on the cautious side knowing i can take a little more later if needed..

but the exact amount can change based on what was eaten at the time, pizza or fatty foods i need more insulin..

i think if you were to do it 'by the book' you do a standard correction... then at your next meal, if still needed you correct with that.

IF you take more than a standard correction, then make sure you keep an eye on you BG afterwards to make sure you have not over done it.. as very little can make a big difference

Ive never asked my care team what to do in this situation... i may actually ask them next time i talk to them.. see what the official line is