Insulin before or after a meal.....this gets fusterating!

OK, this is one subject that i'm totally confused about. Now my doctor refuses to let me give my daughter her insulin AFTER she eats. He says the Healthy way is to give the insulin first and then have her eat. Well i understand this way, BUT when i have to sit there and BEG her to eat all her food then something is wrong. It would be one thing if this happened once or even twice, but i seriously sit at every meal and have to beg her to please eat all  her food. Lots of times she can't because she is full and i feel horrible because it seems like i'm having to force feed her and that's not fair to her!!  I personally don't see why she can not eat and then i give her the amount of insulin to cover the carbs she has taken in. Of course the Nutritionist said that you can do it that way, but that's not the healthy way....At this point its really not about "the healthy way" it should be more about what way is correct for my daughter. Now what is the difference of doing this for a 6yr old when this IS the way it is done for infants.  I have asked 3x's if i could just try giving her the insulin after her meal but the doctor insist on her having it before she eats..... So, does anyone else have this issue or are you having troubles getting your kid(s) to eat once you have given them their insulin?....this is just very fusterating!!!

We give before and yeah we have had what I call food fights. I just get her to eat as close to what she needs to as I can. Right now I honestly dont see what it matters for us. We are not giving and novolog in the mornings just the nph and at night the ratio for nph is low for the carbs she is eating. Tho she does get her nph again then.

Physicians don't live in your shoes nor do they deal with the gray areas that complicate life. While insulin before you eat would allow the insulin to counteract the rise in BG at the most efficient level, the question is whether it is worth the risk if something goes wrong.

For example, what happens if I take insulin, go to Chili's, but wait...they're packed and we have to wait 30 minutes before we're seated. Well then, we have a problem. Especially with quick acting insulin like Novalog, this can be a real problem.

In the end, you are the one physically giving the insulin, right? Not the physician. So you have to make a decision that you feel is the best for your situation with their advice in mind.

I bolus AFTER meals ALL the time.  It doesn't really change my post meal blood sugars.  Even if I forget and bolus an hour after I eat, my blood sugar is right where it is supposed to be 2 hours after the bolus.  Really, what's the difference, 30 minutes?  I would be concerned about the power struggles and the research that shows that power struggles around food can contribute to eating disorders.  You can always try it and see what happens.  Probably, the worst thing that will happen is that she'll be a little high when she tests 2 hours after meals.  AND testing again another 30 minutes later will probably show that her blood sugar is right where it should be. 

Let us know what you decide to do.

One more thought, the little girl we have at school compensates for missing carbs with milk. Would she be willing to drink milk or juice in place of the food she doesn't want to eat?

i dont have any first hand experience with this, but i have heard of parents giving a minimum amount of insulin prior to the meal, then giving the rest after the meal, if the child ate more than the minimum. However, this would require two shots - which obviously isn't a perfect solution for children.

as far as giving after the meal and testing two hours later - from what i have known... your blood sugar should be under 180, 2 hours after the START of eating (of course this would be in a PERFECT world... haha), therefore it's best to give insulin prior to eating, sometimes even as much as a half hour before eating depending on what food is being consumed

however, as someone said above, the doctor doesn't live in your shoes and everyone is different as far as what works best for them. I would just continue what works best for you.

good luck :)

I have ALWAYS given Brandan his insulin AFTER he eats. I never know how much he's going to eat and in my experience the more I try to force him the less likely he is to eat because it turns into a fit. The only exception is when his sugar is super high. I give him his correction dose before he eats and cover the carbs after. For an accurate reading I just wait 2 hours after he's done eating. This is one reason I'm looking forward to getting his pump.

I also personally almost always do my insulin during or after I eat.. unless i know exactly what i am going to eat theres no way im doing it before.. nothings worse than doing it before then you dont eat what you thought u were going to & have to force food... of course i understand u should eat when the insulin is peaking but Its not like my blood sugar goes super high as long as i do the humulog around the time i eat.

I dont kno if someone already suggested this but maybe give her a few units before so theres short acting insulin in her working then give her the res when she finishes eating

Give it after - you have to balance what is right for your daughter and your family with what the ideal situation is. We gave my son his insulin after when he was on shots and his BGs were usually fine when we would check 2-3 hours later. (And unless you are living with the dr, which I assume you are not, because then you could make him feed your daughter and struggle with how is he really going to know the difference?)

When we were in the hospital our doctor said that after is not ideal, but that she strongly feels that giving kids psychological issues with food and eating at young age by either force feeding or withholding food is worse in the long term. She suggested that we set a time limit on meals like 30 mins. After that time, carb foods could be removed and the insulin given and if our son was still hungry, he could eat 'free foods'. We didn't really follow this, but usually he was done eating in 30 min anyway.

When we switched to the pump 3 weeks ago, we started giving about half the dose at the beginning and the remainder after. This is working fine because it is just button pushing on the pump, but I know my son would not have been up for 2 shots if we had tried split doses on shots.

Everyone is right about doing what is best for you.  Yes you are supposed to do it BEFORE a meal.  I am a perfect reason why, my blood sugars spike (300s) after all my meals and will stay up until at least 3 hours after the meal.  If I gave myself the insulin before, they wouldn't do this but I do not want to give myself insulin for 60g of carbs and I only eat 45.  That other 15 has to come in somewhere.  I don't know about drinking it though.  You could try that, but my body reacts differently to liquid carbs than they do to solid carbs.  I know it has to do with how much your body has to break down.  So keep that in mind.  You need to figure out what works best for you and your daughter.  The doctor's should understand and if they don't, you need to have a serious discussion about that.  I think half of an endo's job is psychological support!  Good Luck!

when I was first dx'd and in the hospitial I was taught to give it AFTER. Now, since then all of the endos I've talked to tell me to give it before but I refuse. If I was taught to do it before in the beginning then it might be different. But the way I look at it; I don't always know how much I'm going to eat, if I give it before I might not eat at much as I bolused for and I could go low. I'm going to continue to give it after

Everyone's body reacts differently. I bolus after eating when I'm low, but otherwise I spike higher unless I give it before. Why don't you do a little experiment? Try it after meals for a week and compare post-meal numbers to the previous week when you did it before meals... Were there fewer mealtimes struggles? Were the post-meals numbers not much higher?

When my son's pediatrician recommends something I think will NEVER work in our home, I always tell her, "OK, you can come over to our house everyday and implement that yourself!" LOL.

We dose befor the meal, and if he doesnt want to finish what he said he would eat he has to drink juice  to make up the difference.  The other benefit is we prepare the insullin befor saying Grace- my son likes the idea that his shot is blessed.   

The reason they suggest that you give it prior to the meal is that it will reduce her post-meal blood sugars significantly. It sounds risky and annoying to give it all prior to eating in your situation though - so what I would suggest is giving half of the insulin prior to the meal, and then give whatever else is needed based on what she eats when she's done eating. Hope that helps,


Our daughter is 19 months old and was diagnosed at 16 months old so we are in our 3rd month of Type 1 and I have been told to do before then I was told to do after ....confusing but in talking with some people who live with diabetes I have beed=n told that it can depend on wht you are feeding ...complex or simple carbs as to wether you can have a major high or low....we try all differnt things and Type 1 is not an exact science and is soooo different for everyone.YOU are mom and YOU know your what is best for her and you...... God BLess

I dose before I eat.

I usually take my insulin before I eat unless I'm really low and then I will take it after.

i do before

We were just told today we can give it to her the second she is done if we are unsure if she will finish or not. Which will come in handy with a few meals but for the most part try and give it to her before.

I bolus before I eat unless I am on call, but since I work as an EMT, sometimes I have to leave in the middle of a meal - and I really don't want to go low while I'm trying to take vitals! So when I'm on call, I try to bolus after I finish. A lot of times, I forget, though.