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How Insulin Action Impacts Blood Glucose

in a Conventional Insulin program (using intermediate-acting insulin, N/NPH)

(Three injections of: rapid-acting insulin plus N or NPH)

Before Reading This Article...
Before making any changes to insulin doses, it is important to understand the action of insulin (the onset, peak and duration of different types of insulin). Therefore, as background for the information that follows, we recommend you first review Insulin Types & Action.

Insulin is one of several factors that contributes to a given blood glucose reading at a certain moment in time. How insulin impacts blood glucose depends on the insulin action pattern of one of the three commonly used insulin programs:

1.  Conventional Insulin program

2.  Basal/Bolus program with Multiple Daily Injections

3.  Insulin Pump Program


Remember, in the following text:

“intermediate-acting” insulin refers to N or NPH;
“rapid-acting” insulin refers to Humalog®, NovoRapid®, or Apidra®/em>

Conventional Insulin program

(using intermediate-acting insulin)

(Three injections of: rapid-acting insulin plus N or NPH)

 
The insulin action diagram for a conventional insulin program (above) shows that the blood glucose at a given time is affected by a certain previous insulin dose (follow the curve back) as follows:


Blood glucose before breakfast tells you about Bedtime N or NPH
Blood glucose before lunch tells you about Morning rapid-acting
Blood glucose before supper tells you about Morning N or NPH
Blood glucose at bedtime tells you about Supper rapid-acting
 

For example, if the breakfast blood glucose is consistently out-of-range (high or low), you may want to change the bedtime N/NPH; if the bedtime blood glucose is consistently out-of-range (high or low) you may want to change the dose of supper rapid-acting insulin.

Next Steps on how to make adjustments to insulin doses within a Conventional Insulin program (N/NPH):
Conventional-Pattern Adjustment

References:

The above information was adapted with permission from The Alberta Children’s Hospital Diabetes Clinic information handouts.

The above information was reviewed for content accuracy by clinical staff of the Alberta Children’s Hospital Diabetes Clinic.

This material has been developed from sources that we believe are accurate, however, as the field of medicine (in particular as it applies to diabetes) is rapidly evolving, the information should not be relied upon, as it is designed for informational purposes only. It should not be used in place of medical advice, instruction and/or treatment. If you have specific questions, please consult your doctor or appropriate health care professional.

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