What To Do When You Forget to Take Insulin Before Eating

What To Do If You Forgot To Take Insulin Before Eating

Forgetting to take insulin before eating can throw off your blood sugar levels. But with the right response, you can get back on track and avoid complications. Here's a complete guide on what to do if you forgot to take insulin before a meal.

Check Your Current Blood Sugar Level

First, check your current blood glucose level, either with a finger stick or continuous glucose monitor. This will reveal if your blood sugar is already high from missing the pre-meal dose. A reading above 180 mg/dL indicates hyperglycemia.

Take Insulin As Soon As You Remember

Next, inject your prescribed mealtime insulin dose as soon as you realize the mistake. This will help lower your blood sugar, especially if it is elevated. Don't skip or reduce the dose out of fear of hypoglycemia.

Eat as Planned

Go ahead and eat your planned meal shortly after taking the delayed insulin bolus. Having food in your system helps prevent blood sugar from dropping too fast.

Check Blood Sugar Again in 1-2 Hours

Recheck your glucose 1-2 hours after the meal, when the insulin peaks. This helps you gauge if the delayed dose was adequate or needs supplementing.

Have a Small Carb Snack if Blood Sugar is Dropping

If your glucose is below 70 mg/dL or falling quickly, have a small carbohydrate snack, like half a banana or a few glucose tablets. This raises it to prevent hypoglycemia.

Take it Easy on Physical Activity

Avoid strenuous exercise for several hours after the delayed insulin. Activity can accelerate its glucose-lowering action and increase hypoglycemia risk.

Adjust the Next Insulin Dose If Needed

If your blood sugar remains high before the next meal, give an extra dose to compensate. A bit more insulin can help normalize elevated glucose.

Why It's Important to Take Insulin Before Meals

Taking rapid or short-acting insulin before eating is crucial for controlling post-meal blood sugar spikes. Here's why pre-meal insulin matters:

Prevents Blood Sugar From Rising Too High

The insulin starts working to lower blood glucose as soon as the carbohydrates from food are absorbed. This prevents dangerously high post-meal spikes.

Keeps Blood Sugar in Target Range

With the insulin onboard ahead of time, the mealtime glucose rise is contained, keeping levels within a healthy target zone.

Provides Peak Insulin Activity When Needed

Injecting rapid insulin 15-30 minutes before eating means its peak action coincides with the glucose peak from the meal.

Gives Insulin Time to Start Working

Since insulin takes 15 minutes to even start absorbing, taking it after eating means much of the meal is digested before sufficient insulin activity.

Reduces Need for Correction Doses Later

Pre-meal insulin lowers the spike in the first place rather than needing to bring high glucose down after the fact.

Risks of Not Taking Insulin Before Eating

Forgetting pre-meal insulin has both immediate and cumulative dangers for diabetes control and health. Here are some of the top risks:

Post-Meal Blood Sugar Spike

Without insulin onboard ahead of time, blood glucose can soar upward of 200-300 mg/dL after eating carbs.

Need for Corrective Insulin

High post-meal glucose often requires an extra shot of rapid insulin to bring levels down to target range.

Increased Hypoglycemia Risk Later

The corrective insulin dose can end up lowering blood sugar too much, especially when pre-meal insulin kicks in.

Poor Overall Diabetes Control

Missing pre-meal doses regularly results in consistently elevated glucose, indicated by higher HbA1C levels.

Increased Risk of Complications

Over time, poor glucose control raises chances of nerve damage, kidney disease, vision loss, and cardiovascular problems.

Tips to Remember Pre-Meal Insulin

To avoid forgetting insulin doses, implementing reminders and routines can help. Here are some tips to remember pre-meal insulin:

Set Cell Phone Alerts

Program your smartphone to alert you when it's time to take insulin before meals and snacks.

Use Apps Like MySugr

Diabetes logging apps send notifications when you should dose for food or provide reminders if you forget.

Post Visual Reminders

Place signs on your fridge or kitchen cabinets saying to take insulin before eating.

Integrate it Into Your Routine

Make checking glucose and injecting insulin part of getting meals ready so it becomes habit.

Pair it With Another Action

Link it to something else you always do before eating, like washing your hands or grabbing a plate.

Enlist Support People

Have family or roommates help remind you to take insulin if they see you forgetting.

Consider Insulin Pumps or Pens

Pumps eliminate individual injections, while pens make dosing faster and more convenient.

What to Do If Your Blood Sugar is Already High

If you check your glucose after realizing you forgot insulin and it's above 180-200 mg/dL, here are some steps to take:

Take Insulin Immediately

Inject your full prescribed pre-meal dose without delay to start lowering your high blood sugar.

Drink Water

Staying hydrated helps bring elevated glucose levels down and prevents dehydration.

Take a Brief Walk

A short 10-minute walk right after injecting can help accelerate insulin absorption.

Check Again in 1 Hour

Test your blood sugar after an hour to see if the insulin is taking effect or if more is needed.

Give Correction Dose if Still High

If still above 180 mg/dL after an hour, take a correction dose using an insulin sensitivity factor.

Recheck Every 2 Hours

Continue to monitor blood glucose every 2 hours until numbers are back in normal range.

Getting Back on Track with Missed Doses

When pre-meal insulin is missed, you can take steps to get your blood sugar controlled again. Here are some tips:

Stick to Your Meal Plan

Follow your regular carb meal plan to prevent further spikes. Don't restrict carbs too much.

Increase Monitoring

Check glucose more frequently until stable, every 1-2 hours including overnight.

Adjust the Next Dose If Needed

Give slightly more insulin for the next meal if glucose is still running high before eating.

Do Post-Meal Checks

Monitor blood sugar 1-2 hours after eating to see if doses need fine-tuning.

Make Dietary Adjustments

Lower carb counts slightly or substitute lower glycemic index choices until back on track.

Stay Hydrated

Drink plenty of water and avoid dehydrating beverages like alcohol until levels normalize.

Preventing Low Blood Sugar After Delayed Insulin

Hypoglycemia is also a risk if you take insulin late after a spike. Here's how to prevent it:

Always Have a Carb Source Available

Carry quick-acting glucose tabs or gels to treat any lows that occur.

Check Glucose Frequently

Test blood sugar every hour at first to catch any dropping numbers quickly.

Adjust Insulin at Subsequent Meals

Reduce doses slightly if hypoglycemia occurred and glucose is still dropping.

Eat Extra Carbs If Exercising

Consume some extra carbohydrates before and during physical activity when insulin is peaking.

Suspend Insulin Pumps if Needed

Those on pumps can suspend delivery for up to 2 hours to minimize hypoglycemia risk.

Avoid Alcohol

Consuming alcohol can impair hypoglycemia awareness and exacerbate glucose drops from delayed insulin.

Troubleshooting Challenging Scenarios

Certain situations make it harder to safely manage a forgotten insulin dose. Here's how to respond:

High-Carb Meal

For high-carb meals, split the full dose across two injections taken 30 minutes apart to prevent intense spikes.

Moderate Physical Activity

Have a carb snack before mild exercise and check glucose frequently when insulin peaks.

Consuming Alcohol

Take insulin after (not before) drinking alcohol and eat carbs while drinking to maintain glucose levels.

Driving

Pull over and treat low blood sugar if driving when hypoglycemia occurs.

Overnight

Set multiple overnight alarms to wake up and check glucose every 2-3 hours through peak insulin activity.

Using Medical Devices for Missed Insulin Help

Insulin pumps, CGMs and smart insulin pens can all provide assistance and data when dealing with forgotten doses. Their benefits include:

Tracking Doses Taken

Devices record dose details so you can see if boluses were missed.

Updating Dose Recommendations

Some provide adjusted dose advice based on your glucose responses and needs.

Delivering Automated Corrections

Certain pumps and smart pens can give correction doses automatically when pre-meal doses are missed.

Monitoring Glucose Continuously

CGMs show real-time glucose 24/7 to reveal rising and falling levels.

Sending Alerts for Missed Doses

Apps and smart devices can send dose reminder alerts so fewer doses are forgotten.

Why It's Critical to Have a Game Plan

Knowing exactly what to do when you've forgotten to take insulin before eating is essential for maintaining safety and health. Having a clear game plan allows you to respond effectively rather than panicking. Be prepared with the following:

Rapid-Acting Insulin Available

Always carry a rapid insulin like Humalog or Novolog for taking missed pre-meal doses.

Glucose Testing Supplies

Have your glucose meter and test strips to check levels frequently.

Extra Test Strips

Carry extra test strips for increased testing needs after missed doses.

Fast-Acting Carb Sources

Have glucose tabs, candy or juice boxes on hand to treat potential lows.

Glucagon Kit

Make sure you have a glucagon emergency injection kit available in case of severe hypoglycemia.

Medical ID

Wear a medical ID indicating you have diabetes and take insulin.

Support Person Informed

Ensure a family member or friend knows what to do and assist if needed.

The Importance of Learning From Mistakes

When you forget to take insulin before eating, use it as a learning opportunity for better management. Reflect on what led to the lapse and how to prevent it going forward.

Discuss the experience with your healthcare provider at your next visit. They can help adjust your treatment plan if forgetting doses is becoming a pattern.

While missing pre-meal insulin poses risks in the moment, it does not have to mean losing control altogether. With the right game plan, supplies and education, you can get your blood sugar back on track and work to prevent future missed doses.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.