Eating Out

[hedge]

Hi, I'm curious to know what you guys do about eating out. My partner has to eat 30 mins after having his shot of insulin so obviously this is going to prove very difficult when we want to go out to a restaurant.
How important is it to eat 30 mins after his jab? Will it make much of a difference if he eats a bit later?

[Cyborg]

That's going to be tough if he's already low or borderline low. Even if he's not, 30 minutes is a long time. Can he take his insulin with him? Either in pen form or in a small cooler of some sort?

I would never take my insulin before leaving the house for a restuarant. Never telling what kind of delay could pop up.

[JediSkipdogg]

It is very important and depending on what insulin he's on it may be less time. Humalog and Novolog both start working in about 15 minutes after they are given. If you don't start eating by that time, then the insulin will work faster than the food. This will then cause you to have a low before the food kicks in and you could misdiagnose the low and correct it and then rebound to an extreme high. Not to mention the fact that you had the low and have all the complications that come with that. Therefore it is very important to eat right after giving a shot.

[DeusXM]

It sounds like your partner is on Mixtard. Leaving aside the fact that he'll definitely want to look into multiple daily injections if he wants flexibility and control, his best bet for injecting in a restaurant is to do it when the food arrives.

Unfortunately it can be all too easy for a restaurant to take forever to bring your food, and if you've just injected a load of insulin and have nothing to eat reasonably soon, you'll be in a lot of trouble with low blood sugar.

The reason there is a 30 minute waiting period is because Mixtard takes quite a while to get working. The idea behind the wait is that after 30 minutes, the insulin will start working on the blood sugar and deal with the raise in BG from the meal. If your partner waits until his meal arrives before injecting, what will happen is that his BG will initially raise reasonably high but soon come back down under control. This is far, far preferable to him injecting and then potentially having to wait more than 30 minutes.

Is your partner newly diagnosed? I ask because the insulin regime he's on is one they usually put the newly dxed on because it's fewer injections a day. Most of us are either on insulin pumps or a system called MDI (Multiple Daily Injections). MDI typically requires an injection every time you eat, which means you have much more flexibility. Also, the insulin you inject before eating is much quicker acting than Mixtard - typically, the pre-meal insulin (called bolus insulin) works after about 5 minutes of injection, removing the initial spike in BG from eating.

If you're new to this then I recommend sticking with Mixtard purely because diabetes takes a while to get used to and MDI requires a lot of work and experience to be successful. But certainly get your partner to bear it in mind for 6 months down the line or so.

Incidentally, your partner will probably find he needs to inject more insulin than normal if he's eating at a restaurant.

[seacomp]

Will it make much of a difference if he eats a bit later?
The advice you've gotten here already is all good. I'd just emphasize that it can make a big difference if "a bit later" turns out to be a lot later because of some delay in the food being served.
You don't want your SO going low in a public place.
My own practice, is only to inject after food is ordered and only if there's bread or something on the table, otherwise wait till the food arrives.
If the food's late, start eating the bread. He'll go high, but better than going low.

[Tiggy26]

I always tend to inject just before I begin to eat - that way I know that I dont really risk dipping low while I eat, because the food will begin to work before/at the same time as the insulin does.

If my BG is below 5mmol, I tend to eat first then inject after I've eaten - that fixes any hypo probs too...

But, as I'm sure everyone always says - bodies act differently so things that work for me may not necessarily work for others!!

[HelenM]

I think that you said that your partner was on Novorapid (otherwise checkout what Deus says) If I'm right ( its not afterbut within30 mins of injecting, thats easier to cope with. Its best in that case to inject immediately before eating.
When I go to a restaurant I order and then wait a little until bread is on the table then either go to the ladies to check my glucose level and inject or if I can do it discreetly just do it at the table.
As the others have said what you mustn't do is take it and then wait too long, a couple of times when I've thought dinner was ready but something has delayed it I've ended up having a hypo whilst eating which is not very pleasant.

[hedge]

He's on novorapid before each meal, so that's 3 times a day as well as his lantus every morning.
I'm confused ( now there's a first!!:ahhhhh: ) should he be eating straight after his jab or waiting 30 mins or not?

[psilocybin]

it depends on what he is eating...high fat or protein mealsi would wait a bit to take the jab...otherwise i take my jab direcectly after the meal...its all about learning about which foods does what to your blood sugar

[seacomp]

He's on novorapid before each meal, so that's 3 times a day as well as his lantus every morning.
I'm confused ( now there's a first!!:ahhhhh: ) should he be eating straight after his jab or waiting 30 mins or not?
I just looked up Novorapid - it's of the new very rapid acting types of insulin. It goes into effect in under 15 minutes. So the answer to your "or" is neither.:ahhhhh:
I use Humalog which is the same type of insulin, and I generally inject 5 to 10 minutes before a meal but that's when I can control the situation. The advise for eating out still holds.
(and being confused goes with the territory.:smile: )

[psilocybin]

uhm seacomp it depends on your body..i have to inject 10 mins after meals or i go low....and trust me i have tested ur theory and i do go low all the time......

[seacomp]

uhm seacomp it depends on your body..i have to inject 10 mins after meals or i go low....and trust me i have tested ur theory and i do go low all the time......
Well Psil, the point is that the insulin is a rapid acting insulin NOT a regular (old fashioned) insulin that had a 30 minutes onset.

[psilocybin]

well im just raising a point...going low right after a meal is rough because u have to correct and than some time after that your sugars go through the roof....basically when taking rapid just take it whenever is best for you it dont matter if it works best for you 10 mins befor meal or 10 mins after meal....it will not hurt u unless you go low like me(why i take it 10 mins sometimes longer after a meal)

[DeusXM]

At the risk of treading on people's toes here - given the recency of this person's diagnosis and the guidelines provided for when he should take insulin, I'd say he is not on a Lantus and Novorapid regime but on a Mixtard regime. Mixtard is totally different to the Lantus/Novorapid regime and as such all advice on action profiles based on that don't apply to this case.

Secondly, Novorapid isn't 'really new' - it's been around for at least 5 years. However, advice based on when you should take Novorapid does not apply to the taking of Mixtard.

[Cyborg]

well im just raising a point...going low right after a meal is rough because u have to correct and than some time after that your sugars go through the roof....basically when taking rapid just take it whenever is best for you it dont matter if it works best for you 10 mins befor meal or 10 mins after meal....it will not hurt u unless you go low like me(why i take it 10 mins sometimes longer after a meal)

If you test before you eat, then you know how much and WHEN to bolus... ;)

[seacomp]

At the risk of treading on people's toes here - given the recency of this person's diagnosis and the guidelines provided for when he should take insulin, I'd say he is not on a Lantus and Novorapid regime but on a Mixtard regime.
No treading on toes, but there is a contradiction between the 30 minute advice and Hedge's statement about Novorapid.
Something needs to be clarified so this person can take their insulin properly.
Perhaps, "newer" in contrast to traditional regular insulin would have been a better term.

[duck]

He's on novorapid before each meal, so that's 3 times a day as well as his lantus every morning.
I'm confused ( now there's a first!!:ahhhhh: ) should he be eating straight after his jab or waiting 30 mins or not?

With the rapid (less than 30 minutes to kick-in insulins), the rule of thumb is you can eat right away. With the regular (30 minutes before effect) insulins, the rule of thumb was to wait 30 minutes AFTER taking your shot to eat. The idea is to mimic what the healthy body would do--react to food with insulin right away.

Keep in mind that this is an INDIVIDUAL disease, and your partner will need to figure out what works for them. I use only Novolog in my pump, and even though I have it figured out pretty well, depending on circumstances I may wait to bolus until AFTER I have started eating, or I may bolus well in advance of eating.

[Gangrel]

I keep it simple. I'm on Humalog, so that is about 10-15 mins to start. But even in the olden days on other short acting, I would always do my insulin as soon as I ordered my meal. My thinking is if the meal is THAT delayed and i start to go low, then I order some Coke to tide me over.........

Maybe it's just me, but I don't keep it as complicated as some of you sound. I don't change my time based on if I'm eating a high fat vs. low fat meal or anything like that........ Keeps me a lot less stressed and burdened.

[playgtar]

I'm using Novalog fast acting insulin. I don't take a shot until I see my food on the table. I do that because I don't want to have a low. If I shoot up when I enter the restaurant and they screw up my order, well, I'll be eating sweet tarts while waiting.

Could he possibly delay his injection? What type of insulin does he use. I'm sure there's someone here on the same stuff who can tell you.

[DeusXM]

No treading on toes, but there is a contradiction between the 30 minute advice and Hedge's statement about Novorapid.

Yeah, I've just found the bit where it says he's on Lantus and Novorapid. I assumed (given the recency of diagnosis and the advice from the doctor) that they must be on Mixtard. No good doctor would prescribe taking Novorapid half an hour before eating. That's just lethal.

He should only inject when there's food in front of him. And I'd personally say that went for both in restaurants and at home.

[Erin]

Just to clarify for you Hedge,

Old insulins (usually called 'regular' insulin) took 30 minutes to kick in, that is where the advice to wait 30 minutes is coming from.

Fortunately, that is NOT what your OH is on. He is taking Novorapid, correct? With Novorapid (or any other -rapid or -log insulin) you can begin to eat almost instantly after injection.

Some people have more success taking the shot a little before, or a little after they begin to eat, but it really depends on the person. I would start your OH off by having him take it at the same time the meal is served. If you notice him going high or low you might want to adjust the time frame. I also take my insulin a bit early (maybe 30 minutes before a meal) if my blood sugar is high.

But it is perfectly safe (and advisable) to take insulin in a restaurant when the plate hits the table.

The information you are getting from his doctors is not consistent with the tools they are giving you... eek!

[hedge]

Thanks very much Erin ( and everybody ) I feel a bit better now. Gonna try him having his jab and then eating 10 mins after.
Oh...and Erin....that's where the advice and info from the doctors stopped - all the rest we've had to work out for ourselves with the help of you guys.
:flowers:

[Gangrel]

I would try to get an endocronologist if you can. It sounds like your regular doctor is pretty useless!