The use of lispro for high sugar content snacks between meals in intensive insulin regimens

Prospective audit of conversion from regular to lispro insulin during routine clinical care

“…Suggestions were given regarding optimization of the basal insulin regimen and patients were encouraged to consider two or more injections of neutral protamine Hagedorn (NPH) insulin per day. Patients were also encouraged to take extra lispro to cover large snacks and for the self‐management of unexpected episodes of hyperglycaemia 5 …”

“…Patients were also encouraged to take extra lispro to cover large snacks and for the self-management of unexpected episodes of hyperglycaemia. 5 Written patient consent for participation in this prospective audit was obtained at the time of conversion to lispro. Baseline demographic and clinical data included HbA 1c , body mass index (BMI) and details of the patient's insulin schedule.…”

Experience with Insulin Analogues in Children

“…Increasing the pre-breakfast NPH insulin or the pre-lunch mealtime insulin to deal with an afternoon snack is not a solution, as this might well cause hypoglycaemia before lunch or in the early afternoon. A dose of a rapid-acting analogue, given just before the snack, will cover the associated glucose peak and bring the pre-dinner glucose level back to target, with less risk of a carry-over effect [33]. …”