Is insulin lispro (Humalog) taken 3 times a day?

From the Guidelines

Insulin lispro (Humalog) is typically taken before meals, which usually means three times a day for most people who eat three main meals daily. This rapid-acting insulin is designed to be injected approximately 15 minutes before eating to help manage blood glucose levels that rise after meals. The exact dosing schedule depends on an individual's specific treatment plan as determined by their healthcare provider. Some patients may need Humalog more or less frequently depending on their meal patterns, blood glucose control needs, and whether they use other insulin types as part of their regimen. For example, someone who eats more than three meals or substantial snacks might require additional doses. Humalog works quickly, with effects beginning within 15-30 minutes, peaking at 30-90 minutes, and lasting for 3-5 hours. This rapid action makes it effective for controlling post-meal glucose spikes but requires careful timing with food intake to prevent hypoglycemia. According to the American Diabetes Association standards of medical care in diabetes 1, dosing adjustments may be necessary in both mealtime and basal insulins, based on blood glucose level and an understanding of the pharmacodynamic profile of each formulation. Further options for treatment intensification include adding a single injection of rapid-acting insulin analogue (lispro, aspart, or glulisine) before the largest meal 1. Key points to consider when prescribing insulin lispro include:

• The importance of individualizing the treatment plan based on the patient's specific needs and response to therapy 1
• The potential benefits of using rapid-acting insulin analogues, such as improved postprandial glucose control and reduced risk of hypoglycemia 1
• The need for ongoing monitoring and adjustment of the treatment plan to achieve optimal glycemic control and minimize adverse effects. In terms of specific dosing recommendations, the American Diabetes Association suggests that insulin lispro can be administered before meals, typically 15 minutes before eating, and that the dose should be adjusted based on the patient's blood glucose levels and response to therapy 1.

From the Research

Insulin Lispro Administration

• Insulin lispro (Humalog) is typically administered immediately before meals, due to its rapid absorption and shorter duration of action 2, 3, 4.
• The frequency of administration can vary depending on the patient's needs and treatment plan, but it is often taken three times a day, before each main meal 2, 5.
• Studies have shown that administering insulin lispro immediately before meals can improve postprandial glucose control and reduce the risk of hypoglycemia 2, 4.
• However, the optimal administration time may vary depending on the patient's individual needs and circumstances, such as meal composition and carbohydrate intake 3, 6.

Dosage and Timing

• The dosage of insulin lispro should be adjusted based on the patient's individual needs and response to treatment 5.
• Administering insulin lispro 15-30 minutes before meals may be beneficial for some patients, particularly those with hyperglycemia 6.
• However, injecting insulin lispro at 30 minutes before the meal may result in loss of glucose control at 4 hours post-meal in some cases 6.

Clinical Studies

• A study published in Clinical Therapeutics found that insulin lispro administered twice daily in combination with NPH human insulin improved postprandial glycemic control without increasing the risk of hypoglycemia 2.
• Another study published in Diabetes Care found that insulin lispro improved postprandial glucose control in patients with diabetes mellitus, without increasing the risk of hypoglycemia 4.
• A study published in Diabetes Care also found that optimizing the evening insulin dose in patients using insulin lispro can improve evening blood glucose control without deteriorating nighttime glucose levels 5.