I have a quick insulin scenario that I need help understanding. I am a student nurse currently working my gero rotation. I had a patient who is Type 1 diabetic with severe depression. Lunch is served at 12pm and i tested her BS at 11:15am. BS was 555 (normal for her). The sliding scale for BS > 450 = 6 units. The staff nurse advised me (and my instructor) to administer only 3 units of insulin AFTER lunch because the patient has a poor appetite (due to depression).
This doesn't make sense me. I understand the rationale of administering only half the dose (wouldn't want BS to drop too low if giving 6 units since pt eats little); however, I don't understand why you wait to give insulin after lunch if the BS is already high. Wouldn't it make more sense to give before the meal?
Can someone who is proficient with insulin please explain? I'm so confused.