Novolog

How long before meals are you giving Novolog? I try to give it about 15mins before (right before the patient leaves their room for the dining room if I can), but one of our doctors has this idea that diabetics should be getting their novolog 5 minutes before they eat. Which is A) Impossible with 4+ diabetics and B) puts them all in the dining room which isn't allowed.

So I am wondering when other nurses are giving short acting insulin.

[anh06005, MSN, APRN, NP]

Well if I remember right the onset is about 15 minutes so as long as they are eating by then I'd think it's fine. The DOCTOR said 5 minutes which I'd be fine with too but as you mentioned it's near impossible with several diabetic patients who want to go eat.

I don't think many doctors know what the REALITY is....as in juggling multiple patients and caring for all of them at the same time vs. going room to room, writing your orders and going on your merry way.

Now I will say if someone's blood sugar is lower I'd give them insulin last vs someone who has some wiggle room.

Oh, about 5-15 min. Some of our people are on a Novolog sliding scale at HS and that may be given without a snack if the resident chooses because it's such a low amount relative to the BS reading.

[TheCommuter, BSN, RN]

If the resident has a history of refusing meals and/or tends to be a brittle diabetic whose blood glucose will plummet into the 20s, I'll administer the Novolog as soon as (s)he takes the first bite of food.

Otherwise, I try to administer it 5 to 20 minutes before meals.