Thank you!

As a 31 year veteran, I try to teach naysayer diabetics this technique - to take smaller amounts of insuln at a time. Some listen but many give me "what proof do you have." Maybe this will help!

Yes Yes Yes...I am on the pump and I KNOW that "broken up" doses help tremendously. Just yesterday at lunch I took a small dose, waited about five minutes took a littler larger blous, then "finished off" my mealtime bolus with yet another small bolus at the end of my meal. I have found that particularily with a fat laden meal (such as I had at lunch yesterday) that this method helps a lot. But even for "regular" boluses..this always help me to get my insulin to "work better"..but Scott is right, do what works best for you and if this just one of many "tools" to deploy, then go for it. Any good result is worth the extra "effort" involved.

This is good information and if you are on the pump it can be done easily but if you inject with a needle device you become a pin cushion. I do like the idea of a sprinkler needle. Any one thinking of coming out with such a device?....Jim

Scott,great article. As a retired BioScientist and a practicing Type 1 with 40 years of experience(20+ on MDI),I always injected small amounts of insulin believing that it was a better way to increase the absorption. I also injected the split doses of insulin in the left side and the right side of my body believing that the distribution of insulin through my entire body would be faster. My A1C test results were always in the 5 to 6% range.

Since last June I have been using a pump and I started splitting my meal insulin doses and bolusing before and after eating.
My first A1C after 4 months on the pump was 5.6%

This type of information is awesome. Its another trick to add the diabetes regimen. Something MacGyver might use if he had diabetes...love it. Diabetes is a major pain but the more things I learn the easier it is to treat, sort of a cat and mouse dynamic. Keep these articles coming.

is this the reason why Lantus is a 24 hour insulin?
if i will divide it to 2 shots will it be a 12 hour insulin but twice as effective?

When I was doing MDI using Levemir and Novolog, I split the Levemir dose 1/2 in AM and 1/2 in PM in addition to using small multiple doses of Novolg for meals and corrections. It was experimentation and trial and error that got me to where I had good control for a "manual Pancreas."

Lantus does not last 24 hours in me, but can in others. I divide my dose in half, and take it twice a day instead of once—about every 12 hours. It's true that this smaller does won't last as long as the larger, but it is not as dramatic as what anonymous above asks. Each smaller shot shot lasts maybe 18 hours, so there is plenty of overlap, so I am never "out" of basil insulin.

Thanks, this is a really interesting article.

Scott -

I'd be interested in how this works in an infusion (i.e. pump) scenario. My Medtronic lets me take a bolus "immediately" or over a period of time, in 30 minute increments. The former is like "pushing the plunger," but the latter seems too long to wait if I am having a high. Do you know if pump manufacturers have studied this issue, i.e. in terms of timing those immediate boluses for optimum absorption? Seems like a five-minute duration for a single dose might give more effective distribution than a "plunger bubble."

what i have done with high blood sugars is give myself a shot in my muscle and then try to work that muscle to get the insulin to absorb faster. For example, the other day my sugar was at 300, and 1u of Humalog lowers me about 125 pts, so i took a 1.5u into my arm muscle, and while i was driving to a customer on the highway, i exercised my arm and my sugar was down to 150 in about 30 minutes...

Another worthwhile coverage might be the fact that U-100 is significantly slower than U-40 insulin was, and in fact, U-40 was about the same speed as today's analogues are ... making one wonder whether today's "advances" are really just a scam to bilk today's consumers out of our money!