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georgina n
what does an insulin's 'peak' mean? is that when blood sugar is likely to be lowest or highest?

john e russo md facm faafp
There are both non-analog and analog insulins. There are both basal and bolus insulins. After a single injection of insulin there is a time to onset of action - a time to the blood level of the insulin is reached - and a total duration of action. Non-analog basal insulins had a peak and a less than 24 hour duration of action. Analog basal insulins have virtually no peak and an approximately 24 hour duration of action. Bolus insulins are injected prior to a meal. The non-analog regular insulin has a very delayed onset of action - an unpredictable peak level - and a variable duration of action. Analog bolus insulins have a very rapid onset of action and a peak at about 2 hours with an approximately 4 hour duration of action. Only analog insulins are appropriate for use today. There is not a precise correlation between the peak blood level of insulin and the glucose level as the decline in glucose associated with peak insulin effect is somewhat delayed meaning that it takes time for the the insulin to work. Your question is more applicable to bolus insulin than basal insulin as analog basal insulin has no real peak. In general when insulin exerts its peak effect glucose will tend to be at its lowest level in response to this insulin although as noted above bolus insulin has a limited duration of action. If I may be of further assistance please let me know. I wish you the very best of health and in all things may God bless.

Your first responder had a good answer - except the insulin's peak has nothing to do with how much sugar has been taken out of the bloodstream. Just like most any other medicine, it works slowly at first until it's working full strength (which is it's peak) then it starts to work less well again.

It means when the insulin is having its strongest effect. When this occurs will be dependent on what type of insulin it is.

Your blood sugar should be neither highest or lowest, but within the target range – assuming you're doing it right that is.

think of it like a car building up speed until it reaches it's highest mph and then gradually slowing down. when an insulin peaks, it would have the biggest impact on your blood sugar and could potentially cause a low blood sugar if you didn't eat enough or had some extra activity. it would not necessarily cause a low blood sugar. different insulin peak at different times and last for various amounts of times. people on tn insulin pump, don't really have peaks, but can have overlaps if they don't use the bolus wizard.

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