Registered Nurses' Association of Ontario

Starting a Client on Insulin? The Answers to Frequently Asked Questions

1) What are carbohydrates?

Carbohydrates are the body’s major source of energy. Dietary sources of carbohydrates are sugars (fruit, some vegetables, milk, added sugars) and  starches (breads, grains, cereals). Carbohydrates  raise blood glucose levels after  meals.


2) Can I still eat sugar?

It is important to clarify what the word sugar means to the client. “Sweet” foods and drinks like regular pop, juice, candy, cakes, etc., should be limited until  a registered dietitian can be consulted.


3) Should I eat differently now that I am on insulin?

It is important that the client consult a registered dietitian as soon as possible to assess individual nutrition needs, but until that time there are a few things the client can do to ensure healthy blood glucose levels are maintained:

• Eat meals at regular times, no more than 6 hours apart. Three meals a day is usually recommended. Snacks are sometimes included depending on the individual’s activity level and needs.

• Include carbohydrate-containing foods  in each  meal.

• Choose lower fat foods and  high fibre foods  more often.

4) Do I need to have a bedtime snack now that I am on insulin?

The need for a bedtime snack is individual and  is dependent on:

• the type of insulin,

• timing and  quantity of meals,

• activity  level,

• time  of sleep, and

• blood glucose level.

Consult a diabetes educator to determine individual needs. The client should have   a bedtime snack if at risk for low blood glucose during the night. However, adjusting the insulin dose may be preferable for preventing nocturnal hypoglycemia rather than eating

additional food for some individuals.


5) Can I still drink alcohol?

When the liver is processing alcohol it is not able to provide glucose to the blood when needed. Make sure that blood glucose is tested often. Remember that hypoglycemia can happen many hours after drinking and increases the risk of severe  hypoglycemia.


Here are some guidelines to follow to prevent hypoglycemia when drinking alcoholic beverages:

•  Moderation: limit to 1-2 drinks a day.

•  Never drink on an empty stomach. Eat carbohydrate-containing foods  when drinking.

•  Never omit  food to substitute for extra alcohol calories.

•  Avoid liqueurs and  mixes.

•  Try to eat meals and  snacks at regular times.

•  Wear Medical identification and  drink with friends who are aware of your  risk for hypoglycemia and  what  to do if hypoglycemia occurs.

•  Have a source of quick  sugar on hand to treat hypoglycemia immediately.


6) Can I still sleep in?

A delay of approximately 1 hour should not be a problem in the morning routine. Generally, taking insulin within 1 hour of the usual time should not pose too much difficulty. It is best to eat or drink a carbohydrate-containing breakfast and have the scheduled medications within 1 hour of the individual’s regular routine. The person may then return to bed.

Chronic Disease
Subcutaneous Administration of Insulin in Adults with Type 2 Diabetes
Client and Family Education