We would like to thank Pinsker et al. (1) for their thoughtful letter addressing the American Diabetes Association’s article about glycemic treatment in the Standards of Medical Care in Diabetes—2015 (2). The Professional Practice Committee (PPC) agrees that postprandial glucose excursions can be better controlled by adjusting the timing of prandial (bolus) insulin dosing relative to meals. The optimal timing of prandial insulin dosing depends on the type of insulin used (regular, rapid-acting analog, or inhaled), the preprandial blood glucose level, the type of food and the carbohydrate content of the food to be consumed, and any uncertainty about when the food will be available.
Given the concerns of Pinsker et al. (1) and the importance of the timing of prandial insulin dosing for glycemic outcomes, the PPC will describe the factors that should be considered when individualizing the timing of prandial insulin dosing in the Standards of Medical Care in Diabetes—2016.
Article Information
Duality of Interest. No potential conflicts of interest relevant to this article were reported.
