Comment on American Diabetes Association. Approaches to Glycemic Treatment. Sec. 7. In Standards of Medical Care in Diabetes—2015. Diabetes Care 2015;38(Suppl. 1):S41–S48

One of the difficult challenges for individuals with type 1 diabetes is trying to determine the optimum time to inject a bolus of rapid-acting insulin for meals. Therefore, we were surprised that the updated 2015 American Diabetes Association (ADA) Standards of Medical Care in Diabetes lacks a specific recommendation on this topic (1), especially given the contribution of postprandial hyperglycemia to achieved hemoglobin A1c levels (2). Although several recent publications have concluded that premeal bolusing 15–20 min ahead of time with currently available rapid-acting insulin analogs is advantageous to reducing postprandial hyperglycemia in people with type 1 diabetes without …