WHY The Pre-Bolus Might Be Your WORST Enemy

[@lauraburgess1534]

That's when I start talking to the Dexcom, saying "yeah, yeah, I know, shut up." 😆

[@lnnormand9341]

I'm in 51 yrs of t1d. Wish i met you when I was in my 20's.

[@FTFWARRIOR]

I'm glad to meet a Warrior like you too! Keep up the fight! I'm always here if you need any help and guidance.

[@lavellvelez2157]

What do you recommend for a person with gastroparesis? My digestion is slower.

[@jethrotull5847]

I watch the trend graph curve to aid in estimating if my pre bolus needs correction. Unfortunately I’m a T2 with a pancreas that sometimes decides to contribute insulin. This makes it necessary to always estimate pre bolus loads very conservatively, so when the “trend” curve starts going up again I bolus in 1 hour based on the aggression of historical rise time with respect to my current BG level. Again conservative application prevents lows. Complicated but CGMs are a true miracle of science.

[@lucieni]

T1 is such a nuanced condition it’s actually ridiculous! It’s like having a baby to look after. Oh wait...

[@FTFWARRIOR]

hahaha so true!

[@CindyGee]

A type 3c might struggle with prebolus due to the need for the digestive enzyme equation. I've read where Fiasp is useful because even after eating, you have about 20 min in which to inject.

[@dvdv7777]

Pre-bolusing needs some skill, yes, but it is invaluable overall. I do a 15 minute pre-bolus. Typically, postprandial BG is

[@FTFWARRIOR]

I agree, pre-bolusing before having your food at a restaurant is risky haha

[@johnb4183]

Pre-bolusing is a both a science and an art in addition to experience with the insulin and the the effect YOU have with the food your eating

[@sarahlynch2324]

I have a question, if you're low like 59 would you pre-bolus to avoid a spike? Or would you treat your low, prepare your meal and then eat? This is my current situation.. I ate dinner but didn't pre-bolus. Ugh diabetes 😑

[@FTFWARRIOR]

Personally, I like to be in range before I bolus, others may risk it to attempt to stay perfect in range, but my #1 priority is to not go low haha

[@sarahlynch2324]

@@FTFWARRIOR right, I dislike the lows too but I didn't bolus right away and checked a little later and gave some insulin after eating. The struggle is real

[@kimiup1852]

Which insulin works upon meal starting? I thought 2 hours was the fastest acting.

[@FTFWARRIOR]

most of the fast-acting insulins start working around 10-15 minutes after the bolus has been given

[@kimiup1852]

@@FTFWARRIOR NovoRapid (which I’m on via OmniPod) takes 2 hours to kick in. Please state names of insulin that start working in 10-15 minutes.

[@FTFWARRIOR]

@@kimiup1852 humalog and novalog are the most common that are used among T1Ds these days, with novolog being the US version of what you take- novorapid

[@JasonBuckman]

@@kimiup1852 The insulin starts working 10-15 minutes after you take it in. It peaks at around 2 hours.

[@christopherone1]

@@JasonBuckman it peaks at 1 hour, it's nearly gone at 2 hours so it's not peaking then.

[@lindafields290]

I’ve had range 200 /500 for over 25 years ! A1C is 7 nothing is wrong with me. Drs are blown away I’m type 1

[@dvdv7777]

You are playing with fire. There is no guarantee that you won't develop complications just because you haven't had them so far. No need to have totally perfect BG, but 200 - 500 all the time is far, far too high.

[@christopherone1]

there's no way you could have an A1C at 7 with 200 - 500 blood sugars, that's not possible.

[@JasonBuckman]

I have to do extended boluses for 8-10 hours after I eat my first bite. I bolus at the first bite, two hours after, and then every hour until about 9 hours after the first bolus. My sugars stay flat if I do this.

[@FTFWARRIOR]

9 hours after each meal you have to do this? I might be misunderstanding you... but if that's what you're doing, then something else is off... You shouldn't have to do that. That sounds like a lot of work!

[@JasonBuckman]

@@FTFWARRIOR You're not misunderstanding me.

[@FTFWARRIOR]

@@JasonBuckman ahh shoot man, that's a lot of work then. Have you watched the training at diabetesinaction.com yet?

[@Already100]

Do you take a slow acting insulin? If not you might want to talk to your DR about this. Good luck

[@JasonBuckman]

@@Already100 When I was doing this I was on a slow-acting. I had to do the constant short-acting for food. Now I'm on a pump. Now I just increase my basal rate when I eat.