How long can you wait after bolusing before eating?

[MinimedPumper07]

If you are 150+ can you bolus and wait like an hour or is that too much?

[solox316]

i would only give your correction bolus that early, and your meal bolus as it gets closer. that way there isnt the risk of going too low.

[DCaplinger]

i would only give your correction bolus that early, and your meal bolus as it gets closer. that way there isnt the risk of going too low.

Whaaaaaat? This is a new concept for me. Can you expand on that a bit?

Regards,

[MinimedPumper07]

I wanna hear from others. What is the longest you will bolus before eating and under what circumstances?

[JediSkipdogg]

The longest I will wait is 15 minutes because if something happens and you don't eat....well, then you have to eat.

I definitely would not go any longer than 30 minutes for a food based bolus. A correction bolus you can give at any time.

[MinimedPumper07]

If u are at 170 and wanna eat now what do you do?

[JediSkipdogg]

Then you bolus both the food and the correction at the same time. Nothing wrong with that.

[Funnygrl]

No, you can't wait an hour. The insulin is already peaking by then.

[MinimedPumper07]

but if you eat when u are at 170 wont u skyrocket in the 200's for a while? isnt it better to wait like a half hour?

btw i have tried doing what i just said and i always am like 200 2 hrs post meal. is that because my correction ratio is wrong?

[Funnygrl]

I already told you, no even if I was 170 I wouldn't take a meal bolus and wait an hour. I'd take a correction bolus, but not a meal bolus.

Sometimes I'm amazed you haven't killed yourself yet ;)

As for being 200 post meal, it could be a basal or a bolus problem. Have you read Pumping Insulin by John Walsh?

[MinimedPumper07]

im such a noob i know...
no need to rub it in though. i have read parts of that book. my basals are fine.
if you say you just take a correction, does that mean you don't eat then, you wait a while before eating?

[Funnygrl]

Honestly, you've been pumping awhile now. Your posts make it clearly that you truely desire good control. Read what you can about how to test pump settings, and insulin profiles and such. Then you can really use your pump features to your advantage.

[ant hill]

If you wait that long then I can gather that you are not exercising. If you have done say riding a bike or anything to get your heart pumping then you will find that the bolus will work faster!! ;)

[xMenace]

btw i have tried doing what i just said and i always am like 200 2 hrs post meal. is that because my correction ratio is wrong?

I see where you are coming from, but the evidence seems to be saying your rates are off. It may be your bolus ratios but it may also be your basal rates. You should not be 200 pp.

If rate fine-tuning, pre-bolusing, and food composition changes don't do it, you could then try super-bolusing, But that's a last resort.

I try to bolus 20-30 minutes early. I've gone as high as 50 minutes once and 40 a few times. These were get-togethers where the meal was tarfy and I had DW watching me. Food was handy.

[Eddy]

but if you eat when u are at 170 wont u skyrocket in the 200's for a while?


Maybe, maybe not. There's no hard, fast answer. Think of it as a race between the insulin and the glucose; either one may win. You'll have to profile different foods at different starting BGs at different times of day with different activity patterns to know the answer.


isnt it better to wait like a half hour?


Again, it depends. That might be correct. You might still go high. You might drop with a nasty hypo.

For me, half an hour would be disastrous unless I were eating something like pineapple. The 1-hr insulin peak would pound me into a wicked hypo before the food could finish releasing glucose. I frequently use old-fashioned R -- and sometimes even N -- with my meals because I want to slow down the insulin's effect.

But that's me. That's how my body works. That regimen might send someone else skyrocketing after the meal, then drop them several hours later.


btw i have tried doing what i just said and i always am like 200 2 hrs post meal. is that because my correction ratio is wrong?


It could be wrong correction, wrong coverage, or wrong basal. If you don't have a handle on your basal, it's futile to try figuring out the rest.

We can give generalities and explain trends, but cannot give you specifics. You must determine those on your own. Use small, cautious perturbations when you experiment. Have some rapid-release carbohydrate handy in case you go hypo.

If you don't mind sharing specifics -- such as age, BMI, diet, doses, gender, other medications, physical activity level, weight -- we might be able to steer you... but you'll still need to research a lot on your own.

Oh... and I assume that you're type 1. If you're type 2, that's a totally different beast.

[solox316]

Whaaaaaat? This is a new concept for me. Can you expand on that a bit?

Regards,

If one wanted to try to take care of the 170 first, then what I wrote is the same as what most others have posted. Give the correction at any time, wait to give the meal bolus until you feel like you are ready to eat.

That being said, if it is meal time, then eat. Your level will work itself out if you cover correctly, eventually.

[MinimedPumper07]

See thats what I'm getting at. I think its all in the timing. I worked my basals out a few weeks ago and I stayed 80-140 the whole time I was fasting. I think I am just eating my food too quickly. Sometimes I wish I could do the correction, and then wait like an hour, but I don't have that kind of time. Also I am not exercising enough :/

[shiftzor]

I thought that was the big reason for pumping, you could give yourself corrections without the usual MDI worries of changing sites etc. Can't see the point of taking a huge risk like taking all your bolus in one go and waiting an hour. As already said just give a correction bolus then bolus when you eat food, if your I:C is correct then 2 and a half hours later your bg will be within range. 4 hours later your bg should still be within range. If it’s not right then your I:C/basal rate is wrong.

[JediSkipdogg]

I am totally confused on what you are trying to prevent. You seem to be going against the reason for pumping. For example, I woke up at 10 this morning running 66. I gave myself some food to correct and by 1:00 I was 147. I gave a bolus to bring the 147 down to 100 at that time and then now I'm eating lunch at 1:40 and I gave my lunch bolus. I didn't hold or give a bolus early for either instance.

Why would you not correct a high immediately on a pump?

Why would you want to give a food bolus an hour early just to give it with the correction?

The main advantage of a pump is to give insulin when you need it and not have to wait.

[Eddy]

See thats what I'm getting at. I think its all in the timing. I worked my basals out a few weeks ago and I stayed 80-140 the whole time I was fasting.


How long of a time period was that? When did you see what numbers? If you steadily dropped or increased during an 18-hour period (e.g., dinner to lunch), I'd say that your basal still leaves much to be desired.


I think I am just eating my food too quickly.


Maybe. Or maybe it's what you eat. Or it could be that insulin kicks in slowly. There are many possible causes, which is why people are asking for more details; specific advice requires specific data.


Sometimes I wish I could do the correction, and then wait like an hour, but I don't have that kind of time.


I'll try to respond gently to that statement. Does your current situation really save you time? How time-consuming would it be to check an hour before mealtime, press a button to correct, and then return to what you were doing?


Also I am not exercising enough :/


Ehhhh.... it's a catch-22. Exercise helps control over the long haul, but can really mess with you during the short term.

[Eddy]

Re how long to wait after mealtime bolus before eating:


I've gone as high as 50 minutes once


Dude. That would put me in a coma if I tried it with a full-meal bolus. Novolog/Novorapid is on peak, and human insulin is nearly 50% spent... in me, at least.

Well, I guess that gets back to the original point: What can work for one might kill another.

[JediSkipdogg]

See thats what I'm getting at. I think its all in the timing. I worked my basals out a few weeks ago and I stayed 80-140 the whole time I was fasting. I think I am just eating my food too quickly. Sometimes I wish I could do the correction, and then wait like an hour, but I don't have that kind of time. Also I am not exercising enough :/

If during a basal test you ranged from 80-140 during that test then you definitely failed the test in my opinion. You should not move more than 10 mg/dl up or down during a basal test, I think some allow you 20 mg/dl.

As for the exercise, that's going to have nothing to do with how well your levels are. That will actually throw another mix into the mess you seem to have since you have to cut your basals back (or eat more) before you exercise and you need to maybe keep them lower depending on the type of exercise you do. If one does strength exercise then their muscles are more actively working during the 12-24 hours after the exercise has stopped, so that may change your BG during that period.

[shabbie]

If you are 150+ can you bolus and wait like an hour or is that too much?

i COULD wait an hour or so before i eat, BUT if i bolus that early i end up with too many carbs on board when the insulin ran out :confused: ~ make sense?

i would take a correction, wait for my bg's to start coming down (perhaps 1 hour?), then take a meal bolus and eat.

nothing wrong with taking that correction AND meal bolus and eat within say half an hour.

a lot depends on how many carbs i'm about to eat really :T

[solox316]

See thats what I'm getting at. I think its all in the timing. I worked my basals out a few weeks ago and I stayed 80-140 the whole time I was fasting. I think I am just eating my food too quickly. Sometimes I wish I could do the correction, and then wait like an hour, but I don't have that kind of time.

If you are testing for dinner, and you are 170, then correct with your meal bolus and eat. No big deal.

Maybe the better question is why was your reading 170? I am not faulting the 170, just saying that if you can solve that, then you won't need the answers in the thread about bolusing early.

If elevated not at a meal time, why not (as Jedi said) correct right away, as long as you are conscious of insulin possibly on board.

If you are spiking too badly after eating, which I gathered from your comment of eating too quickly, talk to your dr. about symlin... but you really have to have your basals and IC ratio in pretty good check, and understanding...

[MinimedPumper07]

For example, I woke up at 10 this morning running 66. I gave myself some food to correct and by 1:00 I was 147. I gave a bolus to bring the 147 down to 100 at that time and then now I'm eating lunch at 1:40 and I gave my lunch bolus. I didn't hold or give a bolus early for either instance.


what im getting at is that at 1 u were at 147, so u corrected, and did not eat until 1:40, at which point u ate and gave a meal bolus. If instead at 1 u would have corrected the 147 and ate and meal bolused all at the same time, you would have spiked, but you didn't spike because you waited 40 minutes for your correction to take effect before eating and meal bolusing.

if i am at 170, correct and meal bolus at the same time, it will take around 4 hours to get back into range than if i were at 170, corrected, waited an hour then ate and meal bolused - that would just take 2 hours to get into range.

[JediSkipdogg]

what im getting at is that at 1 u were at 147, so u corrected, and did not eat until 1:40, at which point u ate and gave a meal bolus. If instead at 1 u would have corrected the 147 and ate and meal bolused all at the same time, you would have spiked, but you didn't spike because you waited 40 minutes for your correction to take effect before eating and meal bolusing.

Yeah, I probably would, but it's not going to kill you. I'm not going to change my life because a number goes above 200 for 30 minutes. In the long run that isn't going to cause any complications by itself whereas the waiting an hour to bring the BG down because I don't want a correction and food bolus at the same time is going to cause more harm, probably in the area of depression and/or stress.

I see alot on here that say diabetes is stressful....in my opinion it only is if you make it stressful. 26 years of it here and I don't let a random high bother me or a low stop me. I correct and get on with my life.

[Eddy]

If instead at 1 u would have corrected the 147 and ate and meal bolused all at the same time, you would have spiked


Maybe, maybe not. It depends. With the right food, I can inject an hour after eating, and still go hypo.


if i am at 170, correct and meal bolus at the same time, it will take around 4 hours to get back into range than if i were at 170, corrected, waited an hour then ate and meal bolused - that would just take 2 hours to get into range.


Oh well. If you're at 170, how long have you been there? The best answer is to stay in range if at all possible.

As people have suggested... take a second look at your basal. Varying 60 mg/dL during a basal test shows opportunity for improvement. Let's start at the beginning. How much of an overnight drop do you usually see?

[MinimedPumper07]

I have messed with my basals as much as I can stand. There are just too many factors that influence my fasting bg. Most of the tests I did I started the test at around 110 and by the end of the test 5 or 6 hours later I would be at 80-90. I am happy with that.

[Eddy]

I have messed with my basals as much as I can stand. There are just too many factors that influence my fasting bg.


People here are trying to help you. However, the "I'm too busy" and "there are just too many complications" comments do not help. Perhaps I am perceiving your attitude incorrectly, but you seem to discount that others might be equally -- or even more -- busy and complicated.


Most of the tests I did I started the test at around 110 and by the end of the test 5 or 6 hours later I would be at 80-90.


Extrapolating, that's a daily drop of about 100 mg/dL. That's not normal. That's excessive.

What do you see overnight?


I am happy with that.


Ultimately, that's the bottom line. If you are happy with what your approach provides, that's what counts.

[cheryl]

I can honestly say, that I don't like eating at a 170...errrr nope not at all...unless I noticed that it is coming down from corrections and I cannot stand it anymore....very rare I do that though...

Honestly 140's do not make me nervous to eat with unless my reading a couple of hours before were lower...then I might be thinking ok what is the deal...

Anyhow, if I am 146 as for instance today at lunch.....I was 187 after breakfast did a tiny correction...I knew I was on my way down I waited 20 minutes or so to start eating....that is what I do....oh by the way my IC ratio is off for breakfast again errrrr...so I know what my issue's have been LOL

It's hard....I know I work and am a Mom of four kids....I used to think I don't have time for this....but I find it....even if I have to bring my food with me....if I have to go out....LOL....or I make sure if I am super duper busy...I might attempt to eat two hours before I am about to be busy....or lets say your having these higher issue's why don't you try to test your bg like 45 minutes before your gonna eat so if your higher you have corrected and when you are ready to eat....your lower or somewhat by this point...see my drift...I do things like this so I can still eat, still be busy and still get things situated takes a few seconds to test.....so I would do that....

Cheryl

[MinimedPumper07]

Extrapolating, that's a daily drop of about 100 mg/dL. That's not normal. That's excessive.

What do you see overnight?



Ultimately, that's the bottom line. If you are happy with what your approach provides, that's what counts.

Its not a 100 point drop in one day. My bgs usually hit about 70s if i dont eat for a really long time and then sometimes they actually start bouncing back. It would not just fall to 0 by the end of the day, thats silly. And my night time basals are good. Last night went to sleep at 103, woke up at 104.

I am happy with what I have so far. I think I will try super bolusing next time I am high.

[Eddy]

Its not a 100 point drop in one day.


"Extrapolating", dude. You missed the key word.


My bgs usually hit about 70s if i dont eat for a really long time and then sometimes they actually start bouncing back.


That's probably due to glucagon telling your liver to convert glycogen. Run out of glycogen, and things get "interesting" if the insulin is still flowing.


It would not just fall to 0 by the end of the day, thats silly.


I wasn't going to respond to your post, but the above is dangerous and needs to be addressed. You claim that one's BG "would not just fall to 0". Really?

Substantiate your claim that a drop just can't keep going. Yes, you'd probably convert glycogen, then have gluconeogenesis if you ran out... blah blah blah.

Drops can continue. People die. You'd be well-advised not to disregard or mock that fact. During my first sub-20 mg/dL drop, I consumed enough sugar to raise my BG by 400 mg/dL. I ended up at 225 mg/dL. Are you trying to claim that I'd have been fine without taking sugar? Sorry; I doubt my invincibility.

Let me reiterate my point: Your fasting drop was excessive. Full stop. If you don't like extrapolating, go the other way. Take a normal person's 24-hour drop -- say 20 mg/dL -- and work backward. Six hours? Maybe a five-point drop.

At any rate, about half an order of magnitude smaller than what you observed. Something else was at play. If you have that big of a fluctuation as "background noise", then try eating and bolusing on top of that, what do you expect?


And my night time basals are good. Last night went to sleep at 103, woke up at 104.


That tends to indicate your night time is correct, assuming no fluctuation at night or shortly after awakening.


I am happy with what I have so far.


Then perhaps I've lost sight of the original question. I interpreted it as dissatisfaction with the numbers you had. My apologies; perhaps I was painting your world with my brush. If I hit 130+, I'm off by more than a unit, and consider that a serious screwup.


I think I will try super bolusing next time I am high.


Fine. My point, and I believe the point of several others, is to figure out why you were high... and that there may be other, better alternatives than super-bolusing.