Pre-bolusing anyone? [Archive]

Russell A.

10-08-2009, 08:29 AM

Just wondering if anyone has had success taking a shot or bolus 15-30 minutes before a high carb/high fat meal or indulging in something sugary?

Russell

jenb

10-08-2009, 08:38 AM

Hi Russell. I always do a bolus 20 to 30 minutes before eating and a second smaller one either at the start of a meal or about 15 minutes after the start, depending on the carb source. I find that high fat meals require a bolus as long as 3 or 4 hours after eating. Fun with insulin!

Jen

Mich

10-08-2009, 09:34 AM

Hi Russell,

Same here. I pre-bolus for quick carbs but not if they are with a lot of fat (as in pizza) which requires a long square bolus for me, and usually an adjustment as long as six hours later.

I pre-bolus for oatmeal, biscuits, birthday cake, etc. if I just can't resist a little bite.:-

Mich

Scratch

10-08-2009, 09:58 AM

I will prebolus for high carb, fast digesting meal.

I wouldn't prebolus for a high fat meal, seeing how fat will slow down glucose uptake.

butterflykisses

10-08-2009, 10:36 AM

I almost always do and it works great. It doesn't matter whether its high fat/protein. I use a combo bolus in that situation, but still start it early.

Russell A.

10-08-2009, 12:14 PM

I almost always do and it works great. It doesn't matter whether its high fat/protein. I use a combo bolus in that situation, but still start it early.

Katherine:

How much ahead of time do you pre-bolus and do you take the whole "normal" amount or just a portion?

Russell

DanG

10-08-2009, 02:24 PM

I pre-bolus for oatmeal, biscuits, birthday cake, etc.

pre-bolus for oatmeal?
Do you sweeten your oatmeal? I just have a bit of molasses and a few raisins.
I have always had the impression that oatmeal is very slowly metabolized, so pre-bolus could be problematic. I do oatmeal every morning for breakfast, and try to almost post-bolus so I can get to work safely. Oftentimes, when I get to work, I am seeing the white clouded vision of a hypo-on-the-way so I try to get just a tad more nourishment that might be faster than the oatmeal. Maybe I'm wrong? The other factor is that I have basal coming up, as I do lantus in the morning also.

Mich

10-08-2009, 03:06 PM

Hi Dan,

I eat 1/2 c of cooked oatmeal. I sweeten with sf maple syrup and a teaspoon of canola margerine. We use the steel-cut oats and we love it. I count it as 36 grams of carb, which is 4 units for me. It's most of the day's carbs in my case. But it's sooo good.

It's another one of those situations where you and I metabolize oatmeal differently. I spike if I don't pre-bolus.

Mich

zoelula

10-08-2009, 03:12 PM

I always bolus fifteen minutes before a meal, unless I'm on the low side when I bolus and eat right away. In restaurants it's a toss up. If it's not crowded and I feel confident I bolus ahead of time. If it's busy and I'm worried, I'll wait until the food arrives.

Russell A.

10-09-2009, 07:43 AM

It is too funny that this discussion has turned toward Oatmeal b/c that is exactly what I am trying to fine tune with a bolus. I eat oatmeal everyday made with milk with a little of s/f syrup.

I normally take about 5 units 1/2 up front and the other over 30 minutes. BUT my BG spikes just over 200 and than drops back to below 100 for lunch.

So I am trying to pre-bolus about 15 minutes before I eat breakfast to see if it lowers my spike. Also trying to determine if I need to adjust my basal.

Hmmm!

Russell

Subby

10-09-2009, 07:57 AM

Russell, my thought is if you basal is in question, you're best to sort that out first! Good ol' basal testing... and if you find like some that skipping breakfast causes runaway BGs thus making basal testing somewhat innefective at that time, then working with a small amount of carbs you specifically understand, might give you the baseline you need to assess your basal rates...

dbaratta

10-09-2009, 09:36 AM

I bolus what i need for a given meal. If it is high carbs I take more insulin. I am on a ratio, but, I have noticed that if I eat a high carb meal, or cake, or bread (things that are bad for me), BG might be okay 2-hours post meal, but I have liver dumps later in the day or night that are no good, so, I avoid eating high carb meals that require more insulin. But, that is just what happens to me.........

dbaratta

10-09-2009, 09:39 AM

Oh wow, I guess it depends on what kind of insulin you use right? My diabetes counslers told me to bolus when the food is in front of me. I have to take my insulin right before I eat my food because it starts working 15 minutes later. I am on rapid acting insulin....probably why huh? 20 to 30 minutes before my meal for me and I would by hypo for sure.

Mich

10-09-2009, 09:50 AM

Poppy,

Most of us are talking about fast acting insulin. We time it so we go low just as the "fast carbs" are being metabolized, so the two things cancel each other out.

For me, this is how I avoid a big spike.

Mich

Subby

10-09-2009, 09:57 AM

I have to take my insulin right before I eat my food because it starts working 15 minutes later. I am on rapid acting insulin....probably why huh? 20 to 30 minutes before my meal for me and I would by hypo for sure.

In comparison, rapid acting usually takes up to at least 30 minutes just to get started for me. If I take a large dose all at once, is can get held up to an hour or more (so I don't do that any more). Bottom line - people can vary a lot. The idea of prebolusing is something that someone who gets very fast response to rapid insulin, can probably just set aside.

dbaratta

10-09-2009, 09:58 AM

I get that, but 20 to 30 minutes before you eat doesn't make you tank? It does me.......

dbaratta

10-09-2009, 10:10 AM

OH YEAH! AGREED! Everyone is different. But so are rapid acting insulins, my doc said they have insulins that are more rapid than others. Is that true? Sometimes I am not sure if he really knows what he is talking about. LOL

Subby

10-09-2009, 10:32 AM

There are three rapids: on paper Novorapid and Humalog claim to be about the same, Apidra claims to be faster. In reality they can seem to have all sorts of speeds per person. So really the question becomes (and is what we all assume here)

How long does the rapid insulin YOU currently take, take to kick in?

... with infinite possibilities. :)

Mich

10-09-2009, 10:42 AM

Hi Dbaratta,

I also consider where I was before I pre-bolused. I may be running a tad elevated from my last meal (or stress or ???) and I use the pre-bolus to begin pushing me back to point A before I eat again. So no, I don't tank. I don't pre-bolus a half hour ahead. More like 10-15 minutes normally.

Mich

dbaratta

10-09-2009, 12:27 PM

Russell A.

10-09-2009, 12:51 PM

For sure. That is me. Insulin get into my system so fast sometimes I find myself wolfing my food in panic if I get held up for a few mintues after my shot. At times I wait till I start eating before I take my insulin.

Poppy: Have you ever checked your blood when you feel like you are dropping like that. I find a lot of times it is in my head or just a fast drop but not always really low.

I can work myself into a freenzy when I am low trying to eat and get my BG up. It takes my mind and body a lot longer to actaully feel like my BG is not critically low.

Check next time.

Russell

butterflykisses

10-09-2009, 05:49 PM

Katherine:

How much ahead of time do you pre-bolus and do you take the whole "normal" amount or just a portion?

Russell

Usually about 30 minutes before, but kind of depends where I am before hand. If I'm around 100, definitely will bolus 30 minutes before. If I'm down close to the low side (say 70's) I'll do about 15 minutes before. It also depends on what I'm eating whether I bolus normal or combo. Of course its not always so easy to pre-bolus, takes some planning ahead! But I do see the benefit in postprandial numbers and when I don't do it my numbers are usually, but not always, higher.

butterflykisses

10-09-2009, 05:53 PM