Pumping before meals

[kira17]

hello all, I was wondering if it was necessary to pump up to an hour before you ate. i heard it helped the liver get a jump start on bringing your blood sugars down to the normal rate before eating. I've never done this, I have always just pumped and eaten. I was wondering if this was important to my eternal salvation as a diabetic. :D Have a lovely day!

[dixiepixie64]

I would beware of bolusing that far in advance of eating. On occasion I have bolused at a restaurant just as I was being served and had a hypo event while I was eating. That was unpleasant! Secondly, what if you fill up and don't eat as many carbs as you bolused for?

If I am eating something that causes an immediate high spike, I will bolus about 25-50% of my estimated requirement right before I start eating on occasion but otherwise I wait until near the end or after my meal.

I do try to get my BG around 90-100, or as close as possible, BEFORE I start eating, as I hate the feeling of the post meal spikes.

[Amanda_Jo22]

Kira, what type of insulin are you using in your pump? If you use Humalog/Novolog/Apidra, and you bolus one hour before a meal, you would most likely go low before you even eat.

[nantomsuethom]

Welcome to the forums Kira. :)

Thomas would definately go low if he bolused an hour before he ate. He will sometimes bolus 30 min. or so after some meals but not before.

[duck]

I generally bolus *right* when I eat. However, there are times when I do it differently--

If I am high, I may take the correction and meal bolus together a little earlier than when the food arrives...I kinda play it by ear, but I have been known to do this.

If I am low, I may wait to bolus until after I have started eating.

And if I am about to have a meal that I know is slow to raise blood sugar levels for me (like ice cream), I wait as much as one half hour to bolus.

[ricardo]

hello all, I was wondering if it was necessary to pump up to an hour before you ate. i heard it helped the liver get a jump start on bringing your blood sugars down to the normal rate before eating. I've never done this, I have always just pumped and eaten. I was wondering if this was important to my eternal salvation as a diabetic. :D Have a lovely day!

Humalog starts working in less than 15 minutes. If you are well controlled before dinner, don't pump in a bolus until right when you start to eat, or just a FEW minutes before. You can't do like we did in the old days on Regular; taking a shot 1/2 an hour before eating!
Ricardo

[Dewey]

I generally bolus *right* when I eat. However, there are times when I do it differently--

If I am high, I may take the correction and meal bolus together a little earlier than when the food arrives...I kinda play it by ear, but I have been known to do this.

If I am low, I may wait to bolus until after I have started eating.

And if I am about to have a meal that I know is slow to raise blood sugar levels for me (like ice cream), I wait as much as one half hour to bolus.
Hi Kira, and welcome! :thumbsup: I completely agree with Duck, in that if I have an elevated sugar, I will bolus a little earlier. If low, I also might wait to bolus (if one is needed for the carb content of the meal). I too, play it by ear, and try not to do it too soon. Hope this helps some, and again, welcome. :)

[kira17]

Thanks everyone! I just happened across an article that said it helped regulate blood sugars if you bolused 30-60 min. before you ate. I often have high blood sugars after my meals at my post-check, so I was wondering if that was my problem...although I didn't really see the connection. Stranger things have happened to me in my life though, so I thought I'd check it out. Thank you all for you help! now if only you all could solve my high blood sugar problems...I'd be set! :thumbsup:

[duck]

Thanks everyone! I just happened across an article that said it helped regulate blood sugars if you bolused 30-60 min. before you ate. I often have high blood sugars after my meals at my post-check, so I was wondering if that was my problem...although I didn't really see the connection. Stranger things have happened to me in my life though, so I thought I'd check it out. Thank you all for you help! now if only you all could solve my high blood sugar problems...I'd be set! :thumbsup:

Advice like that can be dangerous, particularly if the reader was low before they ate--Bolusing an hour before could be disastrous. That advice sounds more like advice given before the newer, faster insulins came about (Humalog/Novolog).

About your highs after eating--Do you have your insulin to carb ratio figured out well? There may need to be some tweaking...

[twocute64001]

bolus an hour before and I would pass out, My insulin seems to work fairly quickly and if I am in a normal range I wait until I see how much I am really going to eat.

[kira17]

About your highs after eating--Do you have your insulin to carb ratio figured out well? There may need to be some tweaking...[/QUOTE]


My ratio is set at 1:10 right now, do you think I should lower it? I've been steadily lowering it since I was diagnosed, but I've been worried that maybe it's just my basal rates instead. I can't seem to figure it out. Or maybe just doing a combination bolus would be beneficial? What do you think?

[ricardo]

My ratio is set at 1:10 right now, do you think I should lower it? I've been steadily lowering it since I was diagnosed, but I've been worried that maybe it's just my basal rates instead. I can't seem to figure it out. Or maybe just doing a combination bolus would be beneficial? What do you think?


FIRST THINGS FIRST: you HAVE to get your basals set correctly. to do that you'll need to skip at least one meal at a time and check your bg's every hour. Once you have the basals correct, THEN you can fine tune your ratios. Ratios USUALLY, but not always will be lower in the morning than for lunch and supper. Some folks use the same ratio for all meals.

Refer to Pumping Insulin by Walsh, or other good book for full details on setting your basals.

Ricardo

[duck]

About your highs after eating--Do you have your insulin to carb ratio figured out well? There may need to be some tweaking...


My ratio is set at 1:10 right now, do you think I should lower it? I've been steadily lowering it since I was diagnosed, but I've been worried that maybe it's just my basal rates instead. I can't seem to figure it out. Or maybe just doing a combination bolus would be beneficial? What do you think?[/QUOTE]

Basal rates: Test those first by choosing a set period of time (you'll need to set aside at least six hours and as much as eight or more). What I did was (and these times are for demonstration purposes) I would eat at noon a meal with known, measured carbs, and bolus as directed...at 2PM, I'd check my sugars--if they were in line with expectations, I check again at 4PM. If at 4PM they are between 100-160, I stop eating for at least two hours and check my sugars every half hour. If my sugars stay level and do not drop below 100 or rise above 160, the basal rate for that period of time has been set correctly. If they change beyond these numbers, corrections need to be made.

Once you have established your basals, you can begin to figure out your insulin to carb ratios. It is much more difficult the other way around, IMHO. You do this by consuming a known amount of carbs and taking the prescribed bolus--If your sugars are high two hours after eating (and you know your basals are set properly), you need to tweak your insulin to carbs.

From what you are saying so far, I think you need to tweak your insulin to carb ratios, but that's assuming your basals are set correctly...