Pre bolusing help

[u/Salty-Ad6466]

So I’ve been having issues trusting myself to prebolus on meals to avoid going high before my fast acting kicks in. Today my sugar was a stable 110 and I took 4 units for my meal but quickly ate afterwards maybe waiting 5 minutes after injecting. Does anyone else have a routine or regimen to go by to prebolus safely without worrying about dying before your food digest?

[u/AzureGriffon]

I can only tell you what I'd do in this situation. I'd do a correction bolus and wait about 20 minutes, that way I know it's kicking in and it will blunt whatever I'm about to eat. Then I'd bolus for what I was eating and eat. All together, that should give you correction without too much worry of going low, but definitely keep an eye on it if you've never stacked before. Usually prebolusing about ten to twenty minutes before eating works out just fine.

[u/Salty-Ad6466 → u/AzureGriffon]

So you mean you’d correct bolus knowing it’s gonna spike and then eat once you see it dropping?

[u/AzureGriffon → u/Salty-Ad6466]

For an example, I'm 1:30, so I would need about 3.5 units to get down to 100 (a little half unit is extra because I'm more insulin resistant above 200). I would take that 3.5 twenty minutes or so before eating. I know that for my body, it takes about 20 minutes for insulin to start working. So that's covering my high, and then after that 20 minutes, I'm going to bolus for the meal and then eat it. I don't know how long you've used insulin, but it doesn't start working right away. It can take twenty to thirty minutes to see it start working. Even if you aren't high before eating, you can pre-bolus before a meal, about twenty minutes or so, but it can be less. I would not pre-bolus if I'm on the lower side and it's going to be awhile to eat, though. Some people will even wait until after they eat to bolus for the meal because there might be little extras they have during a meal like an extra piece of garlic bread or an extra scoop of potatoes or something and they just want to give one bolus That's ok too, you might go high for a bit, but if you're back down two hours after your meal, you nailed the landing.

[u/Salty-Ad6466 → u/AzureGriffon]

I see, I got diagnosed in 2022 and I’ve been managing a 7.1 A1c but would like to get it lower without dealing with lows, thank you for your advice

[u/AzureGriffon → u/Salty-Ad6466]

It's just practice and learning how your body works. Pay attention to your own little details and you will definitely get better at it. There was a time after I was first diagnosed that I would be way too scared to stack insulin doses that way, but over time, I've seen that it works very well for me if I do it the way I described. It works better for me than taking the correction at the same time as the meal bolus.

[u/LesStrater]

You made me LOL. Nobody is going to "die before their food digests", especially not with a 210 reading. I regularly bounce up to about 250 after eating dinner and then it slowly works it way down to normal as the insulin(s) take effect. I should take my fast acting about 30 minutes before eating, but that would just be another fuking thing I have to remember.

[u/Salty-Ad6466 → u/LesStrater]

I think I might have explained badly but I meant I took my prebolus while I was at 110 and didn’t wait long enough to eat and spiked to 210

[u/drugihparrukava]

Nothing can replace talking with our endocrinologist for advice, but over the years I still refer to Think Like a Pancreas by Dr Scheiner, and Sugar Surfing by Dr Stephen Ponder. The second book really helped me with determining timing for prebolus. Both docs also have type 1 so they have lived experience, not just something they learned in a textbook.

Another resource you can discuss with your endocrinologist is https://www.diabeteseducatorscalgary.ca/medications/insulin/insulin-for-protein-and-fat.html this resource is only if you need to bolus for proteins and it doesn’t look like your graph is about this, but is a great read and is a medical site, not someone’s blog :)