The bolus seem to work super fast if I'm low and take at leat two hours if I'm high. Why is that?
35-50 is a big treat for me! It has to be carefully planned and pre-bolused. I do a poor person’s dual wave bolus with a combination of Apidra and Novorapid/Novolog. Otherwise, if the timing is wrong, then carb of 35-50g g = 70 to 100mg/dl spike!
how much are you bolusing at once? I find I need to pre-dual wave bolus for most of my meals. I run into troubles when I bolus more than 2 units at a time. My I:C ratio is 1:5 so, depending on what I eat, I could be bolusing up to 12-20 units for one meal. Depending on a number of factors, such as current BG level, amount of carbs I plan on eating, when I plan on eating, I set the dual wave for 6 or 30 minutes.
My insulin works faster with the dual wave for some reason. It might be that a single bolus of 12 units causes a reaction in my tissue that keeps it from being absorbed properly. When I was on MDI’s I would inject 2-3 units 4-6 times in different places all at once to get the proper dosage without over-doing one area.
I’ve also had it bite me in the butt and drop too low when the food comes out too late or the insulin acts too late if its a last minute decision on going out to eat.
I have also heard the advice that when adding in a pre meal correction, you should account for the correction not only the dosing, but in the timing. So if you are high before the meal, you should add the corrective dose to your carb dose and take your bolus earlier, 15-30 minutes before eating. If you are low and will subtract from the carb bolus, then you should bolus later, even after eating. Has anyone else used this technique to reduce meal time spikes?
TAG-ing and pre-boluses helped me a lot! I also cut back on the “unnecessary” carbs (potato chips, cookies, cupcakes, etc.)
Yes - for highs 140-180 about 20 min over 180 about 30 or 40 minutes early dose. For lows, we will use a combo bolus over 30 minutes. When I have tried delaying the dose for lows, I would sometimes forget the dose until my CGM reminded me - I find a 30 min comboi bolus 0% now works well.