Bolus Doses

Hi all

As I’ve mentioned on other threads Í just started using Bolus insulin (Apidra) 4 days ago and am on a “fact-finding mission” to learn how to dose correctly. I’ve also just started carb counting so it’s all new to me. Several of you have given me good input and reminded me to just take it slow, stay on the same dose for a few days and see what happens. So that is what I’m doing and trying to make sense of what I see.

I’ve had several meals now of about 30 carbs (I know I’m not perfect at estimating yet, and I don’t eat a lot of packaged food, but I’ve checked several listings). As many of you suggest starting with a 1:15 IC ratio I took 2 units for those meals. At 2 hours I’ve ended up in the 200s most of the time. So I have two questions:

What determines the I:C ratio. Could it be I need to do more like 1:10?

I have been nervous so I lay out my food and do my shot with the food ready on the table, so I am literally doing shot and then taking my first bite. I’ve heard some people say do shot and then eat 15 minutes later( that would certainly be less rushed!) Does timing of the dose influence the end result?

Thanks. I’m looking forward to the first meal I get right!!

Yes, rapid acting insulin is typically take 15 minutes BEFORE meals. Yes, timing is very important. Depending on how fast acting those 30 carbs were, the carbs may have hit your bloodstream before the insulin.

What was your BG before you ate? That’s critical in figuring out how insulin is effecting you after meals.

There are other factors that influence readings, including amount of protein & fat. The amount of both can cause highs later than 2 hours.

What determines your ratio is trial & error & being precise in the number of carbs:) Maybe it was 30, maybe it was 35 or 40.

I have Using Insulin winging its way down to Central America even as we speak! Also, Carb Conscious Vegetarian. Can’t wait to get both books!

Thanks, Gerri. Can you explain how the BG before I ate is “critical in figuring out how insulin is effecting you after meals” so I can look at those numbers in my logbook too?

Dave is right about about reading the book.

You say your BG was 200 two hours after you ate. What BG was before you ate is important. For example, if it was 200 before you ate, then your insulin dose was correct since it didn’t go up after eating. You can’t just judge what your carb ratio is based solely on after meals without knowing the baseline from which you’re starting.

I’m not expecting anyone to totally educate me, Dave, and if you know how to make the mail from the U.S. to Guatemala faster, please let me know!!

I actually have been learning a lot by trying things and then asking questions about what I find. The answers people including you have given to my questions have been enormously helpful to me to keep me going in the right direction. Gerri, your answer to the question above makes perfect sense to me as another piece of the puzzle.

I can’t tell you how much I appreciate everyone’s input. I’m actually a very self-sufficient person normally, (hey, I picked up and moved alone to Central America!) but I felt totally over my head and alone before finding this website.

Nope, the regular mail would be the “slow boat from China”. I am paying to have it brought down from Miami by courier so I’ll get it sometime this century!

Thanks. I am the sort of person that likes to understand things like yesterday, so patience, patience I keep telling myself!

Zoe, you’re doing great by being so inquisitive. I’m trying to figure out some of the same things as you. I’m glad you posted your questions here so that we can all share in the answers.

Thanks, Grace. Glad to know I’m not the only newbie and I hope you’re coming along in your journey too.


Really is pieces of a puzzle & sometimes we have to force the pieces that don’t quite fit. It’s frustrating because there is no set formula. If only there was–sigh. Tweaking, lots of tweaking & lots of trial & error.

The total picture is how it begins to come into focus, so great that you’re keeping good records.

Morning fasting BG
BG before meals
Carbs per meal, bolus insulin dose
BG 2 hours after meals
BG before bed

Keeping meals simple & consistent is helpful in figuring things out in the beginning.

Know you don’t believe this, but you really are doing very well! Keep breathing, honey.

Oh yep, lists. It actually reminds me of when I made the move to Guatemala. My lists gave birth to little baby lists! Any day now I’m going to start dreaming in numbers.

Tomorrow I’m off to the farmacia to see if I can find syringes with 1/2 units.

Thanks for the encouragement
Abrazos (hugs)

Abrazos, amiga.

Hi zoe

I found this workbook to be very helpfull in insulin adjustments and its a free download hers the link(copy and paste)

i’ve been meaning to read this, i’m going to check out the john walsh book to. I’m getting sick of not knowing what to do in between doc visits

Which book is more helpfull think like a pancreas or using insulin?

Wow, thanks for that link, Michael! I just looked at the Table of Contents and there is lots of great stuff in there! I’m anxiously waiting for my copy of “Using Insulin” to get here but that looks like it has plenty to work on till then!

anybody ever check out this site?

Today I had two meals that were in target! Hooray! I did it! It took me five days to get those two meals but I did it! Hopefully more ahead! I had a LOT of resistance to counting carbs and eating low carb, but my fear of lows helps…lol.

Zero success at finding syringes with 1/2 unit doses, the ones here all had 2 unit lines so my pen is better. What was I thinking, this is Guatemala!

Congratulations! Great! Tomorrow will even be better!