I am an insulin using T2 (NPH at bedtime only and Apidra for all meals and snacks - NPH as I am trying to get pregnant and my endo won’t allow Lantus/Levermir with pregnancy), very well controlled on insulin, last A1C of 5.1%. The one thing I have been confused with is bolusing (injections) for extended meals. For example- a meal with a roll, or bread, appetizer and salad and then the main meal. How do you bolus for a meal like this - as if all the courses (roll, app, and main meal) have carbs, especially if extended over a period of time like 1-2 hours? Do you take one rapid acting injection for your appetixer/roll and then an injection bolus for the main meal, or another way? Looking for input and to see what others do. Thanks.
Oops - I meant Bolusing for an extended meal!
Any ideas anyone?
If I go out to eat, it’s always an “extended meal” Part of the fun of eating out, is eating slowly and enjoying company. I just add it all up and bolus for the total. Careful with the bread basket, though! (I only eat bread with breakfast, I’d rather use dinner carbs for actual food-only bread I eat with dinner is Indian bread).
I think the only concerns I might have would be if there were a long gap between appetizer and main course. (especially if I didn’t want to eat bread!). When I’m eating out I don’t usually take the chance of bolusing 15 minutes ahead but usually wait till right before the food comes, though, so that would solve that problem.
I do not recall ever being on NPH but the link chart shows the peaks and action range for each Insulin. I wouldn’t feel right advising you on what to do concerning longer meals with NPH and YOUR system. It would be a Good idea to ask your Dietician what to do or perhaps someone else here is in a similar circumstance as you.
I am on Lantus and Humalog. When I attend a longer meal usually with higher carbs and fats, I bolus 7 units 10-15 minutes before I start eating. Then about 60 minutes later, I bolus again with 4 units(units vary). This keeps me in a decent range most of the time. This technique varies with each Person regarding the timing and dosage and changes in their day.
I prefer self-serve meals–less chance of slow food and low blood sugar results. I also ask for a sweet drink to have near me, just in case I need it. If I am at a Family or Friend get together, they always serve me first or ask if I need something sooner, if the meal is delayed. Good Luck!
http://www.diabetesnet.com/diabetes_treatments/insulin_action_times…