Hi everyone. Just wondering if this ever happenes to you. If my bg is over before i eat and i take the bolus for the meal and the correction at the same time i usally reach my target around the 3.5 hours mark. But if i test my Bg lets say 3 hours post meal and correct it without eating i might reach my target in 90 min or 2 hours depends. Why is this so and is this normal. Another question is why do i need so much insulin at breakfest 1:8 Carbs but my isf is at 54mg/l (3 mmol). Is this something we see often a so high ISF. I am 6.2 feet 190 lbs. For me this is small.
Insulin resistance/increased carb sensitivity in the morning is typical. It’s part of the dawn phenomenon. Most people have smaller ratios for breakfast.
Larger insulin doses absorb more slowly & less predictably than smaller doses. This explains why your combined correction/bolus has a slower result than just a correction dose alone. Also, your
bolus timing could be a bit off. Food may be starting to digest before bolus/correction has time to work effectively.
Gerri is exactly right (as usual). If I can add one thing to the discussion. One of the key things I do to have the correct timing with a large correction+meal bolus is double the amount of your normal wait time between bolus and eating. For example I bolus 15 minutes before in normal circustances, but if I’m high and correcting I will add give the correction+meal and wait 30-40 min to eat to allow for the correction to happen and then eat. It works for me and doesn’t cause me to have a super spike 1.5 hours post meal.
If i am 150 i would give 1 unit etra and for sure within 90 minutes ill be at 100. I cant give my meal bolus and correction at the same time without eating in the next 30 minutes cause for shur ill be low by that time.
My tdd is 40 right now. 20 lantus and about 20 humalog with meals. I am thinking of a pump. U on one is wiftch one.
For a blood sugar of 150, 30 minutes wait time would likely be fine, but for 200 or more, you would likely need more time before eating or you would just shoot up higher and that would be the reason that it takes hours to come back down. John Walsh suggests that you take the combined bolus and wait until you are 150 or under to eat. If you eat at 200 or 300, you will shoot up to at last 250 or 350 before starting to come down, and that just prolongs the glucose exposure. Using a CGM, my daughter waits until she knows that her bg is well on the way down to eat, if at all possible. When you are just going by one bg test, you don’t know if you are actually still climbing or not either. It is just a snapshot. Doing a few extra tests will help you not to be afraid of lows when bolusing ahead.
You can also fudge a bit which makes life somewhat easier. I used to never pre-bolus b/c I wasnt sure how many carbs I would end up eating, but after a while I realized I can just take most of a bolus (or bolus+correction) in advance and then top off with a unit or 2 when I’m ready to eat as needed. Have had good results, especially with slower-digesting stuff (its sort of a primitive extended bolus).