Hi all,
does anyone have tips for getting post meal numbers down a bit? I usually rely on my doctors to tinker with the pump settings, as I still feel relatively new to pumping. Any advice would be most appreciated! P.S. I eat healthfully, with low carbs.
Theres more than one way to bolus… thats one way to improve post meal numbers… other than correcting…
I presume your just using a regular bolus+correction… theres ways of bolusing over a period of time, or taking the bolus amount and giving it part at the beginning (immediate), and then the rest of it later…(my memory of the omnipod is a bit hazy so perhaps someone can fill in the details on the exact mode names for the Omnipod)…
Youll definitely want to talk to your pump people about how to use these…
YMMV
If your worried about sugars spiking right after eating then I’ve found it’s helpful to bolus up to 20 minutes before I start eating (I usually try for 10-15 minutes). If you’re eating low carb already then that’s my best advice. The other thing I make sure to do is have some fat with my carbs, meals with carbs but low fat always end up spiking my sugars. Good luck!
Are you waiting two hours before testing? If so, perhaps you need to bolus a little higher. Even though you are eating low carbs, perhaps you are not totally accurate in carb counting and need a little extra insulin.
Bolusing 15 - 20 minutes before eating (if in range) is very helpful…but not always easy to manage. 
If you are seeing this daily (if testing 2 hours after eating?) then you probably should give more insulin for that meal (change the I:C ratio for that meal). Sometimes that needs to be done every 3 days until you seem to have it set right…for the time being.
This poses an interesting question: My doctor says wait two hours (as testing 1 hour post will just “drive you mad”,) but I’ve read on here some have the theory that they want their sugars to be in range 1 hr post meal. Thoughts??? I obviously am striving to be the best I can! Thanks for the reply
Thanks Rebecca! I am aware of this idea, yet have to admit, I’m not always that “prepared!” Will give it another consistant go
Thanks John! I do know about the extended bolus, but let’s just say I haven’t perfected it 
Will ask at my next visit how to become more comfortable with using it!!
Thanks!
I don’t think you can get reasonable results unless you wait an appropriate amount of time before post-meal testing. Most experts agree on the two-hour time frame. I’m not sure how the science works, exactly, but you’ve got to give your body time to process food and insulin time to work. If you correct for an earlier timeframe, you could end up over-correcting. Of course, everyone is different. You might want to check ot some of the good books mentioned here on insuling pumping.
The problem with testing too soon is your BG can go up… or the insulin hasn’t gotten working yet…
If i test after 2 hours. im usually hitting the meal spike dead on, but if i correct on it, ill end up stacking insulin and go low later (if the bolus is right for that meal) due to the correction…
Know it takes some time… but you might find yourself testing 2 and 3 hours after a meal… I tend to go 3 hours because I can safely correct at that 3 hour mark… Might try to bolus, eat 15 min later, then 1 hr, 2 hr 3hr and (if its not overly high) 4hr… and youll see the action curve of your insulin (as long as you dont eat anything in the meantime)… Might also want to keep this on a separate sheet of paper (in addition to your normal log)… can show this to your endo and he might be able to figure out your insulin action, (but you should do this more than once, everything in pumping tries to be based on trends not numbers)… you might find your short acting is all spent in 3 hours, or it might be lingering 4-5 hours later… (this can be put in the PDM and it will base correction calculations on this). You also might find 3 hours more useful for you to do a correction than 2, but your going to want to try both a few times…
You don’t say what insulin you are using. When I changed to Apidra I found my post meal BS’s were in much better control because it is ultra fast acting. Novolog is also. Most endo’s have sample bottles to try and you could ask to try both to see if you get better results. Good luck. Also the lower my BG is before I eat the lower my 2 hour post meal sugar so I try to keep my BG around 90…know that is easier said than done.
Thanks paula! I am using Humalog…
Wow, lot’s of info. But great info, so thank you!
even if you aren’t prepared - my son will sometimes just bolus for 40 carbs ahead of time, and then just bolus for whatever else he eats once he actually knows what he is eating. 40 is pretty safe since he almost always wants more than that.
Hi Gina…check out Danny’s new group TAG…it deals with taking the protein and fat into account when you bolus as well as the carbs, and extending the bolus to compensate…seems to work for a lot of people. Good luck.
HI Gina, I’m not on the Pod yet but will be in about 8 days! But what I’ve learned in the month of prep for going the pump since I had to learn how to take injections and cover the carbs is that by keeping a good log you’ll find how to better adjust for this. I was having some highs after meals and also found out that like some of the other posts I need to take my insulin at least 15 minutes before eating. I like the idea of being able to take a certain amount and then cover the difference which I don’t do now as I don’t want to be shooting up twice but seems easier to do with the pod. I’m gonna ask that question when I go in for my first training next week…I try to remember and let you know what I find out. Also with a log you’ll find out which things affect you differently. I am finding that I need a higher ratio in the morning that I do with the rest of the day but after some time and keeping good records you’ll hopefully be able to figure some of this out…but like you I am also trying real hard to get the 2 hr mark down to what I think is acceptable and I’m thinking some foods will just be hard to keep tight control on but I usually find that if I’m higher than I want after 2 hrs it is good at the 3 hr mark. Agree with one of the other posts that you might want to track at intervals to find out how your reacting~Good Luck!
My nutritionist is really big on eating protein with every meal. She feels that it helps prevent a post prandial spike and then a crash. I don’t have it figured out yet, but it seems if I don’t eat protein, I end up going lower that I want before my next meal.
And yes, it is very easy to bolus with OmniPod. If you are just adjusting for eating more carbs than you bolused for, all you have to do is enter the number of extra carbs, hit Enter and Confirm or override what the PDM calculates. I am so over MDI with all the alcohol swabs and needles. I used to do 5 injections a day (humalog with each meal and levemir AM and PM).
Brad
You can also set up different IC ratios throughout the day. That helped me solve high BG readings I was getting post meal in the mornings but not evenings.
Thanks. I currently do use a higher IC ratio in the am. My spikes aren’t huge, but as a perfectionist (one whom has now decided to stop ignoring her diabetes) I simply want tighter control. Better numbers all the way around. I will have to bite the bullet and keep better records I think. Thanks again!