i know it’s been eternities i have actively engaged here, but i would like some advice from you guys.
i have been occupying myself more with food the past few weeks and seeing its impacts on my sugars. knowing the benefits of prebolusing i have tried myself several times at it in the past, but it never really stuck as a habit. usually i just forget after a few days, and the absolute disaster was a year ago when i accidentally bolused twice (once as “prebolusing” and the other one right before the meal ) sending my sugar into the absolute deepest levels of possibilities out there
So the closest i come to prebolusing now is max 1 min b4 meal, and i know that isnt enough…
since i dont eat at regular times it is really difficult to set an alarm clock for the prebolus, so i am asking you guys, any ideas on how to remember 15 mins b4 meal to bolus?
thanks a lot!
So your current habit is to bolus 1 minute before you eat. I would add a 15 minute activity between when you bolus and when you eat. Walking for 15 minutes would be an excellent timed buffer before your meal. Depending on your eating environment, you could catch up on your email (or reading TuD) between dosing and eating. Just remember to set a 15 minute timer so you don’t get distracted and end up going low.
Pre-bolusing is a great tactic to keep post meal BGs in line. Good luck.
Do you use a pump? Looking at my pump’s history for previous bolus has saved me many time from double-bolusing.
Just to flesh out the discussion a little, the logic behind prebolusing is this:
In a non-diabetic individual, as carbohydrate from digested food enters the bloodstream, insulin is released to keep it from building up to dangerous levels. The rationale for prebolusing is to mimic that pattern as closely as possible, so that the insulin begins working just as the carbs enter your system. That’s why the timing of a prebolus needs to be based on the particular type of insulin and your own individual response pattern to it, since different insulins kick in at different rates. The goal is to have the insulin and the carbs start working at the same time, so that BG remains reasonably steady without sharp spikes.
I suggest that you start with one meal, hopefully one that is eaten at home. I always pre-bolus for breakfast and set a timer on the stove. (Use a timer that requires you to cancel it to make it stop–phones are that way also.)
There are times that I don’t pre-bolus. When I used to work and had to drive to where I would eat lunch, I wouldn’t bolus until I reached the restaurant. IMO it is dangerous to drive after bolusing if you haven’t eaten a meal. So I used to try to have a low carbish meal when I couldn’t pre-bolus.
And obviously you have to pay attention to what your current BG is. If you are normal or low, you can’t pre-bolus very far ahead. When I read of people here who pre-bolus 40 minutes ahead, I can’t do that unless I am really high.
If I were you, I would start with 5 or 10 minutes ahead and go from there.
Actually, in my experience the timing of the pre-bolus varies even using the same insulin in the same person. In my case pre-bolusing only works because I have a CGM which I can use to determine when the insulin is kicking in.
Trying to just wait xx minutes before eating is going to leave me sometimes eating too early and other times eating too late.
I have a very nice wrist watch… It’s actually one of my more prized possessions. It has a dive timer on it, which just means the circular ring surrounding the bezel can twist to different numbers from 0-60. When I bolus, with novolog, I set it to zero when I bolus-- then I eat when it gets to 20. When I bolus With afrezza, I eat at zero and pretty much do the opposite. The watch timer has been part of my program all along… I literally don’t feel comfortable eating, at all, without this watch on because it has just become a fundamental part of the process to me… I’m a little quirky about it but it works for me
I feel very, very weird about it when I don’t prebolus (unless using afrezza)— I feel like I’m almost deliberately sabotaging my program…
As with everything else D, there is no one size that fits all. I am fortunate in that insulins act in a very regular and predictable way for me. But everyone’s pattern is their own, and individual. If you are one of those who experience wide variations from bolus to bolus, then letting the CGM guide you is exactly the right thing to do.
I do a finger stick and set my meter to remind me to check again in 15 minutes. The darned thing starts beeping and then I have to remember why I set it If your meter hasn’t got a reminder feature, your mobile phone probably does.
If I forget to pre-bolus, I just do the pre-bolus and then…wait. It doesn’t bother me to wait another 15 minutes for a meal. I like the suggestion that @Terry4 made: catch up on email, read a chapter in my current book, go for a walk - all great ideas for being productive while I wait for my insulin to start working.
it seems a lot of the replies to your question are telling you how not to forget to start eating after you prebolus. but i think you question is how to remember to prebolus in the first place, right? i am a forgetful person, so i can relate. just post signs around where you eat. like on the fridge, your lunch area, etc. that say ‘prebolus and set timer to 15 min!!!’ after doing this a lot, you can recycle the signs as your hunger will become linked to the thought of prebolsuing. at least that’s how it would work for me. or keep the signs up.
thanks for all the suggestions!
@v_prediabetic is right, my biggest problem is to remember to bolus 15 mins b4 meals, not to remember to eat. who on earth forgets to eat?
my problem is, my meals are fixed. once i remember to bolus, the food is usually in front of me, warm and delicious. no waiting or checking mail then. i also dont always eat at home (uni, cantine) and there i often dont even know the carb content before i see the food, and then it has to be eaten. so there i could only do a partial prebolus, and then add the insulin i still need right b4 meal.
for me, eating is a social activity, we eat together, be it at home with my family or with friends. so my problem really is to know 15 mins in advance of the meal that i need to bolus NOW. i know, not that easy.
i think im gonna start with an alarm on my pump for the lunch bolus, because that is usually always at the same time. i’ll see from there
as i said, i am miss forgetful, so i often enlist the help of a my mr. organization husband or a nice, organized colleague to remind me of stuff. could you ask some nice people you always eat with to remind you to prebolus?
One way of dealing with this is to choose “ordered eating.” Take your bolus 1 minute before eating but eat your food in order of how long it will take to digest. Choose slow digesting food first and then the quick digesting simple carbs last. Start with your protein and fat portions first. Savor them. Next thing you know, 15 minutes have gone by and the protein and fat have hardly affected your blood sugar and by the time you get to the potatoes you have essentially “prebolused” for them.
Just a thought.
kinda like @Brian_BSC s approach. maybe i can try that next time i have a food plate with separate food. when everything is mixed that sure doesnt work, but for easy meals at the cantine that is a good idea. i am a slow eater anyways
i guess getting friends into that thing would be a next step, however i will try on my own first. but a good go to option if everything else fails
starting with alarm clock and post its and work my way to independence
thanks so much, love you guys!
it must be hard Angela, your being in medical school and all that eating on the run and in the canteen. I eat 98% of my meals at home, so I have a little internal alarm that says “check and bolus now” - yet still sometimes I mess up. @Brian_BSC suggestion is a great tip, I will try to adopt it myself.
You just have to figure out how to make it your normal. I don’t even think about it anymore-- it’s my routine. It’d be like forgetting to use the bathroom, it just doesn’t happen, and if it rarely does it causes discomfort.
The alternative that works very well for me when on The go, eating in social situations, variable and unfamiliar food, etc, is afrezza. I hope I’m never put in a position to have to chose between afrezza and other rapid insulin because it would be a very difficult decision for me.