Hi. I calculate my insulin injections by the amount of carbs I eat at every meal. Sometimes I have a hard time eating what I have injected for? Do any of you calculate this way and if so, do any of you inject after meals instead of before in order to inject for what you have eaten instead if what you have to eat?
One of the best tips I’ve ever received on TuDiabetes (and from my endo & CDE) is to take insulin further before meals than we used to think we had to and to stop bolusing after a meal. CGMS technology has been proving to endocrinologists over the last few years that insulin works way more slowly than we once thought, so it honestly peaks too late if you don’t take it 20-30 minutes pre-meal. If you’re struggling at all with your A1c, getting your 1 hour post-meal BG level below 140 mg/dL will bring it back into range. And the only way to do that is to match your glucose conversion to your insulin peak more accurately.
So yeah, I stopped bolusing after. The spike wasn’t worth the more accurate carb count because then I was chasing my post-meal blood sugars. I try to guesstimate ahead of time, erring on the light side perhaps if I don’t know how much I’ll eat and taking more later - but I make sure I have at least a minimal amount on board before eating.
I’m with you on stacking insulin. It’s something I don’t recommend to anyone else, but like you said, with practice, you figure out how to make it work for you. I am a stacker, too.
Okay, so, i have a really stupid question… what’s stacking??? Is it what it implies???
I think pump or injections make a difference here. I don’t know how it works with a pump (shots for me), but I suppose it’s easy to inject some insuline before and after the meal with a pump (or continuous ?). With injections, one could do this with shots, but than you need a lot of shots.
So, if you take only one shot and you want to do it before the meal, than you have to adjust the meal to the quantity of the insuline, which is not always easy. I had the same problem and asked to my doctor if I could take my shot after the meal. It was OK as long as I took the shot right after the meal.
Sometimes, if my BS is already a little (or way to) high before the meal, I split my shot in two, one before and one after the meal…
I don’t know if it’s preferable to take the shot before the meal or if it makes no difference, but it makes life easier, that’s sure.
BTW, the insuline I use is NOVORAPID, which is an ultra fast working insuline. This is also important to mention.
For most people fast acting insulin clears their system in 3-5 hours. So stacking would be taking a bolus within 3-5 hours of your previous bolus.
I also agree that it can make things more complicated, but I do it. Almost everyday. It is easier to manage on the pump when I can see (approximately) how much insulin is still active. But I also did it when I was on injections and calculated the active insulin in my head.
I’m with Melissa is the “I learned to bolus early on TuDiabetes” club.
I take my insulin 15-25 minutes before eating. Otherwise I will be high for 2-3 hours after eating.
One option would be to take some insulin before you eat (for the amount that you are sure that you will eat) and take the rest as soon as you are done.
Like Dave said, if I eat more than I planned, I also bolus more after the meal (i.e. I don’t wait for the high blood sugar to correct-- I give the extra insulin right away).
Thanks for all the advice…I will keep it in mind and talk with my doctor too