The purpose of this post is for members to share tips and experiences about any topic that works for them and may be helpful to some other members. I’ll go first.
How to Reduce a High BG Quickly and Eat Too
When my BG is excessively high, I take a combined correction bolus and a food bolus (meal or snack) and wait for my BG to come down and then eat.
Assume I have no insulin on board (IOB) and my BG is 200 and my target BG is 100, normally I would take a correction bolus of 2 units to get my BG down to 100 but would have to wait 4 hours for it to come down to 100.
By combining a food bolus and correction bolus I might take 5-7 units in total. The higher dose of insulin and waiting for my BG to come down to approach my target before eating has the advantage of working first on the higher BG and then on the food and allows me to eat more quickly (in about 90 minutes rather than rather 4 hours) than I otherwise would.
This has worked for me. I used to skip a meal if my BG was too high while waiting for it to come down. Now I immediately put in a larger dose of insulin and eat more quickly.
This is only helpful if you are using an Omnipod. I dont understand why this works for me, but it drops me like a rock. Click the “Omnipod” link above to access the manual - page 35.
I, personally, probably wouldn’t use this to correct for 200. I would use it to correct for 350. It is the Molotov cocktail to bring down BG fast, for me, anyway - fast and hard. Exercise caution.
This is just to drive home the point that extended bolus might seem like a fun idea, but I have gotten burned by being too aggressive. When it works, it works like a charm. When I overdo it, I’m in trouble.
I see finding a personalized pre-bolus time one of the most under-exploited, yet effective tactics to limit post-meal glucose to an acceptable rise. The best way to home in on your ideal pre-bolus times is to use a continuous glucose monitor and watch for a post-insulin dose drop. An optimal pre-bolus time can also be identified using well-timed finger-pricks.
Many people, including me in the past, have guesstimated and used a standard time, like 15 minutes, and it often won’t perform nearly as well as the pre-bolus time you’ve identified with a personal test. Ideal pre-bolus times may change with the time of day and also from day to day.
Terry4, I think I learned pre-bolus from you. Many people have heard of it but many have not. I have a CGM and am retired, and as a result I can put in a meal bolus regardless of my BG and wait until it comes down to a desired number before eating. Sometimes I wait only 15 minutes and sometime I have to wait 90 minutes. This works fine if you can wait and defer eating your meal. Not so good if you have a prescribed meal time such as a lunch hour at work.
When you get right down to it, our insulin dosing tactics are limited to dose size and timing. Everyone has some plan to decide dose size but then use a one-size-fits-all timing technique.
I’m also retired and enjoy more time flexibility regarding when I eat. But I still think people on a fixed schedule could do more to improve their insulin timing.
Mohe0001, Medtronics also has an extended bolus feature that does the same thing, I think. T-slim probably does as well. I don’t understand why it would drop someone like a rocket as as you would not be putting the insulin in upfront but instead deferring some of it to later. Maybe I am missing the issue or perhaps you could describe the issue to us.
One other small item to consider for per-bolus is that not all carbs increase blood glucose at the same rate. You may find that eating a leisurely meal of protein which will slowly rise blood sugar is not the same as eating a yogurt or ice cream. I pre-bolus before leaving the office, giving me about 20 minutes to get home and eat. If I get delayed more than a few minutes getting home and it looks like I will go hypo, I will eat dessert first followed by my meal as my insulin kicks in after 26 minutes, while food kicks in after 15 minutes, however, the rate of climb after dessert is far faster than after say a mainly protein meal. This is where CGM info has it all over finger sticks.
I cannot explain it. I only know that it works like a charm, for me. Takes WAY less than 4 hours. WAY less sometimes. Can produce a WAY rapid drop, quickly. Heed these words, or dont. heed my words struggler - YouTube
