unable to find my original site regarding this topic, so i thought i might re-post it and keep everyone up to date.
i slowly increased my pre-bolus starting from covering 20 gms of carbs (i.e. 21, 22,23,24, 25).
today was the 2nd day that i have tried out the coverage for 25 gms. and now its twice in a row that i have not spiked. i have a reasonable rise in my BGs, but only from a 151 to 165 over a period of 2 hours.( i know that it might sound like my BG is a little high, but i did add the coffee after eating my breakfast)
i also want to add, incase no one remembers my coffee formula: 6 Splenda, lots of cream, and, of course, the coffee (which is strong)
Glad to hear you’ve (hopefully) figured out what works. Don’t be surprised if it changes again at some point! I’m currently tackling cereal, and am getting closer to a solution for that as well (seems 1 unit above what my pump calculates plus a bit of exercise within two hours of eating might do the trick).
like yourself, i have been working on bolusing for simple carbs. my 2 favorites are English Muffins and Oatmeal. under any circumstances, i cannot use a straight out bolus like most people. the closest i have gotten to a formula is a dual bolus of 50/50 for 2 hours. its not perfect yet, but then again nothing is.
thanks for your share. its nice (well sad as well) to know that others like myself cannot get those simple carb boluses right.
I’d think this would be pretty common, and is probably why a lot of people choose to go on a low carbohydrate diet.
For me, I find pre-bolusing prior to eating is important, and combine it with a regular bolus to cover the food (adding on more insulin as needed). I’ve never found the extended bolus to be all that useful. If I spread a bolus out, I end up spiking hugely because the food hits way before the insulin does. I’ve heard it’s helpful for people who have gastroparesis, though. I’d say I have the opposite problem, where foods hits my system before the insulin does, which is why I have to pre-bolus before eating almost everything.
Jen, i would have to admit that i will spike terribly if i do not pre-bolus, and for that and other reasons, i only would eat something like and English Muffin for a special occasions. it’s just too much (chemistry) trouble to bother. however, i do not want to deny myself something yummy all the time.
[quote]Jen, do you drink coffee? and, if yes, do you have the spiking problem
as i do? and, how long do you have to wait after pre-bolusing for your meals?[/quote]
No coffee here. I typically pre-bolus by 30-45 minutes before eating. Even with that, I still have a rise in my blood sugar, even with moderate to low-GI foods that I try to stick to. If I do this and exercise a bit each day (nothing too intense), that’s when I can sometimes flatline after meals. If my blood sugar is on the lower end of my target range, then I can’t pre-bolus by more than 10-20 minutes without ending up low (and if I’m borderline low, then I bolus and eat at the same time).
Jen, what do you mean by pre-bolus and then combine it with a regular bolus to cover the food? I am also struggling with insulin timing. I also have to pre-bolus or I will spike badly. Hwr, I often go quite low, 40s, before I level out, usually less than140, which is my goal. I’m now trying to rectify the lows. I’ve tried taking 2/3 the insulin for the pre-bolus then the last 1/3 insulin a half hour after eating. This causes me to go a bit high and then once again, still go low before leveling out. I’m using the dexcom cgm which of course has a 20 minute lag so timing is difficult. I’ve been on it since March this year, and the omnipod pump since June. Both have helped greatly. Before I never really analysed anything.
[quote]Jen, what do you mean by pre-bolus and then combine it with a regular
bolus to cover the food? I am also struggling with insulin timing.[/quote]
I just mean that I pre-bolus and then use a regular/normal bolus to cover my food, rather than any type of combo/extended bolus. The timing is tricky. I’ve pretty much decided that staying under 7.8 mmol/L (140 mg/dl) is impossible because I don’t eat a low-carbohdyrate diet. So my goal is less than 9-10 mmol/L (160-180 mg/dl) at peak and then levelling out close to my target which is 6.0 mmol/L (108 mg/dl). If I bolus too far in advance, then I find I go low before or during (or shortly after) eating, which is why I’ve figured out that the pre-bolus timing depends on what my blood sugar is before I’m eating. I don’t have a perfect system worked out yet, if a perfect system exists, but am slowly getting there. Today I did Experiment #6 of my cereal (keeping all variables the same except for insulin dose), and I thought I had it worked out but it turns out I didn’t (I had to eat to avoid going low).
i am a VERY slow learner. often i do not want to take the advice of others, which is forever my loss. but after all the encouragement from TuD members, i began experimenting, trying not to be so afraid of messing up my BGs. this issue w/ coffee has been long in coming, so i was very glad to report some progress.
Yes, me, too! In fact, I didn’t even know I could pre-bolus before coming to TuD! I had asked my CDE about it but she told me that she did NOT advise it for me! Incredible! I so appreciate all of the help that members have provided. I know we are all different when it comes to D but at least knowing what others do or try gives me the confidence to try, too. I’m glad you are making progress w/ the coffee. That one is difficult! We all love our coffee in the morning! Keep up the good work!
I know exactly what you mean about taking advice; once I finally got something that (sort of) worked, I was highly reluctant to alter it, even a bit. Glad to know I’m not alone!
And thinking about advice, it occurs to me that no one can tell me the road I ought to take. Heck, I don’t know what road I ought to take! All we can do for each other is share the road we did take, and describe where we are. And that’s quite something.
Sometimes I feel like one of the six blind men trying to describe an elephant, LOL!
So, @Daisy_Mae, let me see if I understand the bigger picture a bit better. You are eating breakfast where you pre-bolus/bolus ‘x’ amount of insulin, then some short period after breakfast, you have coffee with a large amount of cream and 6 packets of Splenda. You bolus ‘y’ amount of insulin to cover the coffee. Is that correct?
yes. i pre-bolus for coffee covering 25 units of coffee w/ splenda and cream. this seemed to work so-so yesterday, but i actually think i need to cover a few more gms of carbs. either that or discontinue the Splenda. does that help answer your question?