Post-meal spikes

For the most part - I have always just waited out post-meal spikes - but now I'm wondering if that is contributing to the fact that I've never been able to get my A1C under 7. So I am wondering - how aggressively do you deal with post-meal spikes? At 1 hour? 2? At a certain bg threshold? I know my pump will figure in the insulin on board - but i'm wondering also if there are times you over-ride the pump?

I wear a cgm so I am able to watch the spike - and it is sometimes pretty dramatic. Especially when eating more unpredictable food. And I'm really tired of the frequent trips up and down. Your thoughts are appreciated!

In case more info on me helps you frame your comments, dx in 1989 t1, pumping since 1997, cgm since 2011. I also take some lower doses of Symlin at bkfst and supper to help with the spikes.

I'll sometimes do an ezBG bolus to bring it down a bit.

One of the things that I do is to take my premeal bolus ahead of when I eat. I realize that this is not for everyone, but since you have a cgm, you may have a feel for this already. I don't have a cgm, but I will take my premeal bolus 20-30 min before I eat. It keeps my spikes under control.

how do you decide when to do the extra and how much to give?

I try to do this as well but have a hard time remembering to do that while I'm in the middle of dinner prep.