I have only been a T1 for approx 2 years now and I feel that I am managing my diabetes quite well.
While on MDI I am still cycling 150-200kms per week and I try to eat healthy as much as possible.
One thing with being on MDI is when to inject when out for dinner?
My Endo always said that you should inject when your meal comes out, but like most people when at a restaurant I like to have entree, main and desert. Usually I wont inject my NovoRapid until my main comes out but by that time I’m already high from my entree.
The ideal situation with any meal is to take the insulin far enough in advance so that the insulin is peaking at about the same time as the food. Of course, that’s easier said than done and it does vary from person to person and even between different meals for the same person. I need a 60 minute prebolus time for breakfast and about 30 minutes for dinner. I’m fortunate to use a CGM so I can watch my BG trace closely after I take a dose.
The only way to know how your personal metabolism works is to experiment, probably at home, when you have your safety carbs at hand, and can plate a meal quickly if needed. Take your meal insulin and then fingerstick frequently enough to hopefully you catch where to BG starts to drop.
For the restaurant situation that you presented, entre, main, dessert, you may want to consider dosing in three steps as well. The biggest problem and risk for we people with diabetes is the vagaries of restaurant service time. If you dose too early and the service is slow then you’re in trouble and can take the enjoyment out.
Another tactic is to dose 2/3 of what you think you’ll need for the meal and then deliver the last 1/3 when the food shows up. Trial and error and keeping some records should help you solve this challenge over time.
I think you mean appetizer, main (entree) and desert. I would second what @Terry4 says. If you don’t mind, you can break your shot into three separate shots counting carbs for each course. Keep the pen needle on and then you can properly match your glucose load.
That being said, I also take a very conservative approach to eating out. At home, I know exactly what it is being served, but at a restaurant it can be totally random. You don’t know what size your portion will be and you don’t know when it will come out or even if you need to send it back. To be really safe it is a good idea to wait until the plate is in front of you and you can see it, count it and make sure you won’t send it back.
I try to have my glucose in the 80s when I first start to eat. That way I know that there is some insulin already active in my system when I dose for the meal. It’s a hard balance & completely relies on knowing your correction factor. As with everything diabetes it all depends on you & your comfort level.
@LizBa - that DIYPS link gives a great rational for an early small prebolus. I encourage others to follow this link. Dana Lewis and her husband are truly breaking new ground with novel dosing tactics that work!
one of the things that i like to do, is when i find a restaurant that i like, i will return to it on many an occasion. i will learn what their service is like (fast or slow or somewhere in between), and i will be familiar w/ the sizes of their portions. i will know that they may or may not put out a bread basket, and although i don’t typically eat bread, i know that it is on the table if my food arrives too late after i bolus. (then i can nibble lightly on the bread until the food arrives) generally, i bolus once my order is taken, unless the restaurant is full and hopping and they are extremely busy. i also request all sauces on the side.
of course this just applies to this particular situation and not all others. if its a new restaurant, i would not bolus until the food is right in front of me. also, and i learned this trick here on TuD, if i find that during the meal, i would like to eat more than planned for, just do another carb count and bolus again.
It has truly helped me. My last A1c dropped by .2 and my “lows” were about 3% (with nothing under 60). My endo likes to call it ‘walking a tight rope’. I call it feeling better post meal.
