When I bolus for a meal, should I eat right after pressing “Confirm”, or should I wait for the bolus to complete being delivered?
Depending on what my blood sugar levels are and what I’m going to eat, it could be a good 10-15 minutes once the bolus starts being delivered to when the beep announces it’s done.
The official answer is that with today’s fast acting insulin it shouldn’t matter either way. In my case (and my lunch bolus is usually around 8-10 units, dinner is nearly 20) my sugars are best when I wait 15-20 minutes after I give the bolus. The only time I really worry about it is if I’m really high going into the meal. Most of the time about 5-10 minutes before the meal I’ll give the bolus and then I’ll eat whenever the food’s ready. Every person’s body and insulin reaction times are different so the only way to know what works best for you is lots of testing! Good luck.
It takes about 15 min for the bolus to begin working in your system. Most really start working about 20-30 min afterward w/ the peak 1-3 hours after that (depending on which type of fast acting you’re taking).
There are a variety of things you might want to consider when getting ready to bolus for a meal (to decide when to bolus, when to eat, etc). For example:
Is your BG in range, high, or low?
I’d maybe bolus and eat immediately if lower or if on target, and I’d bolus and wait a longer time if high.
Are you eating something that is low carb (mostly protein?) or are you eating sugar coated sugar puffs w/ extra sugar sprinkled on top lol?
If lower carb, you could eat/bolus about the same time–again factoring in the BG item as well. If you eat something more carb-heavy, then I’d bolus and wait a bit. But then this is a two-fold question b/c is it really complex carbs (wheat pasta or a grainy bread, for example) or is it something w/ lots of refined simple sugar or high fructose corn syrup in it? I’d bolus and wait a bit if it were simple sugar. I’d do some sort of dual wave bolus if it were more complex. And then if you factor in other items like a rich creamy alfredo sauce (pretty fatty, slowing carb digestion process) then I’d have to adjust how much of the dual wave was stacked up front and how much was stacked for later, and for how long.
Unfortunately there are a lot of factors that play into bolusing “well”…
If you had an example (of BG, meal to be eaten, etc) then maybe we could give our own experience w/ that to help give you ideas about what has worked for us…
Thank you all for your answers!
Here’s an example:
My blood sugar was 240 mg/dL. I was going to eat 20 grams of carb (yogurt, which also has 6 grams of protein).
With my current sensitivity factor of 8, I:C ratio of 5, I would need 4 units for the breakfast and 17.50 units for correctional to 100 mg/dL for a whopping total of 21.50 units of insulin.
The OmniPod would take a few minutes (I believe it was between 10 and 15 minutes) to deliver the entire bolus.
In my ideal world (where life didn’t get in the way of my timing) I would probably start the bolus and then wait about 20 minutes before eating. I would wait to give my blood sugar some time to start coming down because it was high to start with. Yogurt is a high protein food but most of the ones on the market right now have those sugary syrup type flavors so that’s also a lot of simple carbs. If you didn’t have that sort of flavoring I might eat a little sooner. I try to never wait more than 30 minutes after bolusing because I usually find my sugars crashing then.
Depending on how you have your system set up, the pod will deliver .05 or .1 u every 2 seconds (each click), so a total of 21.5 units is going to take a bit. 430 clicks (.05 increments) is 860 seconds which is 14.3 minutes. In 0.1 increments it should be roughly half that time.
So it is almost 15 minutes before the insulin entirely reaches your system, and then another 15 minutes (minimum) before it starts to become noticeably effective (meaning that you would actually see a drop in BG), so from the time you hit “confirm” it is probably 30 minutes minimum before you start to see that drop. If you eat w/ the bolus, you’re not really giving the insulin any time to bring that 240 BG down before stacking food on top of it…so your BG will spike higher than that before the insulin starts to combat it and bring it back down towards your ideal goal of 100.
It is also true (like Rebecca mentioned) that most of the yogurt on the market today has quite a bit of simple sugar in it and it will hit your system pretty quickly. I actually use yoplait light yogurt as a quick pick me up when I’m low b/c it’s 20 g of fairly quick acting sugar (not quite like a dex 4 tab but still pretty quick). So eating the yogurt on top of the 240 BG is going to be a pretty good spike (at least it has been in my experience).
All that being said though, life gets in the way of all of the timing issues in the “ideal” world, so I’d just bolus up front and wait as long as practicality allows, and then I’d eat 
Or alternatively I’d eat something else (if you’re just wanting some calories maybe try some turkey and a cheese stick or something?..not really any carb but still should satiate your appetite).
Hope that helps some!
I always wait about 20 minutes before eating. No matter what my BG might be unless it’s low. If it’s low i’ll wait until the bolus is finished pumping and then eat right away. Otherwise I might sometimes wait up to 45 minutes before eating if my BG is a little high. There are so many different factors to it all. But I will take the time that the PDM says you gave the bolus (which usually is when it finished) and wait 20 to 30 minutes after that to start eating. In my opinion 15 minutes is the least amount of time to wait before eating. But with a BG of 240 I might wait an hour before eating after the bolus to try to get that down! If you have a CGM your trends will be easier to figure out. Plus you can keep an eye on it without to much worry of going low.