Super bolus and prebolus questions

Type 1 and LADA
1

  1. Can a super bolus be given as a prebolus?

  2. Is there any point in using a super bolus when my basal is so low (0.2 units/hour)?

2
  1. I would be very careful about giving yourself a super bolus and then waiting fifteen minutes.

When I have super bloused, I did it because I COULDN’T wait to eat! (And I had to walk somewhere quick).

  1. How big are your BOLUSES?! If they are commensurate with your basal, a super bolus may not be a super idea to begin with.

I guess the best thing to ask is WHY are you super bolusing? This information will help me understand the situation better.

3

The purpose of a super bolus is to shift the timing of some of your usual insulin dose amounts so as to counteract the initial rise in blood glucose that follows eating. I have used the super bolus technique as a prebolus successfully.

Having said that, realize that insulin dosing can vary from person to person and even from time to time with the same person. When you try some of these advanced insulin dosing techniques, it’s best to do so without distractions and always with emergency glucose close at hand. If you don’t use a continuous glucose monitor, it’s smart, at least in the beginning, to do a few extra fingerstick readings so you can closely monitor the effect of the technique.

Are you confident that your basal rate of 0.2 units per hour holds your blood sugar level if you skip a meal? If that is an effective basal rate for you then it means you’re fairly insulin sensitive and adding say one hour’s worth of basal insulin, 0.2 units, to the bolus dose will be significant for you.

The best thing is to do the experiment and record your dose size and timing as well as what you eat, the food quantity, and food timing. A food scale is a very effective tool for helping to match insulin to food. Writing stuff down is highly recommended. I will often test the same meal over and over so I can gain confidence with a new technique.

Personal experimentation is a potent tool to help you learn how your glucose metabolism works. Otherwise you’re simply guessing. Good luck!

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4

You may just need to up your basal.

5

I haven’t fasted a meal for a really long time, but a few years ago I did a 24 hour fast, and my basals were never enough, I kept giving small boluses, though I wasn’t eating anything.
I’ll talk to my Endo about the basals. Thank you for all your advice.

6

Here’s another resource about formal basal testing that you may find helpful. It’s Gary Scheiner’s protocol.

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