What about insulin stacking? do you eat/bolus between meals?

just wondering about how bolusing works when you have IOB before your next meal and you decide to have, say, a 15 -30gm snack. i know that most pumps have a “wizard-like” feature, which should, in theory, account for your IOB and how this will effect your next meal/bolus. but isn’t there worry about hypos from having too much IOB from the later bolus, unless you wait for the snack bolus to finish doing its job?

i have avoided snacking between meals out of fear that i will screw up my BGs. that i will either go high or low. that after i have had that afternoon snack, when i check my BGs (again) before pre-bolusing for my next meal, my BG # is a reflection on the snack’s bolus, and not a “true” BG.

can anyone explain how this works? it seems ridiculous to have to wait four to five hours between meals, especially when you get hungry.

Unless you’re already low or trending low, your IOB has zero impact on the insulin required to cover additional carbs…

Stacking really refers to correcting for a high BG before the prior correction has a chance to finish working…that is really where IOB makes a difference.


thank you sarah28. now i think i will have my warm milk before bedtime. (i was worried that i would go low in the middle of the night if i bloused before bed)

I typically just do what the Wizard says to do. If I want an apple after lunch / before supper, I just punch in the numbers and do the suggested bolus.Yeah “stacking” is where you obsessively correct to bring down a stubborn high. I have finally learned after 21 years to take the “shot” and walk away.

do you end up w/ low BGs when you bolus between meals? do you end up doing any correction boluses or G Tabs to treat either highs or lows? or does everything work out just right for you?

It usually stays level but I can kinda “feel” the insulin working inside me as opposed to my typical fasting routine where I just live off the basal rates .

I regularly stack corrections. I do this in the context of not only looking at my CGM line but also factoring in IOB, the trend 24 hours before, recent and expected near future exercise, snacks, and plain old gut instinct. I’ve been watching my BG lines for so long that my decisions to stack are part of stew of factors that I cannot quantify. It’s the art of managing BGs.

My endo (years ago) had recommended stacking when eating high carb / fat meals such as restaurant style hamburgers (granted this was MDI) He would have me split my humalog dose 1 to 2 hours apart to cover the meal. I did it occasionally, but I’d have to say it was hard to understand with a short 15 minute appointment a few times a year.

but doesn’t your pump’s Wizard feature account for the IOB when making the suggested correction?

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