WOULD THIS HAVE BEEN OK TO DO - ONE BOLUS FOLLOWED BY ANOTHER?

[mum2westiesGill]

14:19pm - 9.5 - 69g of carbs 7 units of humalog taken for lunch - a correction of 1 unit was advised but on my DSN 's advice of only doing corrections over 10mmol I ignored it. I was going to have an extra 26g of carbs at 14:35 and my bolus adviser would've advised an extra 2 units - I didn't have the extra carbs in the end but just wondered if would this have been ok to do?

 

[Ali11782]

Interested to see what everyone thinks.

 

[DaveB]

First, it's probably never worth injecting just 1 unit as a correction. You can follow one Bolus after another as long as one is a correction dose and one is for eating additional carbs (or both for different additional carbs). You need to avoid Stacking correction doses and risking a hypo. You need to allow a few hours for each insulin injection to do it's job.

 

[Sally71]

Yes we quite often do that, bolus for main course + correction and then a little while later bolus for pudding, because daughter hasn’t always decided what she wants for pudding! Just don’t do a correction dose the second time even if you’re higher, because the insulin from the first dose will still be working. (Your bolus adviser should know this and if you did the correction the first time then it won’t allow another one a short time later.)

We have always used pumps and just input the carbs into the bolus adviser on those, and it decides how much - pumps can do ridiculously tiny corrections so I don’t see the problem with only doing one unit for correction as long as you don’t do another one within a short time. However, I find if you can possibly do one bolus for everything rather than several small ones it seems to work better, not sure why, I think this is the issue with stacking that if you have several doses going round from different times the effects can sometimes be a bit unpredictable.

 

[Kaylz]

First, it's probably never worth injecting just 1 unit as a correction

Have to disagree with that, why do you think it isn't worth it?

 

[mum2westiesGill]

Yes we quite often do that, bolus for main course + correction and then a little while later bolus for pudding, because daughter hasn’t always decided what she wants for pudding! Just don’t do a correction dose the second time even if you’re higher, because the insulin from the first dose will still be working. (Your bolus adviser should know this and if you did the correction the first time then it won’t allow another one a short time later.)

We have always used pumps and just input the carbs into the bolus adviser on those, and it decides how much - pumps can do ridiculously tiny corrections so I don’t see the problem with only doing one unit for correction as long as you don’t do another one within a short time. However, I find if you can possibly do one bolus for everything rather than several small ones it seems to work better, not sure why, I think this is the issue with stacking that if you have several doses going round from different times the effects can sometimes be a bit unpredictable.

If the bolus for main course didn't need or include a correction would you still bolus for the pudding?
No way would I do 2 corrections one after another - I know it's corrections that shouldn't be less than 4 hours apart because of insulin stacking.
Like you say one bolus for everything is better than several or a couple one almost after the other - really why do 2 injections when you can just do 1?

 

[Robin]

First, it's probably never worth injecting just 1 unit as a correction

I’m with @Kaylz here. I quite often do. One unit drops me three mmol/L and I’d much rather spend the rest of the morning/afternoon/overnight in the 7s than over 10, if I know I’m not going to be eating soon, so can't tack a correction on to a mealtime bolus.

 

[mum2westiesGill]

Have to disagree with that, why do you think it isn't worth it?

I apologise for interrupting on this post but maybe it's because 1 unit is neither here or there - maybe I'm wrong

 

[Robin]

I apologise for interrupting on this post but maybe it's because 1 unit is neither here or there - maybe I'm wrong

I guess it depends on your correction factor. If 1 unit isn’t going to make much difference, then no it’s not worth it, but for me, as I said above, 1 unit drops me 3mml/L so definitely a discernible difference.
...And we should be apologising for hijacking your thread, not vice versa!

 

[Robin]

Like you say one bolus for everything is better than several or a couple one almost after the other - really why do 2 injections when you can just do 1?

I’d do one bolus if I knew pudding was going to come along quite soon, or it was under my control. If I didn’t know whether I’d have room for pudding, or if I thought someone might say.'shall we go and sit out in the garden for a while and finish our wine before pudding' I’d definitely just bolus for main course and see how it went later. Then if I did have pud, I'd bolus for it when I was sure it was going to arrive.

 

[mum2westiesGill]

I guess it depends on your correction factor. If 1 unit isn’t going to make much difference, then no it’s not worth it, but for me, as I said above, 1 unit drops me 3mml/L so definitely a discernible difference.
...And we should be apologising for hijacking your thread, not vice versa!

Mine is 1 unit to drop me by 2mmols which I've been on for agesss.
No need to apologise - we all try to help each other 🙂

 

[mum2westiesGill]

I’d do one bolus if I knew pudding was going to come along quite soon, or it was under my control. If I didn’t know whether I’d have room for pudding, or if I thought someone might say.'shall we go and sit out in the garden for a while and finish our wine before pudding' I’d definitely just bolus for main course and see how it went later. Then if I did have pud, I'd bolus for it when I was sure it was going to arrive.

In the past I used to always do that ie 2 separate boluses and I still do it sometimes if I'm not sure if I want seconds - MORE Oliver lol

 

[Deleted member 25429]

Have to disagree with that, why do you think it isn't worth it?

I agree with you kaylz I’d do a correction using one unit regularly do if I need it . It depends on your sensitivity, I only use about 15 units in total one unit is 10% of my lantus daily dose

 

[Sally71]

If the bolus for main course didn't need or include a correction would you still bolus for the pudding?
No way would I do 2 corrections one after another - I know it's corrections that shouldn't be less than 4 hours apart because of insulin stacking.
Like you say one bolus for everything is better than several or a couple one almost after the other - really why do 2 injections when you can just do 1?

Of course, because it’s extra carbs which weren’t included in the first bolus. If you don’t bolus for them you’re going to go high!

 

[Sally71]

I apologise for interrupting on this post but maybe it's because 1 unit is neither here or there - maybe I'm wrong

Pumps will do a correction of 1/4 unit or even less if they think you need it, a whole unit is quite a lot!

 

[mum2westiesGill]

Of course, because it’s extra carbs which weren’t included in the first bolus. If you don’t bolus for them you’re going to go high!

Thank you

 

[pm133]

Taking 1 unit of bolus as a correction absolutely will make a difference.
As with others, that single unit would drop me 2-3 mmol/L within about an hour.

 

[Bloden]

Have to disagree with that, why do you think it isn't worth it?

Me too. I never take a 2-unit correction dose. It’s a guaranteed ride on the BG roller coaster! 😱 I take 1 unit and wait...we’re all different.

 

[Inka]

Yes, I’d have that second bolus if I was eating more carbs 🙂 It’s no different between bolusing for your main meal then doing a separate bolus for your dessert.

 

[Lucyr]

I’d have the second bolus if eating more, and as with others if it was within 2 hours of the meal I would only bolus for the carbs not a correction, so wouldn’t bother to test again.

I also do a 1unit correction when needed, and I’m a T2 supposedly insulin resistant! 1u drops me between 2-4mmol depending on time of day so I do a 1u correction all the time when I’m in the 7-10 range to get me back to my 5-6 ideal level. I do half unit corrections too when needed!