Insulin users - when do you inject before a meal?

[Northerner]

...So while it helps the BGs, you need tonne careful to fit it in with everyday life.

Absolutely! My worst-ever hypo was when I injected and then promptly fell asleep. Woke up pouring with sweat, totally disorientated and went to lay down on the kitchen floor because I thought it would cool me down. Thankfully, something in me realised I had to do something about it and found some sugar 😱 I'm EXTRA careful now!

 

[bennyg70]

I have a practical example from today for me!!

BG 4.1 before lunch @ 11.45, Id normally inject now and eat @ say 12:10 - 12:15. 25 mins to 30 mins to get the insulin rolling.

Today I left injecting a little late by 5 mins so 11:50am, and I was that bloomin hungry I ate at 12pm. So 10 mins working time.

I tested @ 2 hours PP. 10mmol (The highest my readings have been in 6 days ). I thought Id leave correcting as I thought there was a unit or so knocking about in me somewhere. Incidently I did feel like my sugars were higher than they should be.

I started doing a bit of work - For a change. 15 mins passed, I thought to myself, I feel a little better. Tested - 7.5mmol.

Ok so there is metre inaccuracys etc to take into account but to me this suggests that the 15 - 20 minutes ive skipped has had a big effect on my PP and the overlap of working insulin and digestion?

 

[lauraw1983]

Hmm my DSN told me to do this when I was having terrible dawn phenomenon issues (which I still have, but not nearly as bad with levemir as it was with lantus) - to inject about 20-30 mins before my breakfast.

I always have to have some fast acting when I wake up and test, same time as I do my Levemir - I very rarely wake up in range and taking any more basal than I do results in hypos.

I need a pump

There is no practical way I can inject much before I eat a meal, I do it once I have sat down and actually have food in front of me. Or only once it it cooked do I weigh out my portion and carb count it accordingly. Diabetes is annoying enough without having to time bloody injections a certain amount before I eat.😡

If I can (say it's a ready meal that has the info on the packet) or I know the kids are in bed so I won't be disturbed before I try to eat, lol, then I might inject a bit before.

Quite a few people I know bolus AFTER they have eaten because they might not eat everything on their plate etc - how do you all deal with that kind of scenario?

Also our clinic and DSN's don't recommend post meal testing, apart from for pregnant women anyway.....

 

[Northerner]

...Also our clinic and DSN's don't recommend post meal testing, apart from for pregnant women anyway.....

I see no logic to that at all, if you can use the information to improve your control why not? 🙄

The thing is, I think a lot of non-Ds (which probably includes a large number of the HCPs we encounter) don't seem to realise that good control requires a certain degree of attention to detail - to them this is 'obsessive' because they don't get it, they just go off what they have read or the findings of some study that may bear no relation to the person in front of them.

 

[bennyg70]

I see no logic to that at all, if you can use the information to improve your control why not? 🙄

The thing is, I think a lot of non-Ds (which probably includes a large number of the HCPs we encounter) don't seem to realise that good control requires a certain degree of attention to detail - to them this is 'obsessive' because they don't get it, they just go off what they have read or the findings of some study that may bear no relation to the person in front of them.

Or they (HCP's) dont want to dish out so many test strips and save money?

 

[FM001]

Quite a few people I know bolus AFTER they have eaten because they might not eat everything on their plate etc - how do you all deal with that kind of scenario?

Hardly ever bolus afterwards and nearly always inject beforehand, by not putting too much food on the plate in the first place ensures that you don't leave any - that way the insulin should cover the food.

 

[Pumper_Sue]

There is no practical way I can inject much before I eat a meal, I do it once I have sat down and actually have food in front of me. Or only once it it cooked do I weigh out my portion and carb count it accordingly. Diabetes is annoying enough without having to time bloody injections a certain amount before I eat.😡

If I can (say it's a ready meal that has the info on the packet) or I know the kids are in bed so I won't be disturbed before I try to eat, lol, then I might inject a bit before.

Quite a few people I know bolus AFTER they have eaten because they might not eat everything on their plate etc - how do you all deal with that kind of scenario?

.....

I find it quite simple to bolus before the meal. I decide how many carbs I am going to eat for that meal and bolus accordingly.

As to not eating all on the plate simple solution is only put on the plate what you are going to eat.

If you are not going to bolus before you eat having a pump would not help you at all. Insulin needs to be used correctly to enable it to work. 🙂

 

[lauraw1983]

I find it quite simple to bolus before the meal. I decide how many carbs I am going to eat for that meal and bolus accordingly.

As to not eating all on the plate simple solution is only put on the plate what you are going to eat.

If you are not going to bolus before you eat having a pump would not help you at all. Insulin needs to be used correctly to enable it to work. 🙂

Don't be so rude & condescending. *I* DO bolus before meals, thanks. 🙄

I know a few people on pumps who bolus AFTER food as it was what they were told to do, so please, don't presume your way is the ONLY way. Not everyone's lives are the same and there are various factors to take into consideration about when to bolus for their meals, not just how "simple" it is for you - that's super for you. REAL LIFE however for many people isn't quite so simple.

A pump would actually help me a lot (nothing to do with the above reasons!), but thanks for your "advice".

 

[lauraw1983]

Or they (HCP's) dont want to dish out so many test strips and save money?

Yep I am not daft and realise this is probably a big part of why they "advise" that. Esp with the changes they brought in for driving too which meant more test strips for many people.

Because Alan, when it's affecting someones mental health too, something has to give, and while yes diabetes control is of course important - so is mental well being and while post meal spikes occasionally probably aren't great, I don't think in the grand scheme they are *THE* most awful thing - if BG is returning to normal between meals and those readings are in range, is it terrible?

I avoided loads of foods when diagnosed, because I had the fear about all the awful things I read about what it can do to levels....and I was getting spikes with certain things (breakfast cereals being one) but recently I have had the odd bowl of cereal if I want and I don't get the same spike, so I presume it was down to a variety of factors but mostly because my insulins weren't as spot on as they are now - still not perfect (haha...if only eh!) but I can deal with the small rise they give me - life cannot be about obsessing about everything to do with diabetes.

 

[Northerner]

...Because Alan, when it's affecting someones mental health too, something has to give, and while yes diabetes control is of course important - so is mental well being and while post meal spikes occasionally probably aren't great, I don't think in the grand scheme they are *THE* most awful thing - if BG is returning to normal between meals and those readings are in range, is it terrible?
...

Sorry Laura, you misunderstand me - I wasn't saying that there was anything wrong with an individual deciding not to test, but that it was wrong for an HCP to effectively make that decision for the person by restricting strips and not accepting that some people feel more in control when they do test. They need to discuss it with the patient and understand their own motivations rather than a blanket piece of advice. 🙂

 

[Pumper_Sue]

Don't be so rude & condescending. *I* DO bolus before meals, thanks. 🙄

I know a few people on pumps who bolus AFTER food as it was what they were told to do, so please, don't presume your way is the ONLY way. Not everyone's lives are the same and there are various factors to take into consideration about when to bolus for their meals, not just how "simple" it is for you - that's super for you. REAL LIFE however for many people isn't quite so simple.

A pump would actually help me a lot (nothing to do with the above reasons!), but thanks for your "advice".

Laura,
what was meant and as you well know was to bolus 15 - 20 mins before the meal. Not just before.
You may know people that bolus after, do you know what sort of a spike they get or whether they have diggestion issues as in slow emptying? If they don't have those problems I dread to think what their post meal spike is.

Since insulin first came in it has been bog standared to bolus 30 mins before you eat as it takes that long for it to start working. The analogues were claimed to be quicker but this has proved to not be right.
I was not being condescending in my comments or being rude to you either.
Even working on farms and equine studs or in shops no matter what I bolus 30 mins before I eat as I decide then how much in carb value I want to eat.
The majority of people do this as find control so much easier.

 

[trophywench]

Sue that just isn't true for all of us, I WOULD be hypo before I ate if I sent the Novo in that far in front. Porcine Lente and Humulin I, YES. But not Novorapid, for ME.

I don't know what's typical, and why does it matter anyway?

If you ask me it's a bit like a T2 asking 'How many carbs can I eat?' and everyone choruses 'Don't ask us - your meter's the only one that can tell you that' in response.


Y M M V.

 

[Pumper_Sue]

Sue that just isn't true for all of us, I WOULD be hypo before I ate if I sent the Novo in that far in front. Porcine Lente and Humulin I, YES. But not Novorapid, for ME.

I don't know what's typical, and why does it matter anyway?

If you ask me it's a bit like a T2 asking 'How many carbs can I eat?' and everyone choruses 'Don't ask us - your meter's the only one that can tell you that' in response.


Y M M V.

Jenny,
I wasn't saying everyone bolused 30 mins before a meal. Many do though but most bolus at least 15 mins before the meal.
I'm not puting it very well as very tired and brain dead.