Does anyone do a pre-bolus of ~ 1h 30m?

[declan88]

In response Jonty

2 - ... asingle slice of Burgen toast for breakfast... 6 units of novorapid to 'cover' it. 5 units lunch...5x the amount of carbs,
3 units evening meal 40-60g carbs.
My
pre-bolus time also reduces, usually about 30 mins prior for lunch and immediately before evening meal.

Like you, I stopped needing basal insulin 4 years ago. I'm 57. 🙂

Body temperature
Lowest in the night
Probably hottest early evening

Ever noticed when u go on hols to a sunny clime the hypos come...

 

[declan88]

Re ... "The reason you are having to wait all that time before you eat is because your pred kicks in at lunch time hence needing all that insulin and the waiting game."

So what about all the other people who have told me, in the FB group & also in this thread, that they also find their bolus doesn't kick in until ~ 1hr or more? They are NOT on prednisolone as far as I'm aware. Here are some examples ....

- "I have to wait at least one hour after bolus, to eat. It's so frustrating, I'm 61years old"
- "I was dx at 42 with T1 and 24 years later I'm seeing the same pattern. Sometimes I have to wait an hour to eat to avoid spikes, which is often difficult"
- "My son is 12. Had t1 for 2 years. We see the same thing. Sometimes and hour b4 he starts to drop"
- "I have the same problem! I need to bolus about an hour before meals. it takes that long for the insulin to start working, I watch it on my dex. It doesn't take "5-15" minutes like it supposedly supposed to. If I take it then eat soon I will absolutely get a horrible spike. Sometimes I can get away with 30 min for lunch and dinner but breakfast is 60+ minutes. I take apidra and tresiba. No pump."
- "I need to wait far longer at breakfast/lunch 30-60 minutes - and if I apply the same wait at evening meal time I would fall hypo before taking a mouthful."

So it appears that many others suffer from similar delayed action bolus, particularly at breakfast.

This morning I've done a 2h pre-bolus and plan to take my steroids after lunch when breakfast bolus should all be used up ... we will see. Thank you all for your inputs .. very interesting.

Injected drugs' effectiveness is a composite of absorption, activation, alteration, breakdown and excretion.

A publication on the activity of humalog (lispro) used for glucose metabolism as a proxy for activiation only so results gave be rake with a pinch of salt.

https://www.aafp.org/afp/1998/0115/afp19980115p279-f1.gif

As I can work out humalog activity at:
15 mins post injection (pi) starts to work
15-60 mins pi increases steeply in actively to 80% full activity
90 mins pi had reached full activity
4 hrs pi has dropped to 10% max activity
6hrs45mins pi has no activity

 

[mikeyB]

I made a comment on another thread about every type 1 being different, especially with comorbities. Lovely demonstration gang, thanks for proving the point

I very rarely eat breakfast unless I’ve paid for it, but I have to bolus 1 hour before lunch to avoid spikes, and approximately mid meal in the evening. The difference is explained thus: I’m on Humalog, which takes its time to reach a peak in me, hence the lunch timing. The evening timing is entirely due to the fact that my neurological symptoms are much worse in the evening. Everything slows down, including gastric emptying, so if I pre bolus the meal, I go hypo either during or shortly after eating, then watch a spike building an hour or so later. Hence the bolus at the end of the meal.

It usually works, sometimes doesn’t. I occasionally get the meal spike three hours after eating. That’s a bit of a sod, but as you will see on the waking BG thread, I usually get there in the end. It’s the Libre that tells the story of how I get there. I take my Humalog pen to bed.😎