Injecting after eating and MySugr bolus advisor

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mum2westiesGill

mum2westiesGill

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Relationship to Diabetes
Type 1
If you wanted to inject after eating and use the mysugr app bolus advisor would you test before and after eating and which test would you take the bolus advice from?

Asking this re eating out and courses being slightly delayed
 
Inka said:
I’d take it from the before meal test.
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Thanks @Inka so you would test before the meal then add carbs amount after you've eaten and take this bolus advice?
 
I don’t use a bolus adviser so I’m not totally sure how they work, but I’d test before eating and use that number for the bolus advisor, adding the food carbs as usual. The only difference would be that I’d take the recommended bolus after the meal instead of before.
 
I’d test before I go and use that for any correction needed, then I wouldn’t test at the meal unless I felt low, I’d just bolus for the carbs.
 
On Friday when eating out

1 - tested before meal and entered bgl level on MySugr app
2 - ate meal
3 - straight after meal went back to test entry on MySugr app
4 - entered carbs once I knew how many carbs I'd roughly eaten (think I over estimated carb amount because I was hypo at bedtime but that's eating out for you grrr)
But the app won't let you enter carbs or get bolus advice if it's longer than 15 minutes - so at this point I had to re enter the bgl level from before eating to be able to put carbs in and get bolus advice

Any advice is welcome 🙂
 
I’d take the reading from before you ate. The problem with bolusing after you eat is that food usually works much faster than insulin does, and some of the carbs will have started to get through to your bloodstream before you’ve finished eating. So if you test afterwards, you will probably be higher than before you started. If you put that number into the bolus wizard with your carbs, it will say “oh you are high, need to add some insulin on to bring you down again”, but the reason you are high is because of some of the carbs which you have just entered into the bolus wizard, so you are giving yourself two lots of insulin for the same carbs and will probably go hypo. If that makes sense!
 
When you tested and entered blood sugar you could have worked out the correction dose then. When you enter the carbs seperately you don’t need to enter a blood sugar you can just calculate the dose for the carbs. Then add them together when you’re injecting.

But for eating out, personally I’d just correct earlier on before I go so that i start the meal with a good blood sugar and to make it easier once there, no one wants to spend much time sorting diabetes and using apps etc whilst enjoying a meal out.
 
Sally71 said:
I’d take the reading from before you ate. The problem with bolusing after you eat is that food usually works much faster than insulin does, and some of the carbs will have started to get through to your bloodstream before you’ve finished eating. So if you test afterwards, you will probably be higher than before you started. If you put that number into the bolus wizard with your carbs, it will say “oh you are high, need to add some insulin on to bring you down again”, but the reason you are high is because of some of the carbs which you have just entered into the bolus wizard, so you are giving yourself two lots of insulin for the same carbs and will probably go hypo. If that makes sense!
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So definitely use the reading from before I eat and enter the carbs and get bolus advice after I've eaten - with there being 15 minutes for when you can enter carbs for bolus advice after I've eaten I would have to re enter the reading from before I've eaten
 
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Yes, I wouldn’t bother to retest after eating because that doesn’t tell you anything useful. All it tells you is that you’ve gone up a bit which you know anyway. How about if you wait until the food arrives in front of you and then test and enter the carbs just before you start eating? Or are you not sure how much of the meal you will be able to eat and that’s why you don’t bolus until afterwards?

Or you could do what @Lucyr suggested. Test before eating and get the bolus adviser to tell you how much (if any) correction you need (don’t enter any carbs and don’t inject yet). Then after you’ve eaten enter the carbs only with no BG value and get the amount of insulin you need for the carbs only, and add on the correction amount that it gave you earlier when you inject.
 
Sally71 said:
Yes, I wouldn’t bother to retest after eating because that doesn’t tell you anything useful. All it tells you is that you’ve gone up a bit which you know anyway. How about if you wait until the food arrives in front of you and then test and enter the carbs just before you start eating? Or are you not sure how much of the meal you will be able to eat and that’s why you don’t bolus until afterwards?

Or you could do what @Lucyr suggested. Test before eating and get the bolus adviser to tell you how much (if any) correction you need (don’t enter any carbs and don’t inject yet). Then after you’ve eaten enter the carbs only with no BG value and get the amount of insulin you need for the carbs only, and add on the correction amount that it gave you earlier when you inject.
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@Sally71 thank you so much for your reply and late at night too - you're a star!
Like you say retesting after eating would just tell me that my bgl is higher. You've got it 100% correct when you ask if I'm not sure how much of the meal I will be able to eat which is why 8 times out of 10 when I'm out (or even with a takeaway at home) I don't like bolusing until after the meal.

That sounds perfect what @Lucyr suggested 🙂
- test before eating and get the MySugr bolus adviser to tell me how much (if any) correction is needed (don't enter any carbs and don't inject)
- (immediately) after eating (do a separate entry) enter the carbs only with no BGL value and get the amount of insulin I need for carbs only, add on the correction amount (if any) which it gave me earlier from the test before eating - then I'm ready to inject at this point 🙂🙂
 
That sounds like a good plan! Glad to have helped a bit 🙂

That’s the thing with diabetes, there are many ways you could deal with it, everyone does it slightly differently and there are no single right and wrong answers. Some people prefer to do all the sums themselves and don’t trust bolus advisers, others find it easier to have a piece of technology to help them. Some people are quite happy on injections and others prefer pumps (and there are many pros and cons for both). Some people test many times a day, others only a few, how many you do depends on what you are doing with the information, if you are testing just because you think you should but don’t really understand why then it’s a waste of time. But if you find the information helpful, then great. You have to find a system that works for you, that you can cope with and isn’t a massive nuisance all the time but also which hopefully keeps your blood sugars under good control most of the time (everybody has bad days sometimes!). Then forget about what everyone else does and just carry on with what works for you!
 
Sally71 said:
That sounds like a good plan! Glad to have helped a bit 🙂

That’s the thing with diabetes, there are many ways you could deal with it, everyone does it slightly differently and there are no single right and wrong answers. Some people prefer to do all the sums themselves and don’t trust bolus advisers, others find it easier to have a piece of technology to help them. Some people are quite happy on injections and others prefer pumps (and there are many pros and cons for both). Some people test many times a day, others only a few, how many you do depends on what you are doing with the information, if you are testing just because you think you should but don’t really understand why then it’s a waste of time. But if you find the information helpful, then great. You have to find a system that works for you, that you can cope with and isn’t a massive nuisance all the time but also which hopefully keeps your blood sugars under good control most of the time (everybody has bad days sometimes!). Then forget about what everyone else does and just carry on with what works for you!
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Thank you!
You've helped 100% not just a bit! You've written it all down in very easy step by step steps so once again thank you! For me at last I've got there.

Like you say everyone does things slightly differently.
I 100% agree with everything you've said here.

What a brilliant Mum your daughter has - you've gained a second daughter lol.

Re eating out to help with the carb amounts I've got the carbs and cals app but now I've also got the NutraCheck app which has a brilliant eating out section.
 
Actually I’ve just had another thought. I’ve never used MySugr, is it on your phone? Not connected to your BG meter at all? In which case would it not be easier to do the following:

Before you eat, do a test, make a note of the number, but don’t enter it into the app
After you eat, enter that BG number into the app along with carbs, and it will give you total bolus of carbs + any correction all at once, then you inject.

I’ve only ever used the bolus wizards on pumps, and in the case of the Roche ones (who now own MySugr i believe, so I understand how their calculations work) the test meter was part of the pump and would do all the calculations and transmit that information directly to the pump, so the only way to get a BG reading in was by doing an actual test. But it sounds like you can enter any BG value separately which makes it easier.

Anyway, do whichever you prefer - glad to be of service 🙂
 
Sally71 said:
Actually I’ve just had another thought. I’ve never used MySugr, is it on your phone? Not connected to your BG meter at all? In which case would it not be easier to do the following:

Before you eat, do a test, make a note of the number, but don’t enter it into the app
After you eat, enter that BG number into the app along with carbs, and it will give you total bolus of carbs + any correction all at once, then you inject.

I’ve only ever used the bolus wizards on pumps, and in the case of the Roche ones (who now own MySugr i believe, so I understand how their calculations work) the test meter was part of the pump and would do all the calculations and transmit that information directly to the pump, so the only way to get a BG reading in was by doing an actual test. But it sounds like you can enter any BG value separately which makes it easier.

Anyway, do whichever you prefer - glad to be of service 🙂
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Hi @Sally71 I'm sorry I had to disappear but I had to get off to work. Thank you for sharing another great thought. Yes MySugr is an app on my phone - it's what Accu-chek / Roche now use as their bolus advisor for their current test meters. It's not connected to my BGL meter.

My BGL test meter is the Accu-chek Mobile meter. It has a bluetooth wireless adapter (depending on if you want one) which can be plugged into the side of the meter to then transmit data (ie BGL test results) to the MySugr App - if you choose not to have the bluetooth adapter then you just add data to the MySugr App manually. So yes you can enter any BGL value separately.

Your thought would be another great way to get round bolusing after eating when I'm eating out so
- test on meter before eating, no need to make a note of the bgl number because the bgl number will go onto the meter when I test
- after eating check meter for bgl number
- go onto the app and enter bgl number along with carbs, this will give me total bolus of carbs + any correction all at once, then I'm ready to inject.

I'm thinking maybe the way @Lucyr suggested might be slightly quicker because I would only need to get my bgl meter out once for testing before I eat - please when you have chance have a read of both ways and see what you think
 
Either way works, so do whichever you find easiest!
 
Sally71 said:
Either way works, so do whichever you find easiest!
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Hi @Sally71 I did your way last night but not eating out instead it was like a trial run at home when we had our bbq for tea - carb count was right but at bedtime I was hypo so I'm thinking maybe a bit less insulin is needed - what do you think?
 
Yes probably - you’ll have to do some experimenting though to find out whether it’s your carb ratio or correction ratio which is wrong. It could also be one of those one-off weird incidents - never start changing your doses just because you’ve had one hypo, wait until you’ve had about 3 in similar circumstances and can see a pattern forming. So you need to ask yourself:

Do you always go hypo at the same time every day, or only after you’ve eaten?
Do you always eat at the same time in the evening?
If I you eat at different times, do you always go low afterwards?
Do you always have to add a correction amount on or do you sometimes only need to bolus for the carbs? Do you still go low if you only bolus for the carbs?

Then you can start to work out which bit might need tweaking. I see you use 1:10 carb ratio for everything, it’s quite possible that you may need a different ratio in the evening, people tend to be more insulin resistant in the morning and less in the evening so that’s one possible reason.
 
Sally71 said:
Yes probably - you’ll have to do some experimenting though to find out whether it’s your carb ratio or correction ratio which is wrong. It could also be one of those one-off weird incidents - never start changing your doses just because you’ve had one hypo, wait until you’ve had about 3 in similar circumstances and can see a pattern forming. So you need to ask yourself:

Do you always go hypo at the same time every day, or only after you’ve eaten?
Do you always eat at the same time in the evening?
If I you eat at different times, do you always go low afterwards?
Do you always have to add a correction amount on or do you sometimes only need to bolus for the carbs? Do you still go low if you only bolus for the carbs?

Then you can start to work out which bit might need tweaking. I see you use 1:10 carb ratio for everything, it’s quite possible that you may need a different ratio in the evening, people tend to be more insulin resistant in the morning and less in the evening so that’s one possible reason.
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No I don't always go hypo at the same time every day.
Evening meals are varied.
When eating at different times I don't always go low.
I mostly only bolus for carbs.
BGLs are always erratic
 
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