Meals close together or snack in-between and bolusing again before fast acting insulin has run out

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mum2westiesGill

mum2westiesGill

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Relationship to Diabetes
Type 1
If you've ever had meals close together or a snack in-between and bolusing again before fast acting insulin has run out does this cause insulin stacking?
 
No, I was told stacking mainly applied to correction doses. Obviously you have to be aware of when you last ate and injected, but I frequently eat closer than 4/5hrs and have no issues.
 
Inka said:
No, I was told stacking mainly applied to correction doses. Obviously you have to be aware of when you last ate and injected, but I frequently eat closer than 4/5hrs and have no issues.
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This is what I've learnt too re it being correction doses. Can I ask you how much closer than 4/5 hours do you or have you tested, eaten, and done another injection?
 
I don't make allowances for insulin already in my body.
If I have 50g carbs now I'll inject 5 units.
If I decide to eat 50g carbs in 30 minutes time or an hour later or 6 hours later I'll still inject 5 units again.

Not sure if this is universally the same for others but I've never had a problem with that.

I never correct unless I've clearly under-dosed during experimenting with some new food. Can't recall the last time I corrected. It was probably weeks ago but my foggy brain may be wrong on that.
 
pm133 said:
I don't make allowances for insulin already in my body.
If I have 50g carbs now I'll inject 5 units.
If I decide to eat 50g carbs in 30 minutes time or an hour later or 6 hours later I'll still inject 5 units again.

Not sure if this is universally the same for others but I've never had a problem with that.

I never correct unless I've clearly under-dosed during experimenting with some new food. Can't recall the last time I corrected. It was probably weeks ago but my foggy brain may be wrong on that.
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What insulin to carb ratio are you on?
 
Does the MySugr app bolus calculator take into account the iob when you have a meal or snack whilst there is still active insulin in your system (and active carbs for that matter) as I believe Gill relies on the bolus calculator. So if for example she decided to have a piece of cake mid afternoon, perhaps 2 hours after lunch when the carbs from lunch might be at their peak but the insulin might be a little behind (particularly if she didn't prebolus) so a BG reading at the time of wanting the snack would perhaps be higher than the end result in 4-5 hours once the carbs and insulin have run their course. Would the bolus calculator ignore that a correction might appear to be needed because it knows there is still iob?
 
It should do - it seems to work almost identically to the Roche pumps which we had for 8 years (someone on here said that MySugr is owned by Roche now so fairly likely they have made it the same). I know on the pumps if you ate again within one hour it would not give another correction even if BG had gone up (therefore we didn’t bother to test again that soon, no point), if you ate again around 2 hours after the first bolus it would give half the calculated correction, after 4 hours it would give the full correction again. Or something like that!
 
rebrascora said:
Does the MySugr app bolus calculator take into account the iob when you have a meal or snack whilst there is still active insulin in your system (and active carbs for that matter) as I believe Gill relies on the bolus calculator. So if for example she decided to have a piece of cake mid afternoon, perhaps 2 hours after lunch when the carbs from lunch might be at their peak but the insulin might be a little behind (particularly if she didn't prebolus) so a BG reading at the time of wanting the snack would perhaps be higher than the end result in 4-5 hours once the carbs and insulin have run their course. Would the bolus calculator ignore that a correction might appear to be needed because it knows there is still iob?
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I think this was covered in one of Gills other threads, here.
Any insulin for which there are still carbs in the system is ignored, and only correction doses get shown as Active insulin.
 
Sally71 said:
If he’s injecting 5 units for 50g carbs then he must be on 1:10, it’s fairly standard to start people on that and then you change it from there if you think you need to.
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I thought it would be that ratio - I've seem to have been on that ratio for 30 years. I think it may have changed once but not for long before it went back to 1:10
 
Robin said:
I think this was covered in one of Gills other threads, here.
Any insulin for which there are still carbs in the system is ignored, and only correction doses get shown as Active insulin.
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Thanks for that @Robin.... but say her BG was 10.5 at the 2 hour after lunch scenario I suggested when she then wants some cake. If she enters that reading to get her bolus calculation for the cake, will the app suggest she has a correction with her cake bolus or is it capable of knowing that that reading will come down later with the insulin she bolused for lunch and only suggest enough to cover the cake?
For myself I don't rely on a bolus calculator so I would only bolus for the cake and in fact I would not eat carbs whilst my levels were above 8 although I would bolus for the cake and then wait until levels came down before eating but I know Gill is more reliant on the calculator and doesn't worry so much about her levels being high when she wants to eat.
 
rebrascora said:
Thanks for that @Robin.... but say her BG was 10.5 at the 2 hour after lunch scenario I suggested when she then wants some cake. If she enters that reading to get her bolus calculation for the cake, will the app suggest she has a correction with her cake bolus or is it capable of knowing that that reading will come down later with the insulin she bolused for lunch and only suggest enough to cover the cake?
For myself I don't rely on a bolus calculator so I would only bolus for the cake and in fact I would not eat carbs whilst my levels were above 8 although I would bolus for the cake and then wait until levels came down before eating but I know Gill is more reliant on the calculator and doesn't worry so much about her levels being high when she wants to eat.
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As I understand it, the App assumes that if you told it you had 40 carbs at lunch, and 4units of bolus, and your ratio is 1.10, that you will end up at the right level 4 hours later, even if your BG is 10.5 at the 2 hour point. So it will start from scratch working out the bolus for cake, as if your BG was on target. (The bit I'm not sure I get, is when it tells you you still have active insulin onboard if you did a correction dose with your last meal. I assume this is so you don’t stack correction doses, and it won’t add a correction dose to your bolus for your mid afternoon cake.)
 
rebrascora said:
Thanks for that @Robin.... but say her BG was 10.5 at the 2 hour after lunch scenario I suggested when she then wants some cake. If she enters that reading to get her bolus calculation for the cake, will the app suggest she has a correction with her cake bolus or is it capable of knowing that that reading will come down later with the insulin she bolused for lunch and only suggest enough to cover the cake?
For myself I don't rely on a bolus calculator so I would only bolus for the cake and in fact I would not eat carbs whilst my levels were above 8 although I would bolus for the cake and then wait until levels came down before eating but I know Gill is more reliant on the calculator and doesn't worry so much about her levels being high when she wants to eat.
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Yes it’s got meal rise settings in it the same as Combo pump, which means it knows that there will be some increase after eating food and won’t immediately suggest a correction just because your food insulin is still working. It only counts the correction part of the bolus as insulin on board, so won’t allow another correction if you’ve recently done one, and will assume that any insulin taken for carbs will be used by the carbs, but it does also know that you will go up a bit before the carb insulin has finished working.
 
This is 1 hour after my lunch today - please note the blood sugar and the carbs entered are just made up so I can show you how the bolus calculator works and I have deleted the entry.....

at my lunchtime today
Screenshot_20210707-152234_mySugr.jpg


Screenshot_20210707-152334_mySugr.jpg

Screenshot_20210707-152344_mySugr.jpg
 
pm133 said:
1:10
I think that's the same as you isn't it?
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Yes mine is 1:10 too and not been changed for as long as I can remember
 
Today my lunchtime bolus (no correction involved) was 14:13pm and my teatime bolus is going to be around 18:15pm - fingers crossed this will be ok
 
No reason why it shouldn’t be - we'd do the same without worrying about it! Enjoy yourself 🙂
 
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