Should I have taken the 2 units for the cake after eating lunch hour ago

[Katy83]

Good Afternoon all,

need some help, I've just taken 4 units for my lunch ate that and then somebody has given me a cake to eat so I've taken 2 more units was this the right thing to do?
Thanks

 

[Bruce Stephens]

need some help, I've just taken 4 units for my lunch ate that and then somebody has given me a cake to eat so I've taken 2 more units was this the right thing to do?

There's nothing wrong, in principle, in doing that kind of thing. (I can't say whether those numbers are correct or not.)

 

[Katy83]

Oh lovely the amount was right. It was just the fact that I had already take 4 for my lunch ate my lunch and then about an hour after took 2 units for the cake lol. Wanted to know that was the right thing to do as if I hadn't of taken the 2 for the cake then my bloods would of been sky high 🙂

 

[helli]

There is a fear of insulin stacking if we take a second dose whilst we still have insulin on board (typically, within 4 hours of bolusing). However, if we eat carbs within this time, there is no problem with doing a second bolus as you have done.
Typically, when I bolus, I include a correction if too high, if I am bolusing for extra food within the 4 hours, I do not include correction.

 

[trophywench]

Correct, when adding a jab for extra carbs the amount is only for those carbs and nothing else.

 

[Pumper_Sue]

Yes you did right. 🙂

 

[pm133]

Yeah, I'm not sure I understand the concept of bolus stacking.
As far as I'm concerned, if I eat say 50g carbs and my ratios are 1:10 then I either take 5 units if I'm eating it all in one sitting or if I'm eating 30g now and then 20g, 2 hours later, I'm going to take 3 units now and 2 units in 2 hours time. The total insulin is still the same.

I wonder if the issue is with people over-dosing on insulin but I'm really not sure how you can stack otherwise. Open to advice on that.

 

[pm133]

There is a fear of insulin stacking if we take a second dose whilst we still have insulin on board (typically, within 4 hours of bolusing). However, if we eat carbs within this time, there is no problem with doing a second bolus as you have done.
Typically, when I bolus, I include a correction if too high, if I am bolusing for extra food within the 4 hours, I do not include correction.

This describes me perfectly as well. That is exactly the process I go through including the corrections you talk about if my pre-meal is a bit higher than I'd want.

 

[Inka]

Yeah, I'm not sure I understand the concept of bolus stacking.
As far as I'm concerned, if I eat say 50g carbs and my ratios are 1:10 then I either take 5 units if I'm eating it all in one sitting or if I'm eating 30g now and then 20g, 2 hours later, I'm going to take 3 units now and 2 units in 2 hours time. The total insulin is still the same.

I wonder if the issue is with people over-dosing on insulin but I'm really not sure how you can stack otherwise. Open to advice on that.

I only think about stacking in connection with corrections. Your example above perfectly illustrates why it can be daft to think about it for boluses. My consultant confirmed that was the case because I asked her one day when I was paranoid I was missing something. She said the concern about stacking was mainly for corrections when people hadn’t left long enough for the first correction to work, then whacked in another and had a hypo.

 

[pm133]

I only think about stacking in connection with corrections. Your example above perfectly illustrates why it can be daft to think about it for boluses. My consultant confirmed that was the case because I asked her one day when I was paranoid I was missing something. She said the concern about stacking was mainly for corrections when people hadn’t left long enough for the first correction to work, then whacked in another and had a hypo.

Ah right. That makes sense. I avoid that by almost never correcting within 4 hours of a previous bolus unless I know I've under-dosed deliberately.

 

[everydayupsanddowns]

I think you were wise to add extra insulin for the cake, but it is certainly worth keeping an extra-close eye on your BGs when you add insulin on top of insulin that may already be acting at it’s peak.

Sometimes I think of insulin action being more about ’pull’ to the ‘push’ of carbs, rather than a sort of maths/formula. And if 2 doses pull together, you can end up with more movement against the carbs which are digesting on their own timelines.

Not sure if that makes any sense... but I have had both successes and some unusual/unpredictable results with food boluses in quick succession (and carbs on board)

 

[nonethewiser]

Good Afternoon all,

need some help, I've just taken 4 units for my lunch ate that and then somebody has given me a cake to eat so I've taken 2 more units was this the right thing to do?
Thanks

Just like being out in restaurant & having 3 course meal, time delay between courses & not being able to eyeball food before it arrives means bolusing upfront is tricky, so dose for each course best option.

 

[trophywench]

Much hilarity with BG and dosages at times when diving into a place on Ladypool Road Brum several decades ago for a curry, where you were welcome to just wander into the kitchen and watch em slapping the naans onto the inside of the tandoor situated on its gasring on the floor with no apparent heed to hygiene ........ didn't request rice with it in those days, cos it'd be quite likely to still have grit in it ...... and the naans were round and the size of dustbin lids. Free poppadoms with onion and tomato followed by Aloo gobi, veg curry, tandoori chicken, lamb mince curry, okra - if the curry was a bit too hot, just lob some mango chutney in. Had to request plates and forks, but you did always get a pile of paper napkins!

 

[SB2015]

Yeah, I'm not sure I understand the concept of bolus stacking.
As far as I'm concerned, if I eat say 50g carbs and my ratios are 1:10 then I either take 5 units if I'm eating it all in one sitting or if I'm eating 30g now and then 20g, 2 hours later, I'm going to take 3 units now and 2 units in 2 hours time. The total insulin is still the same.

I wonder if the issue is with people over-dosing on insulin but I'm really not sure how you can stack otherwise. Open to advice on that.

The stacking arises where people add to their meal bolus with a correction dose to counter a raised BG.
If within four hours there will still be some insulin acting in earlier carbs.

Some test kits and all pumps have a ‘bolus wizard’ or equivalent, which takes account of this when working out a bolus in response to info given about the carbs to be eaten. This is sometimes called Insulin on board, or active insulin.

As you say you dose according to your carbs without making adjustments so you will not be stacking your doses.

I hope that that makes sense.

 

[mum2westiesGill]

Just like being out in restaurant & having 3 course meal, time delay between courses & not being able to eyeball food before it arrives means bolusing upfront is tricky, so dose for each course best option.

Firstly myself I never bolus upfront because I did that a few weeks ago and ended up hypo.
Dosing for each course if it was a 2 course meal and doing a bolus for the starter then another bolus not too long after for the main course but is it ok to do a third bolus?

 

[Bruce Stephens]

Dosing for each course if it was a 2 course meal and doing a bolus for the starter then another bolus not too long after for the main course but is it ok to do a third bolus?

Sure. Why wouldn't it be? You need to use enough insulin to cover what you eat. If doing that in 3 doses is convenient then do that.

 

[Inka]

Yes, it’s ok @mum2westiesGill Youre taking the same amount of insulin overall. It makes no difference to the amount of you take it all at once, split it into 3 - or split it into 5 or more.