The pre-bolus times are a-changing

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everydayupsanddowns

everydayupsanddowns

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I can’t deny it any more.

I have been pre bolusing for lunch and breakfast for a long time. In the old days it needed to be 45-60 minutes. Then 30 minutes was about right. More recently it is shortening again. I tried 20 minutes for breakfast this morning and (coincidentally) ate just at the point my Dex said BG was beginning to drop. But 10 minutes after finishing a hot cross bun (I know!!) and my levels are still lower than I’d like. Or at least expect.

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Part of my problem is Dex’s lag. At least 10 mins behind. And also the stubborn way it sometimes carries on with the direction it thinks must be happening (overshooting in either direction).

Both of which make it difficult to unpick what is actually happening, and whether I ever did drop below the line (10 mins before I cross-checked).

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The really annoying thing, is that if I don’t prebolus I get a much bigger rise.

I’ll try dropping to 10 minutes or maybe 15, and see if I can find the new sweet spot.

</grump>
 
My pre-bolus times have shortened too @everydayupsanddowns I hate to say the ‘A word’ but I do wonder if it’s connected to getting older in some way. I put mine down to the madness of the perimenopause but it might just be the way things go as you age.
 
Could be @Inka

Bit frustrating to develop a strategy to solve a problem, only for it to cause a problem, but if you don’t do it you still have the initial problem!

I’m sure it won’t take long to find the new timing, but it still feels like an unnecessary faff!
 
I think it might be of comfort to @gillrogers to know that someone else is experiencing a similar problem to herself as she has posted about this quite a bit recently and been concerned about now having to bolus after a meal instead of before.
 
I find that my settings when used for B/fast and Lunch they keep me within the 4 to 10 settings which I am ok with. The only time I go a little over 10 is when I take an evening meal which is either cooked from fresh at home or we are out for a meal. I am normally back within my 4 to 10 target within 1 hour or less after the food. This meal is more difficult to judge the carbs for me but as I am 70% or higher in range weekly my medical team are happy.
I expect my control to get even better now that I have moved onto a G6 + Omnipod 5 combo.
I normally do my meal calcs just prior to or immediately after my meal, particularly if I'm eating out to ensure I have food.
 
I see a distinct lag with Dex G7 also. I have wondered if that is because it is only sampling at 5 min intervals before displaying, whereas when I had Libre 2 it was sampling every minute but only displaying every 5 mins. I don't know if Dexcom G6/7 are physically sampling every minute and giving an average or just 5 min readings.

Much of the time the lag from G7 is both not really noticeable and minimal. I do get terrific correlation much of the time. But recently my G7 sensors have needed extra calibration to get them "in line". This has meant a lot more fps and demonstrated the lag more. When the lag is small and the accuracy high I can go several days without any fps therefore my perception is that its all fine all of the time. So when I'm forced to compare interstitial with fps the difference is bursting my bubble of complacency - a bit!

My recent loss of G7 correlation has coincided with my now necessary blood thinners since my TIA. So there is some sort of change happening: perhaps the daily Clopidogrel, perhaps just a more general response to the (mild) trauma from the TIA, perhaps my slight change in diet to avoid excess Potassium, or perhaps I've been less energetic as advised to do for a while after the TIA. Unlikely to be just Age or time spent with D (still only 4 yrs into this). I am showing bruising around each injection site and have yesterday agreed to reduce my Clopidogrel. Generally too many clues so difficult to pin this down at present.
 
Use fiasp in pump & find 15min prebolus is sufficient for most meals.

Tbh find it astonishing when members say they prebolus 45-60mins ahead, would have to have seriously high bg levels to do that otherwise I'd be on floor.
 
As a humble T2, once again I take my hat off to you T1s who have it so much harder than my bog standard low carb strategy 😉 You are all an inspiriation x
 
everydayupsanddowns said:
I can’t deny it any more.

I have been pre bolusing for lunch and breakfast for a long time. In the old days it needed to be 45-60 minutes. Then 30 minutes was about right. More recently it is shortening again. I tried 20 minutes for breakfast this morning and (coincidentally) ate just at the point my Dex said BG was beginning to drop. But 10 minutes after finishing a hot cross bun (I know!!) and my levels are still lower than I’d like. Or at least expect.

View attachment 29811
View attachment 29812

Part of my problem is Dex’s lag. At least 10 mins behind. And also the stubborn way it sometimes carries on with the direction it thinks must be happening (overshooting in either direction).

Both of which make it difficult to unpick what is actually happening, and whether I ever did drop below the line (10 mins before I cross-checked).

View attachment 29813
View attachment 29814

The really annoying thing, is that if I don’t prebolus I get a much bigger rise.

I’ll try dropping to 10 minutes or maybe 15, and see if I can find the new sweet spot.

</grump>
Click to expand...
Was the Hot Cross Bun your breakfast or just a mid morning treat , as you know I do bake a lot but have got some shop bought Hot Cross Buns as I fancied them, seduced by the smell in the shop , gotta be worth the extra insulin.
 
Martin62 said:
Was the Hot Cross Bun your breakfast or just a mid morning treat , as you know I do bake a lot but have got some shop bought Hot Cross Buns as I fancied them, seduced by the smell in the shop , gotta be worth the extra insulin.
Click to expand...

It was my breakfast! I got some in for the weekend).

Another experiment tomorrow!
 
Inka said:
You and many other Type 2s here are an inspiration too @Vonny xx
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Hear hear! It was a real Learning curve for me when I first joined forums to read experiences of people who only had their menu to rely on to manage their BG levels. Having injectable insulin sometimes feels like cheating!
 
My timingscare on the way back up again. Mind you thnk its cos ive got a bit of a virus or something's at the mo. Basal s going up every other day at the mo. Friends around me have had colds and what ever it is is mild but just annoying. Tickly throat and the odd sneezes and keep catching my breath with a little annoying repetative cough. Anyways DBNs want my to try novorapid in case its something to do with the humalog itself. But not bothering just yet ad im on the way back up and ive finally got my appointment time n a weeks time with my consultant at last!!
 
gillrogers said:
My timingscare on the way back up again. Mind you thnk its cos ive got a bit of a virus or something's at the mo. Basal s going up every other day at the mo. Friends around me have had colds and what ever it is is mild but just annoying. Tickly throat and the odd sneezes and keep catching my breath with a little annoying repetative cough. Anyways DBNs want my to try novorapid in case its something to do with the humalog itself. But not bothering just yet ad im on the way back up and ive finally got my appointment time n a weeks time with my consultant at last!!
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Morning good luck Gill with your efforts and as others have said it is a very individual thing and is as much art as science.
So yes you can use general principles insulin but constantly need to fine tune to best manage your timing of insulin and of course the situation is in a constant state of flux.
I know I have only being diagnosed 9 months so still very early in my journey and yet to get challenged by it over a long period of time.
However I try and stay in control even if I get it wrong rather than it controlling me and what I mean by that is I set the agenda as best I can.
So I have a general pre meal bolus and ideally 10-15 minutes but it can vary depending on prep time,BGlevels etc so I can end up taking it just before meal or even after meal or split and it seems to work fine for me.
I do get these decisions wrong so try and take corrective action like a walk but that is not always possible and I tend to react to situations.
However it causes me no stress whatsoever and I find it does not cause me any issues and in fact my stress levels are very low and I see my diabetes more of an inconvenience rather than anything more challenging.
I do appreciate that I readily accept health challenges as just being part of my life am lucky in that I can cope with events as they occur but just reinforces in my own mind that it is a very individual condition which governs our responses and the only constant is it’s challenges and the support you get on this forum.
 
gillrogers said:
My timingscare on the way back up again. Mind you thnk its cos ive got a bit of a virus or something's at the mo. Basal s going up every other day at the mo. Friends around me have had colds and what ever it is is mild but just annoying. Tickly throat and the odd sneezes and keep catching my breath with a little annoying repetative cough. Anyways DBNs want my to try novorapid in case its something to do with the humalog itself. But not bothering just yet ad im on the way back up and ive finally got my appointment time n a weeks time with my consultant at last!!
Click to expand...

Get well soon @gillrogers

And hope your doses and BGs settle into a new normal for a while.
 
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