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You probably know this.........

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t1robin

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Type 1
........but I didn't. I've been struggling with BG highs after breakfast. If I took more insulin to combat the high I ended up with a massive hypo late morning. At my last check up I was advised to take the morning Novorapid 20 to 30 minutes before breakfast.

Magic! It worked! No high and I've been able to reduce the dosage so that I don't get a pre-lunch hypo. I carb count so I don't know exactly how much insulin I need until I weigh the food. I therefore take 4 units on rising and then top up when I've done the calculations.

I still need to do a little refinement to account for the mornings planned activities but my graphs are looking so much better.

As I said you probably all know this but I thought I'd mention it just in case.

Robin
 
t1robin said:
........but I didn't. I've been struggling with BG highs after breakfast. If I took more insulin to combat the high I ended up with a massive hypo late morning. At my last check up I was advised to take the morning Novorapid 20 to 30 minutes before breakfast.

Magic! It worked! No high and I've been able to reduce the dosage so that I don't get a pre-lunch hypo. I carb count so I don't know exactly how much insulin I need until I weigh the food. I therefore take 4 units on rising and then top up when I've done the calculations.

I still need to do a little refinement to account for the mornings planned activities but my graphs are looking so much better.

As I said you probably all know this but I thought I'd mention it just in case.

Robin
Click to expand...
Well I do know this....but only because a few years ago someone on this forum told me! It never cropped up in any face to face advice I'd ever had. So a very useful thing to post, keep handing down the info to the 'next generation'!
 
Yep, bolusing in advance is a fantastic tool. You’ll find it will probably be different times in advance for each meal (ie lunch, etc) It can make a big difference. I hope it’s helped you 🙂
 
t1robin said:
As I said you probably all know this but I thought I'd mention it just in case.
Click to expand...
Yes, it's fairly well known. The idea of using a bit early in the morning is also pretty common (because of hormones released early in the mornings).

This should really be taught. It was in the structured education I took a couple of years ago (the local variant of DAFNE). (Which I got several decades after the recommended ~6 months after diagnosis, but then this kind of education (and management strategies, and insulin formulations) wasn't around back then.)
 
Some years ago I mentioned pre-bolussing to my pump consultant. He actively discouraged it... fortunately I have learned to ignore him because he is so old fashioned. I hadn't spoken to him for 2 years but, oh my goodness, he gave me his "permission" to adjust the basal on my pump. If I was to wait to ask him for 2 years where would I be? He also prefers to use Hba1c to judge my control as opposed to "time in target" figures on my Libre, even if it was his DSN who prescribed the Libre. So no... I'm not surprised you've never been told.
 
I kind of figured it out myself but I need to take my insulin considerably longer in advance than you for breakfast at 45mins for Fiasp and over an hour for Novo(not so)Rapid. My consultant was shocked when I told him but he couldn't argue with the Libre trace which often ends up almost flat with barely a blip. I will confess that sometimes I get distracted during that period and end up with a little hypo before I realise that I haven't eaten breakfast but I prefer risking that to going mid teens and then dropping, which is really not nice. Other times of the day 15 -20mins is enough but breakfast time needs much longer for me due to Foot on the Floor syndrome.
 
Yep 30 years on Novorapid and I've only recently found this out after a combination of libre use and being on this forum. i'd never noticed it with just finger pricks.
 
rebrascora said:
Other times of the day 15 -20mins is enough but breakfast time needs much longer for me due to Foot on the Floor syndrome.
Click to expand...
I bolus up to an hour beforehand at breakfast time, especially if my dawn phenomenon seems more rampant that usual. If I've got to get up and go straight out, that’s when I rely on scrambled eggs or an avocado for breakfast, rather than muesli.
 
Interesting that some of you go longer than 30 minutes and use the technique for other meals as well. More experimentation for me 🙂
 
Pre bolusing is the best advice I’ve discovered and implemented since joining the forum in terms of reducing glucose spikes and getting less erratic readings. I only need to pre bolus by about 10 minutes before eating and as I don’t eat breakfast I don’t need to bother in the morning. I’ve never been advised to try this in clinic but it is a very effective tool to have in blood glucose management tool box.
 
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