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How often do you pre-bolus at least 5 minutes before eating?
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I responded “always” but if my BG is low before the meal I do not pre-bolus.
It all depends on the numbers going into the meal. If on the lower side, I wait to bolus until half way through the meal. If on the higher side, I bolus and wait for the numbers to come down before eating. What a balancing act!!!!!
It’s hard to pre-bolus when my blood sugar is low but it’s also easy to forget taking it later. I compromise by extending my bolus a half hour and taking a percentage of the bolus even when my blood sugar is low. That’s a benefit of having an omnipod.
Other systems can do this too
Pre dosing is very helpful for rapid analog insulins- Humalog, Novolog, Novorapid (Novolog in some other countries than US), even Lyumjev or Fiasp. A study showed much better post meal control with the same dose given 20 minutes before compared to right before or 20 minutes after. This was shown in the following study: Cobry et al, Diab Tech Therap 2010;12: 173-177
—— Its too bad that they don’t allow images in this system now, I could have posted a slide showing it.
I try to always pre-bolus 15minutes – 1hour ahead depending on BG.
Rapid insulin really isn’t very rapid!!
What’s a prebolus? I bolus whenever my glucose is above 120mg/dl and always before I eat unless it’s very low. Then I check after I’ve eaten.
Well, not quite always, but I try to (sometimes I don’t know there are going to be carbs, e.g.) Certainly a lot more often than just “often.” “Almost always”!
It’s interesting that new CGM patients aren’t always told that this is one of the primary things you can/should do with it. I had a T1 friend who’d been using a Dexcom for a month or so and had never heard of it. I think it was less of a thing back when CGMs weren’t so widely used because it just wasn’t practical. Back then I was always told “don’t bolus until you’re about to eat!” But with a CGM you can bolus, then keep an eye on your track until it starts steadily descending, showing that your insulin is starting to work, and then dig in. That’s a lot harder to emulate with just finger sticks, and obviously a bit dangerous if you don’t have a dynamic track of what’s going on in real time.
Sometimes. If the meal I’m about to eat is heavy carb, pasta or rice, I try to pre-bolus 20 to 15 minutes before eating and also extend the amt. by 2 hrs. If it’s restaurant food and I’m not exactly sure of the carbs I’ll bolus when the food is set in front of me.
Depends where my bg level is prior to eating. If I’m in range or high I’ll try to books at least 5 minutes ahead if not more.
Unless I am eating pure carbs, it tends to take anywhere from 15 to 30 minutes for my BG to go up. Unless my BG is at least 120, I can’t bolus early or I will go below 70 before the carbs kick in.
Often and sometimes – more often than sometimes or not at all. Depends on what I am doing, what I am about to eat, and what BG level is per Dexcom tracking.
I had never heard of pre-bolusing until I wanted to start a family. It has drastically changed my control – before I wanted to have kids, my A1c was 7-7.5%. Now, thanks to prebolusing, I’ve been able to keep my A1c 5.1-6%, depending on where I am in my pregnancy/preconception journey. During pregnancy, I pre-bolus anywhere from 15-45 minutes, depending on what I am eating, how high my BG is etc. Very challenging but so worth it to avoid that post-prandial spike!
I try for 10 minutes, but it is frequently less. Sometimes I bolus right at the start of a meal, and that is mostly due to inattention.
I chose often because of the amount of time it takes me to eat. I am always the last one at the table with half a plate unfinished when everyone else is finished.