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    • 14 hours, 11 minutes ago
      Greg Felton likes your comment at
      If you have T1D, have you ever dated or married someone who also has T1D?
      I fell in love with an insulin-dependent Type 2 20 years ago. There’s something terribly romantic about taking Lantus together at the end of the day.
    • 14 hours, 43 minutes ago
      ConnieT1D62 likes your comment at
      Do you feel that your T1D healthcare provider understands the daily challenges and work that goes into living with T1D?
      One time I was explaining that a new pump would be too expensive at the time because my deductible had just started over.. and she asked if I had insurance and I said yes….. then she said “then it should be free with insurance.” 🤦‍♀️ She may know a little about the challenges of living with diabetes, but she knows nothing about how insurance works or how costly T1D supplies are.
    • 15 hours, 2 minutes ago
      Steve Rumble likes your comment at
      If you have T1D, have you ever dated or married someone who also has T1D?
      I fell in love with an insulin-dependent Type 2 20 years ago. There’s something terribly romantic about taking Lantus together at the end of the day.
    • 15 hours, 32 minutes ago
      Lawrence S. likes your comment at
      Do you feel that your T1D healthcare provider understands the daily challenges and work that goes into living with T1D?
      I am an RN. Been going to same doctor for about ten years. Took me six years to train him. I am very well read when it comes to my LADA. He trusts my judgement and gives me excellent parameters to make decisions. Recently had a bad case of Covid. Insulin needs changed dramatically. Getting back to normal but he made sure I had scripts to cover my ups and downs with insulin needs.
    • 15 hours, 33 minutes ago
      Lawrence S. likes your comment at
      Do you feel that your T1D healthcare provider understands the daily challenges and work that goes into living with T1D?
      Mine acknowledges the struggles and challenges that go along with managing T1D in my daily life. She gives suggestions as to what may or may not help and has often asked me I how I handle situations so she can give suggestions to other T1D patient's.
    • 15 hours, 34 minutes ago
      Lawrence S. likes your comment at
      Do you feel that your T1D healthcare provider understands the daily challenges and work that goes into living with T1D?
      None of my endocrinologists or NPs have had T1D but I always discuss my challenges and they are incredibly helpful. What I always find astonishing is they are constantly amazed at how well I’m doing even when i don’t think I’m doing that well because most of their patients have nowhere near the A1c’s I’m able to achieve. And just hovers in the 6’s!
    • 15 hours, 59 minutes ago
      Jubin Veera likes your comment at
      Have you developed lipohypertrophy due to repeated injections/infusions of insulin? Lipohypertrophy is a term to describe hardened lumps of body fat just under the skin that resulted from repeated insulin injections/infusion sites. If so, share how you’ve handled lipohypertrophy in the comments!
      The hard spots are fairly frequent with the pump infusion sets. Especially if I go past 3 days which I try to avoid! I don’t think I ever got one from injections. I try heat and massaging to treat them and they normally go away after a day or so. Once I had a large area that I had to treat with antibiotics.
    • 16 hours, 1 minute ago
      Magnus Hiis likes your comment at
      Have you experienced any symptoms of physical sexual dysfunction as a result of having diabetes, or having diabetes-related complications?
      I’m 79. My last orgasm was springtime about 3 or 4 years ago. When I complained of ED, my PCP Rxd 3 to 5 (60-100 mg) sildenafil tablets by mouth about one hour prior to sexual activity. This alone hasn’t worked to bring me up to former sexual capacity that I had 10 years years ago. I’m still considering consulting finding a doctor who’ll prescribe a safe but effective way of administering testosterone or an anabolic steroid in a dose low enough to avoid causing cardiovascular problems but high enough to restore normal ability that I had up to my sixties. My present doctors say it can’t be done, but there are doctors who advertise otherwise. Analogs of the hormone insulin can be delivered in small safe doses, why not testosterone?
    • 1 day, 7 hours ago
      Becky Hertz likes your comment at
      Do you feel that your T1D healthcare provider understands the daily challenges and work that goes into living with T1D?
      We are all so very different, and trying to say that all of us with T1 understand what it's like for another who has the same hill to climb is unproductive. Having a health care provider with T1 may often be helpful just because there's apt to be more knowledge about the specifics. How we respond to the disease is such a personal matter, that I really don't think there are any guaranteed benefits beyond the grasp of the factual. Finding a doc with the same general attitude about the disease does feel good, and sometimes that's all I hope for after working hard to make peace with the disease for 70 years. Asking my doc to "get it" used to be almost my mantra, but I've come to realize that the ones who don't just see us as unruly childrenchildren
    • 1 day, 8 hours ago
      Becky Hertz likes your comment at
      Do you feel that your T1D healthcare provider understands the daily challenges and work that goes into living with T1D?
      Both my endocrinologist and my nurse practitioner are great. They compliment me on the way I take care of my life and health and make aure I get all the supplies I need managing all the paperwork Medicare and insurance requires. My nurse practitioner who works with me on managing the pump has her own opinion about the pump settings based on her technical knowledge which is different than what I do with my settings based on living with them. She has thru the years learned to respect what I do and is surprised with how my settings work. So we are now at peace. Both very supportive.
    • 1 day, 10 hours ago
      pru barry likes your comment at
      Do you feel that your T1D healthcare provider understands the daily challenges and work that goes into living with T1D?
      Yes. However, for those of you who assert, "It takes one to know one," the same might be said of age. Geriatrics is a marvelous array of marvels.
    • 1 day, 10 hours ago
      mojoseje likes your comment at
      Do you feel that your T1D healthcare provider understands the daily challenges and work that goes into living with T1D?
      I said yes but that refers to my nurse practitioner who sees me every other visit, if not more often. The doctor may know how hard I try but perhaps takes my efforts for granted.
    • 1 day, 13 hours ago
      Anneyun likes your comment at
      Do you feel that your T1D healthcare provider understands the daily challenges and work that goes into living with T1D?
      How can someone without the disease really understand what it is to live with it? I have never had a doctor with T1D in 60 years.
    • 1 day, 13 hours ago
      Bruce Schnitzler likes your comment at
      Do you feel that your T1D healthcare provider understands the daily challenges and work that goes into living with T1D?
      Yes. However, for those of you who assert, "It takes one to know one," the same might be said of age. Geriatrics is a marvelous array of marvels.
    • 1 day, 14 hours ago
      Kristine Warmecke likes your comment at
      Do you feel that your T1D healthcare provider understands the daily challenges and work that goes into living with T1D?
      My endo is young, very empathetic, thorough, always asks for my input, and does research. I am blessed too. have him, and the one before for over 25 yrs.
    • 1 day, 14 hours ago
      Kristine Warmecke likes your comment at
      Do you feel that your T1D healthcare provider understands the daily challenges and work that goes into living with T1D?
      Yes. However, for those of you who assert, "It takes one to know one," the same might be said of age. Geriatrics is a marvelous array of marvels.
    • 1 day, 14 hours ago
      lis be likes your comment at
      Do you feel that your T1D healthcare provider understands the daily challenges and work that goes into living with T1D?
      None of my endocrinologists or NPs have had T1D but I always discuss my challenges and they are incredibly helpful. What I always find astonishing is they are constantly amazed at how well I’m doing even when i don’t think I’m doing that well because most of their patients have nowhere near the A1c’s I’m able to achieve. And just hovers in the 6’s!
    • 1 day, 14 hours ago
      Daniel Bestvater likes your comment at
      Do you feel that your T1D healthcare provider understands the daily challenges and work that goes into living with T1D?
      My provider does not have T1. Only someone with it can truly understand the various daily challenges and worth it takes to manage this.
    • 1 day, 15 hours ago
      TEH likes your comment at
      Do you feel that your T1D healthcare provider understands the daily challenges and work that goes into living with T1D?
      My provider does not have T1. Only someone with it can truly understand the various daily challenges and worth it takes to manage this.
    • 1 day, 15 hours ago
      Lawrence S. likes your comment at
      Do you feel that your T1D healthcare provider understands the daily challenges and work that goes into living with T1D?
      I have no clue what my T1D health care provider understands about my daily challenges and I don’t know about his daily challenges either. Not sure why I should care as long as I have access to information how to best take care of myself.
    • 1 day, 15 hours ago
      Jeff Marvel likes your comment at
      Do you feel that your T1D healthcare provider understands the daily challenges and work that goes into living with T1D?
      My provider does not have T1. Only someone with it can truly understand the various daily challenges and worth it takes to manage this.
    • 1 day, 16 hours ago
      Richard Wiener likes your comment at
      Do you feel that your T1D healthcare provider understands the daily challenges and work that goes into living with T1D?
      My provider does not have T1. Only someone with it can truly understand the various daily challenges and worth it takes to manage this.
    • 2 days, 7 hours ago
      sweetcharlie likes your comment at
      Have you developed lipohypertrophy due to repeated injections/infusions of insulin? Lipohypertrophy is a term to describe hardened lumps of body fat just under the skin that resulted from repeated insulin injections/infusion sites. If so, share how you’ve handled lipohypertrophy in the comments!
      Hi Connie, I still have my glass syringe and show it off occasionally. We boiled the needle and syringe every morning and sharpened the needle with a file. I was diagnosed at age 6 in 1963. Life is so different now! Then, my diet was extremely limited as was my exercise. Now, I am very active and eat pretty much as I please. I maintain an A1C in the low 6s (6.2 was my last).
    • 2 days, 7 hours ago
      sweetcharlie likes your comment at
      Have you developed lipohypertrophy due to repeated injections/infusions of insulin? Lipohypertrophy is a term to describe hardened lumps of body fat just under the skin that resulted from repeated insulin injections/infusion sites. If so, share how you’ve handled lipohypertrophy in the comments!
      Connie and Beth, I was diagnosed in Nov 1962, age 10. During the early years I developed lumps and indentations on my upper thighs from my injections. In fact, I was able t o spot other t1 kids in my junior high school based upon the lumps in their upper arms.. (I eventually met up with them and learned that I was correct.) By the time I reached my twenties, these indentations had more or less disappeared, but I still have remnants of the lumps. I wish I could say that the layers of tissue now deposited on my legs disguises them, but they don't. I think the changes in insulin have been responsible for this improvement: the isolation and purification of animal insulins were refined, and then the various human clones were game changers in many ways.
    • 2 days, 7 hours ago
      sweetcharlie likes your comment at
      Have you developed lipohypertrophy due to repeated injections/infusions of insulin? Lipohypertrophy is a term to describe hardened lumps of body fat just under the skin that resulted from repeated insulin injections/infusion sites. If so, share how you’ve handled lipohypertrophy in the comments!
      Yes in my upper arms when I was a petite and skinny child in the 1960s with T1D. In those days we used glass syringes with stainless steel 1/2 inch long heavy gauge needles. My mother would jab me in the upper arms, it hurt like the dickens, and I developed several hard nodules. I was diagnosed at age 8 in December 1962 and after the initial two months of her jabbing me in the upper arms, I took over giving my own "shots" and started self injecting via site rotation in my thighs for several years. Eventually the lipohypertrophy in my upper arms resolved and I never injected there again until many years later as an adult on MDI using disposable syringes with very short and fine gauge needle tips. Periodically I would give my tired pin cushion thighs a rest and take a break for a few months or a couple of years and rotate injections in my abdomen or upper arms. Have been using a pump for over 20 years now and rarely use MDI unless I am taking a pump break for a short period of time. Happily, I no longer have lumpy sites.
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    How often do you bolus before you start eating?

    Home > LC Polls > How often do you bolus before you start eating?
    Previous

    If you could reach your health goals (e.g., A1c, time in range) equally well with any of these insulin delivery methods, which would you prefer to use?

    Next

    If you have been hospitalized while living with T1D, how satisfied were you with the staff’s knowledge and care for your T1D during your most recent hospital stay?

    Sarah Howard

    Sarah Howard (nee Tackett) has dedicated her career to supporting the T1D community ever since she was diagnosed with T1D while in college in May 2013. Since then, she has worked for various diabetes organizations, focusing on research, advocacy, and community-building efforts for people with T1D and their loved ones. Sarah is currently the Senior Marketing Manager at T1D Exchange. Sarah and her husband live in NYC with their cat Gracie. In her spare time, she enjoys doing comedy, taking dance classes, visiting art museums, and exploring different neighborhoods in NYC.

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    40 Comments

    1. Molly Jones

      Often was my answer as many of my meals have carbs.
      “Before” would be by at most a minute or two. Digestion is not wonderful but still good enough to bolus when I start a meal, not afterwards.

      This question did not have good answers to choose.

      4
      1 year ago Log in to Reply
    2. Britni

      I said “Often.” The only times that I would bolus after a meal are when my blood sugar’s low or if I’m at a restaurant or party and I don’t know what or how much exactly I’ll be eating.

      3
      1 year ago Log in to Reply
    3. Annie Wall

      I said “always” but it’s really just as I’m ready to pick up my fork.

      1
      1 year ago Log in to Reply
    4. Gary Taylor

      “Often” = “It depends”. It depends on where my premeal blood glucose is. If it is below 80, I’ll eat first and watch for it to start rising and then I’ll bolus.

      4
      1 year ago Log in to Reply
    5. Mary Dexter

      I take my bolus as I finish up making the meal, around the time I set the table, unless I have gone low while cooking, in which case I bolus right before we sit down.

      1 year ago Log in to Reply
    6. Amy Jo

      Pre-bolusing (avg 30 mins but up to 1 hour while pregnant) changed my A1c dramatically – much more impactful than any technology change.

      1
      1 year ago Log in to Reply
    7. MARIE

      Said ‘often’. Depends on pre-meal BG and content of meal. With a mostly LC/HF diet and well controlled BG, it often makes since to bolus about 10 minutes into the meal to avoid the insulin taking effect before the carbs kick in.

      4
      1 year ago Log in to Reply
    8. Anthony Angel

      I find if I do not bolus before I ea, it will elevate my bloods sugars greatly.

      1
      1 year ago Log in to Reply
    9. Daniel Bestvater

      Always 15 minutes to 1 hour in advance to avoid post meal/snack hyperglycemia.

      1 year ago Log in to Reply
    10. Louise Jesserer

      Depends upon what my BG reading is prior to meal. Ranges from immediately to an hour wait…

      4
      1 year ago Log in to Reply
    11. Dawn Konig

      Always

      1 year ago Log in to Reply
    12. Lawrence S.

      I answered “Always.” But, in reality, I sometimes forget to take my insulin before I eat. I try to take my bolus 20-30 minutes before my meal, depending upon what my blood sugar is.

      1
      1 year ago Log in to Reply
    13. connie ker

      I go by my cgm numbers. If the numbers are low, I go ahead and eat food and bolus mid-meal or after meal. If they are high, I bolus and wait for numbers to come down before eating. You do whatever works and you become your own medical scientist. The body is so complex and it is impossible to be perfect with numbers, so don’t ever quit or give up, just press on and remind yourself that Insulin is celebrating the 100th birthday this year.

      13
      1 year ago Log in to Reply
    14. Marvin Shotkin

      I need to pre-bolus well before a meal, since the insulin doesn’t kick in for at least 1.5 to 2 hours.

      2
      1 year ago Log in to Reply
    15. Mick Martin

      As the questioner, OBVIOUSLY doesn’t know much about diabetes, I’d hasten to add that there ought to be an ‘Other’ option.

      To clarify, I’d state that in the main I often begin the infusion of my insulin dose prior to starting to eat, but this REALLY depends on what my blood glucose level is prior to that meal.

      If my blood glucose level is on the lower side, I wait until I begin eating, or even infuse insulin after I’ve eaten my meal. This is because I use Apidra insulin, which is very rapid acting, so it starts to work before the carbohydrates of my food intake is broken down and glucose is released into the bloodstream. (I’ve had MANY occasions when my blood glucose level has fallen so dramatically that I’ve lost consciousness … sometimes before I’ve even got to finish my meal. This is compounded by the fact that I have gastroparesis, which results in a delayed emptying of the stomach contents.)

      2
      1 year ago Log in to Reply
      1. Liz Avery

        You are so right. My digestion is sometimes very slow, and my insulin sensitivity rarely allows pre-bolusing. I answered rarely as this is my life.

        1
        1 year ago Log in to Reply
      2. Linda Zottoli

        I routinely pre-bolus for at least part of what I think I’ll need, before breakfast. But, later in the day, I so often take so long to digest that I routinely don’t prebolus, and even sometimes wait for the dexcom curve to start up before bolusing if it’s a period when the slow digestion is being a particular problem. When I wait for the curve, I often go higher than I want to be before the insulin works, but I tend to get a worse high if I have had to treat a low caused by the insulin working before the food hits, and then digest the food originally bolused for at some unpredictable time. And I’ve also had a low that is difficult to treat, because I’m not digesting. Still manage low 5 A1cs and usually over 90% TIR, and at age 75, dx at 8, I don’t worry about it too much, but do try to eat more of my food earlier in the day.

        1 year ago Log in to Reply
    16. Sherolyn Newell

      I have to look at all the variables just like everyone else and make that decision every meal/snack. The only difference is a few people say they sometimes bolus and wait to eat, and I don’t have enough willpower for that when I am hungry. 🙂

      1
      1 year ago Log in to Reply
    17. Magnus Hiis

      I use DIY FreeAPS X and there’s a lot of meals that it can handle but it always looks better with a bolus

      1 year ago Log in to Reply
    18. Mark Schweim

      Not always, but Almost Always wasn’t given as an option so I said “Often”.

      2
      1 year ago Log in to Reply
    19. Abigail Elias

      My answer is “almost always,” with rare exception (e.g., I am distracted somehow) or if I am eating to counter a low bg. So I answered “often,” despite it being an understatement.

      2
      1 year ago Log in to Reply
      1. Mike S

        Exactly! Almost always should’ve been in there. I’m sure not gonna bolus at 3 am when I’m eating to counter a low! 🙂

        1
        1 year ago Log in to Reply
    20. Joan Fray

      Unless I forget………,

      1
      1 year ago Log in to Reply
      1. William Bennett

        Or don’t find out there are carbs until it’s already being served, yup.

        1
        1 year ago Log in to Reply
    21. William Bennett

      I **always** intend to, but I only **often** mange to. Sometimes you don’t know there are carbs coming until the meal is served, especially when you’re eating out. I almost always feel awkward about quizzing someone who’s cooked dinner for a full ingredients list, and frequently they don’t know if there are carbs or not, because they don’t know things like pasta, beans, bread, and fruit are carbs. “It’s full of honey but it’s locally sourced organic honey!” Sigh….

      9
      1 year ago Log in to Reply
      1. Jane Cerullo

        Got a laugh out of this. My friends always says cooked this especially for you as my sugar rises. Most people just have no idea what a carb is.

        6
        1 year ago Log in to Reply
    22. Jane Cerullo

      Now that I am on faster acting Lyumjev I can bolus when meal arrives. So much easier to remember. Also easier to estimate carbs in a restaurant.

      1
      1 year ago Log in to Reply
    23. Janis Senungetuk

      I pre-bolus if I’m the cook and know exactly what and how much I’ll be eating. If my bg is low I bolus just before I start.

      1
      1 year ago Log in to Reply
    24. Becky Hertz

      Another trick question. If I’m going to exercise and am eating to fuel, I don’t bonus at all. If it’sa regular meal and my bg is in range or above, I try to bonus before with the time depending on where my bg is, if my bg is below my target I don’t bonus until right before I put food in my mouth, if I’m more I’ll usually wait until after I’ve started eating.

      2
      1 year ago Log in to Reply
    25. Sarah Berry

      I usually bolus 15 to 30 mins before eating, depending on starting blood sugars.

      1 year ago Log in to Reply
    26. LizB

      Always. Most times I bolus as I’m about to eat but it depends on my BG. If it’s high or high normal I will pre-bolus. If it’s under 100 I usually bolus right as I go to eat, or maybe just a couple of minutes before. If I’m low I will bolus as I’m about to eat but I will do a dual or extended bolus.

      1 year ago Log in to Reply
    27. M C

      I bolus almost always before starting to eat…. unless I am out and not confident of the timing of the food arriving at the table, then it has to be delayed. Once food arrives the bolus goes in before starting to eat.
      If I haven’t given my bolus before starting to eat, it can sometimes be because my BG is already low, and rarely (but it does happen) it can be due to being so busy or involved in conversations with friends at the table with me that I forget.
      As soon as I remember, the bolus will go in! Luckily, as said, this is only a rare occurrence.

      2
      1 year ago Log in to Reply
    28. Dave Akers

      I never prebolus anymore with my inhaled Insulin. I use it at the same time I eat. If it’s a higher fat meal, I may wait 20-30 minutes after I eat to bolus.

      1
      1 year ago Log in to Reply
    29. Ahh Life

      In 1945, Frank Notestein, the founding director of the Office of Population Research at Princeton, estimated in Food for the World that about 3.3 billion humans would be on planet earth by the year 2000.

      He was only about 3 billion off.

      Now if the best and the brightest are in error by that huge amount for a 50-year projection . . . I think most of the rest of us mere mortals can be forgiven for being in error on a mere 50-minute projection. Nes pas? ✍️

      3
      1 year ago Log in to Reply
    30. Don (Lucky) Copps

      Virtually always, usually 20-30 minutes ahead of 1st bite. Only on rare occasions when I have no idea of the carb count will I wait until I see what I’m eating.

      1 year ago Log in to Reply
    31. Sue Compo

      It depends on my numbers before I eat and the carb count of the meal. I would say 95% I bolus

      1
      1 year ago Log in to Reply
    32. Bonnie Lundblom

      I said “Always” but truly “Almost always” would have been the more correct answer for me to cover for when I’m correcting a low but eating enough carbohydrates to require a small dose.

      1 year ago Log in to Reply
    33. ConnieT1D62

      Usually, but not always. Depends on factors like what, when & where I am going to eat, what I am doing in everyday life, what my BG level is doing, and whether or not my attention is focused or distracted before I eat something.

      Thanks and kudos to all of you who gave real life honest answers to this question. Truth be told, for most of us – whether a T1D long hauler or a T1D newbie – remembering to take a bolus of insulin before you start eating is a crap shoot. You win some and you loose some and nobody’s perfect!

      1
      1 year ago Log in to Reply
    34. Cheryl Seibert

      I always bolus, but if BG/SG is low, then I choose a square/extended bolus with 0% at the current time. That ensures I don’t forget to bolus and better matches the projected BG after eating with a low BG.

      1 year ago Log in to Reply
    35. Kandy Gonzalez

      It takes forever for my food to digest that I bolus after eating with a delay delivery

      1 year ago Log in to Reply

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