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    • 24 minutes ago
      Wanacure likes your comment at
      On a scale of 1-5, how satisfied are you with your current insulin delivery method (pump, pens, syringes, inhaler, etc.)? 5 = the most satisfied, 1 = the least satisfied
      I’m a reasonably satisfied MDI user with Lantus and Fiasp. I’ve looked into getting a pump but honestly, until I find one that does everything I want, I’ll probably hold off. My wish list for a pump: 1) no tubes 2) works well with Fiasp 3) controls that allow me to stay at my target of 70-90 mg/dl all night long.
    • 35 minutes ago
      Wanacure likes your comment at
      On a scale of 1-5, how satisfied are you with your current insulin delivery method (pump, pens, syringes, inhaler, etc.)? 5 = the most satisfied, 1 = the least satisfied
      MDI for the past 60 years and do not see any alternative that I would prefer. The needles for my pens are so thin and sharp that they are painless (a far cry from the lancets I once used). chiefly, I am glad not to have to deal with setting up a pump and. Although I love my libre, I am not good candidate for having devices affixed to me. If my insulin delivery got interrupted they way i have interrupted my cgm service, I would have been in trouble. Furthermore, I have a track record of having both mechanicall and electronic things malfunction. (Seriously, I sometimes act as a beta-tester for technology folks. Maybe I push to many buttons?)
    • 47 minutes ago
      Wanacure likes your comment at
      On a scale of 1-5, how satisfied are you with your current insulin delivery method (pump, pens, syringes, inhaler, etc.)? 5 = the most satisfied, 1 = the least satisfied
      I've had Tandem x2 and Dexcom since September. Previously on Medtronic for around 15 years. Grew to HATE the sensors and switched before the warranty on my last Medtronic was up. So far, I absolutely LOVE the Tandem and the Dexcom. I'm disappointed, however, in the amount of waste and plastic that this pair creates. Of course there will always be plastic waste from any pumps/sensors, but the amount of non-reusable stuff for insertions is ghastly.
    • 48 minutes ago
      Wanacure likes your comment at
      On a scale of 1-5, how satisfied are you with your current insulin delivery method (pump, pens, syringes, inhaler, etc.)? 5 = the most satisfied, 1 = the least satisfied
      Have your doctor prescribe the syringes with .5 unit increments instead of the 1 unit syringes. Not quite a .1 unit which you are hoping for, but .5 is better than 1 unit increments.
    • 2 hours, 3 minutes ago
      Ahh Life likes your comment at
      Over the past 3 months, how much time would you estimate you have spent working through T1D prescription-related issues with pharmacies, insurance companies, durable medical equipment distributors, T1D device companies, health care providers, etc.?
      I answered "No time," but I live in France, where we have a single provider. I receive a prescription from my doctor and go to the pharmacy monthly to have it filled. (Pump peripherals are provided by a separate supplier.) "Appeals" do not exist here since the doctor will only prescribe medicines that are reimbursed. And no, I have never needed a treatment that wasn't covered.
    • 3 hours, 54 minutes ago
      ConnieT1D62 likes your comment at
      In your own words, how would you describe the feeling of a severe low?
      Nothing short of terrifying. I often go into seizures, having no idea where I am, who anybody, or even if I’m alive or dead. I’ll feel like I’m falling or hurtling toward something. At home I feel like my house is tilting. Im leaving a lot out but these are some of the scariest things.
    • 4 hours ago
      Modee likes your comment at
      Over the past 3 months, how much time would you estimate you have spent working through T1D prescription-related issues with pharmacies, insurance companies, durable medical equipment distributors, T1D device companies, health care providers, etc.?
      Most of Europe has the right idea! Is it a good health system for you overall? The US may be too large to implement a national system, but that doesn't hold states back (as long as there is federal money to help).
    • 4 hours ago
      Modee likes your comment at
      Over the past 3 months, how much time would you estimate you have spent working through T1D prescription-related issues with pharmacies, insurance companies, durable medical equipment distributors, T1D device companies, health care providers, etc.?
      I answered "No time," but I live in France, where we have a single provider. I receive a prescription from my doctor and go to the pharmacy monthly to have it filled. (Pump peripherals are provided by a separate supplier.) "Appeals" do not exist here since the doctor will only prescribe medicines that are reimbursed. And no, I have never needed a treatment that wasn't covered.
    • 4 hours, 2 minutes ago
      Modee likes your comment at
      Over the past 3 months, how much time would you estimate you have spent working through T1D prescription-related issues with pharmacies, insurance companies, durable medical equipment distributors, T1D device companies, health care providers, etc.?
      I said 8+ and the reason, as for so many others, can be summed up in a phrase: transitioning to Medicare.
    • 4 hours, 3 minutes ago
      Modee likes your comment at
      Over the past 3 months, how much time would you estimate you have spent working through T1D prescription-related issues with pharmacies, insurance companies, durable medical equipment distributors, T1D device companies, health care providers, etc.?
      PUMP USERS: Just in case nobody has told you, if you use a pump, Insulin is considered durable medical equipment, which can save a lot of money, even with the new price cap
    • 4 hours, 12 minutes ago
      Samantha Robinson likes your comment at
      Over the past 3 months, how much time would you estimate you have spent working through T1D prescription-related issues with pharmacies, insurance companies, durable medical equipment distributors, T1D device companies, health care providers, etc.?
      Just spent an hour and a half on the phone with insurance the other day trying to switch to Dash pods and nothing was accomplished....
    • 4 hours, 17 minutes ago
      beth nelson likes your comment at
      Over the past 3 months, how much time would you estimate you have spent working through T1D prescription-related issues with pharmacies, insurance companies, durable medical equipment distributors, T1D device companies, health care providers, etc.?
      Normally, no time spent but I changed insulins so I wanted to verify everything with my insurance company before asking my endocrinologist to write a new script.
    • 4 hours, 19 minutes ago
      beth nelson likes your comment at
      Over the past 3 months, how much time would you estimate you have spent working through T1D prescription-related issues with pharmacies, insurance companies, durable medical equipment distributors, T1D device companies, health care providers, etc.?
      I answered "No time," but I live in France, where we have a single provider. I receive a prescription from my doctor and go to the pharmacy monthly to have it filled. (Pump peripherals are provided by a separate supplier.) "Appeals" do not exist here since the doctor will only prescribe medicines that are reimbursed. And no, I have never needed a treatment that wasn't covered.
    • 4 hours, 20 minutes ago
      beth nelson likes your comment at
      Over the past 3 months, how much time would you estimate you have spent working through T1D prescription-related issues with pharmacies, insurance companies, durable medical equipment distributors, T1D device companies, health care providers, etc.?
      I said 8+ and the reason, as for so many others, can be summed up in a phrase: transitioning to Medicare.
    • 4 hours, 37 minutes ago
      Jeff Marvel likes your comment at
      Over the past 3 months, how much time would you estimate you have spent working through T1D prescription-related issues with pharmacies, insurance companies, durable medical equipment distributors, T1D device companies, health care providers, etc.?
      I expect that we’ve all had that feeling about how stupid payers can be when it comes to T1D.
    • 4 hours, 37 minutes ago
      Jeff Marvel likes your comment at
      Over the past 3 months, how much time would you estimate you have spent working through T1D prescription-related issues with pharmacies, insurance companies, durable medical equipment distributors, T1D device companies, health care providers, etc.?
      Seriously depends on when you ask. The past 3 months have only been an hour or two, but if you'd asked this same question last September it would've been over 8 as I dealt with the annual "Yes I need a Dexcom and Omnipod again" red tape with my insurance/providers/doctor's office. I am counting the time on hold as well, but still - pretty ridiculous that insurance thinks Type 1 is going to magically go away just because it's been a year. I wish!
    • 4 hours, 37 minutes ago
      Jeff Marvel likes your comment at
      Over the past 3 months, how much time would you estimate you have spent working through T1D prescription-related issues with pharmacies, insurance companies, durable medical equipment distributors, T1D device companies, health care providers, etc.?
      The last 3 months have been filled with frustrating phone calls now that I switched back to traditional Medicare from a Medicare Advantage plan. I have been fighting to get strips authorized in addition to CGM- they did not authorize them because I had no proof that I had a meter!! Crazy making! I had to write an appeal letter in order to get them, but finally got it worked out. I also had some pump replacement issues, trouble getting insulin, etc.
    • 4 hours, 38 minutes ago
      Jeff Marvel likes your comment at
      Over the past 3 months, how much time would you estimate you have spent working through T1D prescription-related issues with pharmacies, insurance companies, durable medical equipment distributors, T1D device companies, health care providers, etc.?
      I answered "No time," but I live in France, where we have a single provider. I receive a prescription from my doctor and go to the pharmacy monthly to have it filled. (Pump peripherals are provided by a separate supplier.) "Appeals" do not exist here since the doctor will only prescribe medicines that are reimbursed. And no, I have never needed a treatment that wasn't covered.
    • 4 hours, 38 minutes ago
      Jeff Marvel likes your comment at
      Over the past 3 months, how much time would you estimate you have spent working through T1D prescription-related issues with pharmacies, insurance companies, durable medical equipment distributors, T1D device companies, health care providers, etc.?
      Much too much time! Part of it, I know, is my own fault, for not keeping anxiety at bay when I have to sort out which plan will work best, annually. But it is something I dread, every single year. When I call to get some help understanding, the people are almost always very nice, but I have had times when the information was incorrect or not explained clearly. I usually commiserate with the person on the phone for having such an annoying system, and agreement seems to rule the day. But I never chose to make sorting out insurance management a career!
    • 4 hours, 38 minutes ago
      Jeff Marvel likes your comment at
      Over the past 3 months, how much time would you estimate you have spent working through T1D prescription-related issues with pharmacies, insurance companies, durable medical equipment distributors, T1D device companies, health care providers, etc.?
      I said 8+ and the reason, as for so many others, can be summed up in a phrase: transitioning to Medicare.
    • 4 hours, 38 minutes ago
      Jeff Marvel likes your comment at
      Over the past 3 months, how much time would you estimate you have spent working through T1D prescription-related issues with pharmacies, insurance companies, durable medical equipment distributors, T1D device companies, health care providers, etc.?
      Just spent an hour and a half on the phone with insurance the other day trying to switch to Dash pods and nothing was accomplished....
    • 4 hours, 57 minutes ago
      William Bennett likes your comment at
      Over the past 3 months, how much time would you estimate you have spent working through T1D prescription-related issues with pharmacies, insurance companies, durable medical equipment distributors, T1D device companies, health care providers, etc.?
      Switching to Medicare has created (seemingly) endless hours and day making this transition with all things diabetes related. We’re still in the midst of making this ā€˜delightful’ change. This week we learned that Medicare covers Either CGM stuff OR glucose test strips. Thank goodness that God is sovereign over all these details. He helps me walk through these challenges without despair.
    • 4 hours, 57 minutes ago
      pru barry likes your comment at
      Over the past 3 months, how much time would you estimate you have spent working through T1D prescription-related issues with pharmacies, insurance companies, durable medical equipment distributors, T1D device companies, health care providers, etc.?
      Eight times a year I have to spend more than eight hours to fix errors on the part of my mail order pharmacy and DME supplier. My endo doesn't keep track of when prescriptions expire or need refills so add another couple hours a year building a to-do list for the doc. I'm ready to start billing for my time.
    • 4 hours, 59 minutes ago
      pru barry likes your comment at
      Over the past 3 months, how much time would you estimate you have spent working through T1D prescription-related issues with pharmacies, insurance companies, durable medical equipment distributors, T1D device companies, health care providers, etc.?
      One of the most unnecessary and frustrating parts of being a type 1 diabetic is all the stress and time involved with insurance companies, pharmacies, durable medical equipment distributers and their need to always contact physicians.
    • 5 hours, 30 minutes ago
      Bill Williams likes your comment at
      Over the past 3 months, how much time would you estimate you have spent working through T1D prescription-related issues with pharmacies, insurance companies, durable medical equipment distributors, T1D device companies, health care providers, etc.?
      Significantly less time since I switched from Byram to ADS. It has made a world of difference and saved so many headaches!!
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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?

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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
      12 months 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
      12 months 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
      12 months 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
      12 months 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.

      12 months 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
      12 months 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
      12 months 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
      12 months ago Log in to Reply
    9. Daniel Bestvater

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

      12 months 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
      12 months ago Log in to Reply
    11. Dawn Konig

      Always

      12 months 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
      12 months 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
      12 months 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
      12 months 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
      12 months 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
        12 months 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.

        12 months 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. šŸ™‚

      1
      12 months 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

      12 months ago Log in to Reply
    18. Mark Schweim

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

      2
      12 months ago Log in to Reply
    19. Abigail Elias

      My answer is ā€œalmost always,ā€ with rare exception (e.g., I am distracted somehow) or if I am eating to counter a low bg. So I answered ā€œoften,ā€ despite it being an understatement.

      2
      12 months 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! šŸ™‚

        1
        12 months ago Log in to Reply
    20. Joan Fray

      Unless I forget………,

      1
      12 months ago Log in to Reply
      1. William Bennett

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

        1
        12 months 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
      12 months 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
        12 months 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
      12 months 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
      12 months 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
      12 months ago Log in to Reply
    25. Sarah Berry

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

      12 months 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.

      12 months 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
      12 months 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
      12 months 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? āœļø

      3
      12 months 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.

      12 months 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
      12 months 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.

      12 months 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
      12 months 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.

      12 months 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

      12 months ago Log in to Reply

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