21 Comments
When do you bolus for a big holiday meal? If you bolus more than once, select all that apply to you!
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This year my nephew has lasagne, yeah odd but he’s fixing it. After guessing I’ll test a lot and bolus every 3 hours or so.
I start eating the slower absorbing food first, while we do a lot of talking. By the time I get to the apple pie, my insulin is at the 1hr mark and peaking. I also do an extended bolus since it will take awhile to digest all the food.
I do not usually eat very large meals as my my stomach will not hold them and my appetite has decreased with age. I try not to eat carbs/ Bolus to closely together as my BG is quite variable. It takes me a long time to eat and digest both. A bowl of cereal and yogurt takes at least half an hour and sometimes up to an hour. If I eat too fast, food can easily be regurgitated. This has happened since childhood and rarely happens since I have learned to eat slowly.
It depends what we eat. This year it will be lamb shoulder roast, mashed potatoes and veggies. Cheesecake for desert. I guess we are not typical.
I selected 15 minutes or less because that’s what I used to do with MDI. Thanks to Covid I likely won’t have to tackle a big holiday meal with my new pump until 2021 and I’m not sure what I’ll do. My grandmother likes to serve “appetizers” for at least an hour and then clean up in between dinner and desert, so carb counting has always been tricky. Being able to bolus for each section of the meal might be helpful.
If I’m cooking, my sugar is usually within range or starting to drop. I bolus before, during and after the meal.
We graze for hours, so I usually set a temporary basal of about 3 or 4 units per hour…. and then either take correction bolus after my nap, or have another piece of pie! It’s just one day and I’m thankful for cgm and advanced pump technology!!
I usually bolus when I start eating of it’s not high in fat. I digest kind of slowly. If I take it ahead, even 15 minutes, I go low before my food kicks in. If what I am eating has a higher fat content, I have to wait about 1/2 hour before the bolus and bolus extra. For Thanksgiving, if I end up eating more than planned, I will bolus again for the extra. I like the comment about adding to the basal, I never think of doing that and it sounds like a good idea.
It depends on what I’m eating and where my glucose is at the time. There’s not a set pattern.
Not having TG this year because I have an 88 year-young father and local nieces and nephews who are travelling the country and don’t think about him (do I sound annoyed?). In a normal year, I’m afraid to bolus early because something usually interferes with the start of the meal: someone is usually late or something didn’t get done on time. I, too, forget I can increase my basal, although I decrease it quite often, especially when I am vacuuming (always go low when doing that) or exercising or when I have just changed my reservoir with fresh insulin. Stay safe and well everyone!
For a typical big holiday meal I start my extended bolus 15 to 30 minutes beforehand, because there has been appetizers sitting out since everyone arrived. We are a slow eating bunch, so 2 to 4 hours later when dessert time rolls around, I look at tSlim Control IQ again agin & see if I need another bolus or if I’m doing okay number and IOB wise. This year we had planned on just the 8 of us – immediate family. Three are currently in quarantine.
Because even for festive meals, my husband avoids grains, starches, and other ‘fast’ carbs, he’ll set a 50/50 three hour extended bolus which gives him 50% of the dose immediately and spreads the remaining 50% over the next three hours. He has to be careful not to take the first bolus too much before his first bite otherwise the insulin will kick in before the carbs do, and he’ll go a bit low.
I enter the bolus just before the meal begins in order to prevent the insulin from dropping my BG before the food really starts to digest. Later I watch for BG trend and add a correction about two hours later if it rises too fast. I use Control IQ with my Tandem pump. That system is likely to correct any high BG before I get there.
I am typically on a lower carb meal plan. First I have to know what my blood sugar is approx. 30 minutes before the meal and whether my blood sugar is stable, going up or down and how fast it is going up or down; thank you CGMS. As I use Afrezza (orally inhalable insulin) which starts to work in 90 seconds I have wonderful spontaneity with time of dosing. I inhale approx. 15-30 minutes before meal if blood sugar is high or if it is going up above normal. Otherwise I inhale my insulin for the meal as I am beginning to eat unless I am hypoglycemic. IF I have a low blood sugar I wait until my blood sugar is back in the normal range before I inhale my Afrezza.
If I’m hosting I know when the meal is actually ready so that helps! I usually bolus for the appetizers, then more for the actual dinner, then again for dessert because it’s worth for a carb splurge on holidays!
I tell Loop what I am eating and let it time the bolus appropriately which it does based upon the speed with which the carbs will hit my system. Fast carbs are 2 hours – potatoes, fruit etc and what my blood sugar is before the meal.
I bolus at the end of the meal because I never know how much I am going to eat. I don’t care for mashed potatoes or green bean casserole, and I scrape the sugary top off the yams. I never know if the rolls are going to call to me or not!
For me, everything depends on numbers. If low, I may wait to take injection, if high I would take 30 min. before, if in range right before sitting down to eat. Following the meal, a correction dose might be necessary. But the important factor in this equation is to enjoy the day and have a thankful spirit. Thankgiving should turn into Thanksliving.
All depends on numbers, 10 – 15 minutes before the meal and then again while after meal. I test often and correct when needed.
I’m surprised that there was not an option for “it depends on BG before meal”. Who wouldn’t pay attention to this important detail?!?!
I marked Before, during and after. Tandem’s Extended Bolus is my weapon of choice! It does all 3 things in one bolus event 🙂 You take some before the meal and then depending on the content of the meal (like breads or other complex carbs), then spread the remainder of the bolus over 30-90 minutes depending on the meal.