40 Comments
When do you usually bolus for a meal? If multiple options apply to you equally, please select all that apply.
You must be logged in to post a comment.
© 2023 T1D Exchange. All Rights Reserved.
I said ” other “…. I don’tt !!!
Since you don’t bolus at all, I am assuming you either use pills, don’t use insulin, or only use long-acting insulin
TO ANITES…. I am 91 years OLD…. Have T1D for about 70 years…. Started with what was available at that time, insulin made from Cows or Pigs… Fast, intermediat or long acting insulins… I started with intermediate, then mixed with fast… never used Slow… Played around with amounts and once or twice per day… When the Human DNA stuff came out I tried the at meal times only thingy… NO GOOD for me !!! Finely setteled on morning shot only of Humalin or Novolin70/30 [ this from Walmart [Relion] was only $25/vial and 13 cents per syringe OTC !!!! ]……. now using Humalin 70/30 Quick Pen [ $35/ month, 14 cents/ needle ]….. Over the years, NO TD1 related problems…. Last few months now have Asbestos related Lung Cancer [ doing infusion imunio theropy every 3 weeks ] and various Pills for my old age parts including AMD. Please let me know on this question reply section if you see this answer !!!!!!!!!!
In the good ol’ days when everything worked, I used the textbook method of 30 minutes ahead of time, if at all possible.
Now, with gastroparesis, all bets are off and all equations out the window. I follow up with several subsequent-to-eating small boluses, hoping the digestive nerve wakes up from his Rip Van Winkle slumbers and decides to work an hour or two. It cannot be overemphasized—this nerve/digestive issue can be quite severe and deleterious.
If I wait longer than 20’ with normal bg (70-130) to eat, then my bg drops to point I feel tired & lack motivation. So I lay on bed, turn to NPR, listen to radio and often fall asleep for 30-60’ nap. So, as long as bg is 140 or less, I eat immediately starting with fruit exchange (10 net carb).
If bg rises after meal, to say 149, I wait at least 2 hours before injecting another bolus of 0.5 to 1.0 lispro (Humalog).
Is it true that Olympic swimming gold medalist had a 400 page guide to adjusting his insulin?
This is beyond complex between my general laziness and what I am eating. If I am served a meal that I’m not sure I’ll eat all of it, I will sometimes split and give some before and then some after. I have tried to get better about pre-bolusing, but I am often distracted and don’t realized how quickly I will have food in front of me. Or I’m the one making it so I am not focused on that aspect of life for a few minutes (unless a CGM alarm stops me).
Thank you for being so honest. I have often walked in the shoes of distraction before meals as well. I hardly ever remember to bolus 15 minutes before I sit down to eat. It’s a crap shoot because in the busy-ness of my life giving a pre-meal bolus doesn’t always work …
It really varies, usually depending upon when I remember to take my insulin. I try to take it about 20 to 30 minutes before I eat. But, it depends upon whether my blood glucose is high or low. If low, I wait close to when I start eating. If it’s high, I take it well, 20-30 min, before I start eating. Then there’s the gastroparesis thing, for which I use extended boluses.
It’s constant adjustments, with lots of room for error.
100% agree with your method. It’s what I do as well. The only difference is if I am really hungry, sometimes I forget to bolus until my CGM beeps at me.
Yes Sherolyn, I forget to bolus for a meal, more than I care to admit. I get easily distracted, and don’t remember until my blood glucose is 250 to 300. Ugh.
If I’m eating out, I bolus as soon as I decide what I’m eating (usually ends up a 5 – 10 minute wait). If I’m eating at home, I bolus then don’t start eating until the bg is below 125 and going down.
It depends on my test with my glucometer before eating. I have a CGM, but I always test with a glucometer before meals. I sometimes bolus as much as 30 minutes before a meal and as late as 30 minutes after a meal.
It depends upon where my bg is and how it’s trending.
Depends on a combination of current glucose and carbohydrate content of meal.
Depends entirely on circumstances, i.e. Dexcom/meter reading plus expected CHO consumption. All, of course, are approximate or pure guesses. I am not always able to be as precise as some fanatics might like. But I’ve survived 47 years as type 1 without any serious complications, and things were much worse when I was started on one shot a day of NPH and only Testape for blood sugar estimation!
It really all depends on my Dexcom readings. That determines when I bolus for a meal.
Like many others posting here, I use more than 1 approach. I try to remember to check my bg an hour or so before mealtime, so that I can adjust it downward to the 80s, if necessary or possible. My goal is to start the meal from a “normal” place. If no adjustments were made, I bolus 15 to 20 minutes before eating. If I had taken insulin an hour earlier, I bolus right before starting to eat. Generally I check to see how things are going about 1.5 to 2 hours after the meal starts, and may add a unit or 2 if things look to be trending upward too enthusiastically.
I have learned to wait until I see the food in front of me in restaurants. Invariably it is my dinner which does not arrive as the others are being served, at which point I am given the option of making a different selection. Frequently my my then becomes “on the house,” but it is an uncomfortable situation if I had already taken the bolus.
I use the pump extended bolus for mst meals.
10-15 minutes prior to eating, but that also depends on blood sugar. If our son is much over target, we wait a little longer before eating. If he’s at target or trending ↘️, we may eat right away. We always do an fs BG check prior to meals, but not snacks.
All the above
It depends on my BG and what we are olsnning to eat, and do after the meal
Almost all of the choices because there are many different factors to consider. If I’m preparing the meal I have a far better idea of the carb content than trying to guess the numbers and when I’ll actually be eating as a guest at someone’s home or at a restaurant. If I’m preoccupied with slicing and dicing while preparing a meal, I’ll either take it 15 minutes ahead or just before I start eating. There are just too many variables to honestly provide a clear answer to this question.
It depends on what my blood sugar is before I eat. I am currently using Afrezza instead of my pump for meals. Since it works so quickly I can inhale it right before I take my first bite. Unless my blood sugar is below 100 and then I might take a few bites before I use the Afrezza.
It depends on where my bs is before I eat. If I am low I will wait to bolus right before eating. If I am in range, I will try to bolus at least 15 min prior. If I am bordering low, I might bolus a unit early then bolus rest just before. Sometimes I bolus some before, some at sit down and some after, depending on the food. It is all variable depending on food, activity, present sensor reading and trend, oh and did I say memory;) The goal is 10-15 min. prior if all is level. I am on Lyumjev.
When pumping the time frame was 20-25 minutes. Now on a pen it’s 40 minutes and a much higher dose. Could be am retired and not as active? Eating out I dose 1/2- 2/3 for what I expect to eat and finish the dose when served but carry tablets with me (only needed once). In “fast food” I scan how busy and how active, maybe dose walking in. Never had a problem.
It depends so many factors I think we all can agree on that
I bolus as soon as I start to eat. I have always had a slowish digestive system (even pre-dx), so the insulin often kicks in before any food does. Since I only eat when I am 80-90 bg, having that timing works well for me. It also allows me to see the plate of food and determine how much of what I will eat. If my bg is higher than, say, 120, I will correct and wait to eat until after I am at my target of 80.
10 to 15 when I remember. About a third of the time. ……..
I’m supposed to bolus 10-15 min before meal…sometimes that isn’t the case. It’s after the meal, during meal or if I’m really on it’s at meal.
It depends on my glucose. If I’m in the 70s or 80s probably a few minutes before eating. Otherwise 15-20 minutes.
Depends on what my pre-meal BG is, and what and how much I am to eat. Most of the time I bolus as I start to eat or during the meal.
Unless my BG is high, I generally bolus just as I’m about to eat. I’m sensitive to insulin and if I bolus in advance I will go low. Most meals I do a dual/extended bolus.
This depends on my BG. If it’s lower, I’ll wait to bolus until mid meal. If it’s higher, then I’ll bolus before the meal. If it’s in range, then I will bolus when I eat.
Depends on my BG but if in target range, 15-20 minutes.
for me somewhere between “right before eating” and 15 minutes before.. If my sugar is 80 and I’m eating a meal around 15 carbs then i take it when i start eating, if my sugar is 100-120, and I’m eating low carb i usually take it 5-10 ahead. If my sugar is above 140 and (plus low carb) then 15 minutes ahead. That all changes though if I’m eating a meal above 15 carbs.
I answered 5-10 minutes before. Once upon a time when I was working I pre bloused, but we had several Aircraft delays, and I was distracted. After all the warnings, I stuffed my face with ever I could find that was edible to keep my crew from calling the EMTs. Of course, after severe lows, severe high follows, your liver is dumping glucose as a natural body reaction.
Being a brittle diabetic of 56 years, high metabolism, and a Type A personality, I have a substantial dawn phenomenon even with adequate insulin. I pre-bolus 35-45 minutes depending on the starting BG. If I am 140-160 before a meal, I try to bolus 10-15 minutes or so ahead of time, but usually bolus just before starting to eat.
I chose several of the answers because it really depends on the circumstances. I try to bolus 20 – 30 mins before I eat, but if I’m at a restaurant, I bolus once I order. Sometimes the food is ready quickly and sometimes not.
Forgetting to bolus before meals is my biggest T1D challenge. I often forget to dose when trying to quickly grab a meal or snack between meetings and deadlines, resulting in hours above range. However, I hesitate to dose in advance because I might (and often do) get pulled away before finishing and risk a low.
Just heard this week that the Medtronic 780g was approved in the US. It is advertised as having more aggressive programming to predict and autodose for missed meal doses. Also target BG can be set to 100 mg/dl and new Guardian 4 CGM that doesn’t require finger sticks. Will be interested in learning user experience with this model.
https://www.medtronicdiabetes.com/products/minimed-780g-insulin-pump-system?utm_source=google&utm_campaign=Pumps+-+BRAND+-+Core+-+Exact_asbly&utm_medium=ppc&gclid=Cj0KCQjwgLOiBhC7ARIsAIeetVAVa5_DcAUjjP-IZpEbpT1BdZyCMVAJIyOUx-a2ca3lQghTthnIciYaAr9-EALw_wcB&gclsrc=aw.ds
Bolus timing depends on the nature and location of the meal.
The last (and probably only) time I ever pre-bolused for meals was during pregnancy. But fortunately, using Afrezza for most of my meals means pre-bolusing is no longer necessary!