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Does it matter?

SueJB

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Heaven
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An easy question I think but I'm not sure of the answer.
I've heard/read that you should bolus 10-15mins before eating. I often forget until the last minute becoz I'm usually the one doing the cooking.
Does it matter?
Also, what's a fiasp?
 
I guess that would depend on your insulin

Nova Rapid is the one most people pre bolus with because it has a peak, so the idea is that you get the peak of the insulin activity and the carb intake to hit at the same time and so avoiding a spike post meal. Least that's the theory behind it and it takes a bit of messing about to get it right.

FIASP is a very fast acting and reading the leaflet with it says you don't need to bolus with it, simply take as your about to eat, never used it but I know of a couple who do and love it for its fast acting ability.

In the long run "does it matter" well some will argue yes others may not but it is way to control or lower post meal spike.
 
Hi Sue, there are sum that pre-bolus 30mins or more with novorapid, as Knikki has said fiasp is a faster acting version of it meaning you don't need to pre-bolus it starts working within 'minutes' - it's also good for corrections for this reason.

Does it matter, yes would be my answer, the flatter/steadier your BG profile the better - although with a short sharp acting insulin has it's down side too!
 
It depends on what my blood glucose is before hand, if it's in the 4's or 5's I would never take Insulin 1/2 before. Usually I inject mine just before I eat and it also depends on what type of food it is.
We never seem to get off the rollercoaster of type 1 life
 
Once upon a time I used an insulin where the instructions were 'inject 30 minutes before you eat' which I did religiously, when digital meters became available it was apparent that this was wrong , Humalog came along with the instruction to inject and eat but this caused spikes (this is 20 odd years back ) so I'd inject early and watch the blood drop before eating.

Then I joined on here to find this had already been invented and was called a 'pre bolus'

It's essential I do this due to portion size (ooh err missus) but for a low carbing T1 it's probably not as essential.

Edit, obviously your starting blood indicates the length of time to wait, the libre is the tool here as you can see the little rise before it starts to drop, the 'complexity' of the carbs is a factor too, but it does work.
 
Fiasp® is a rapid-acting human insulin analog indicated to improve glycemic control in adults with diabetes mellitus.
 
@Knikki, thanks for the info. I don't test after meals so don't know if I spike. Does everybody else test?
 
SueJB said:
@Knikki, thanks for the info. I don't test after meals so don't know if I spike. Does everybody else test?
Click to expand...
I never used to, then started doing it after so many years and realized breakfast and lunch I had significant peaks upto 15 mmol etc. All those years of unknowingly damaging my body. I now pre bolus and have requested FIASP insulin.

They say the post prandial levels are significant to hba1c readings for those below 8% level. As they can raise levels for around 3 hours before decreasing, then the next meal hits so not much time in range.

I'd suggest doing some testing, even every 15 minutes after some main meals to see how it reacts. Novorapid typically takes 20 minutes to start acting for me.
 
SueJB said:
@Knikki, thanks for the info. I don't test after meals so don't know if I spike. Does everybody else test?
Click to expand...

Testing all the time, but I have a Libre, which means I don't prick my fingers every time I wish to check...
But yes -I should say it is important to take a pre-bolus, at least if your insulin is not of the fastest sorts, and even then depending on what blood sugar levels you start from...
Not all insulins work as fast as asserted, but that could depend on many things, such as renal capacity etc...
 
@mike@work I wasn't questioning whether to bolus or not it was more about the time. I rarely use my Novorapid so suppose my question was a bit redundant in the first place. Just curious though.
 
SueJB said:
@Knikki, thanks for the info. I don't test after meals so don't know if I spike. Does everybody else test?
Click to expand...
I used to test between 8 and 10 times a day until I got the Libre, now not so often
I use Fiasp, a fast acting insulin, and take that as I eat. When I was on NovoSluggish I used to inject around 20 minutes before to avoid the dreaded spike. With Fiasp My line is pretty straight 80% of the time
 
I don’t prebolus my Novorapid, I dose just as I’m sitting down to eat, but then I eat very low carb and don’t get a spike. I work out my dose for the carbs and protein before I eat, usually entering all the ingredients into MyFitnessPal while I’m prepping the meal, and entering it into MySugr in advance of meal times. I use the bolus calculator on that, as well as the one on my pump, and make my own decision about what to actually insulinate for, and over how long. If I was running higher end of my range, say over 6.5, I’d maybe dose a few minutes early, but it all depends on what I’m eating. Basically I wing it

I don’t think Fiasp would work for me, as it’s onset is too sudden for my particular food.
 
SueJB said:
@Knikki, thanks for the info. I don't test after meals so don't know if I spike. Does everybody else test?
Click to expand...

If your using very low amounts of Nova then I don't know, but yes most people do test after meals after a bit you get to know your own body and how it deals with such things.

Like me I stuff my face at breakfast but I know that some 4-5 hours later that the carbs from that will hit and if I don't do a correction then they will rise significantly.

Like all things with this wonderful condition we is all different
 
SueJB said:
@mike@work I wasn't questioning whether to bolus or not it was more about the time. I rarely use my Novorapid so suppose my question was a bit redundant in the first place. Just curious though.
Click to expand...

OK - I see...
Can't give you a better answer than the answers above
But as said here, and it will be said again and again - we are all different, so some testing before and after eating, is the only answer that will give an somehow adequate picture of how YOU react...
 
Thanks @Mel dCP I think quite a lot of us wing it
Your comments on Novo are really useful. I suppose to use MyFitnessPal and MySugr you need a mobile right?. Interesting that you insulinate for protein, I've never done that.
 
SueJB said:
Thanks @Mel dCP I think quite a lot of us wing it
Your comments on Novo are really useful. I suppose to use MyFitnessPal and MySugr you need a mobile right?. Interesting that you insulinate for protein, I've never done that.
Click to expand...
I wing it if I’m away from my own kitchen, with mixed success

You can do them on a laptop, but on a phone is much easier and of course more portable. The first few months of low carb/keto, I didn’t need to, but as my body got used to it, I’ve found I have to dose for lean white fish and shellfish - not salmon, fatty fish, eggs or plant protein though. I dose 1:10 for every single gram of carbs in one dollop and 1:20 for the relevant protein, and that’s extended over two hours usually.
 
I think it's really important to test before and after each meal. If you don't, how do you know that you are giving yourself the correct insulin dose? Pre-Libre, I was testing about 10 times per day; a significant part of controller T1 well is about getting into good habits.

As others have said, if you have a carby meal you'll need to match the insulin peak with the carb peak; this isn't usually required if you low carb, unless you are running a really tight ship. As others have suggested, around 30 mins if you are having something with a moderate to high GI.
 
Out of interest what do you dose for protein in comparison to carbs?
 
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