How early before your meal do you inject?

tim2000s said:

What you describe here sounds like your basal is not properly titrated with uplift on LC after four hours. Unlikely to be bolus.

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I was experiencing the same. I increased my basal slightly and it looks like it helped. Thanks for the tip.

20 minutes before breakfast, 5 minutes for lunch when working or 10 minutes at the weekend, 10 to 15 minutes for evening meal, will leave longer if blood glucose is up a bit.

Does everyone plan it dependent on what you are eating or just have a set time?

I am finding early bolus is helping especially at BF but I have changes a few other things like light yoga 1 hour after BF and not eating nuts as snacks so nit sure what is doing what but it FEELS better and BS is good. I mostly am looking to NOT feel movement as that makes me crawl out of my skin and HUNGRY.
Early bolus really helps BF even if I am lowish. I don't pop up as high or fast. So glad I found this

I don't have a rule for when to take my insulin before meals. Loads of variable factors play a part in my decision.
A couple of instances will show why....

I went out for a run before my evening meal after work last night. Blood level before the run was 5.2 so I boosted my short term levels up by having a swig of lucozade. Ran a bit further than intended. Got home. Blood level was 4.2. Evening meal was ready in 20 minutes. Decided to wait till after the meal to inject bolus. Had about two thirds of my usual (??) dose knowing my levels would plunge during the evening. So my bolus injection was 20 minutes AFTER eating.

Went to bed on a 9.2. Ate the one last mince pie left in the house after Christmas as an assurance against dropping low during the night. Had my normal basal, because in all honesty I don't the effects of basal so I never change the dose.

Woke up on a 3.4. Had breakfast (cereal and pure orange juice) without taking any insulin. Then drove 40 miles to work. Where I have injected a small dose of bolus. This was 1 hour AFTER eating.

My life leaps around in this pattern constantly, so having a rule for when to take insulin has never been important to me. Spikes and lows in my blood levels are not a problem. I deal with them as they happen. I look at the resuls my HB1AC every 3 months. If that is bad (subjective) then I may cahne something. So far I have been lucky with my control (or, maybe, perfectly controlled lol)

From months and months of running a Libre CGM, my Novorapid doesn't shift at all for 35 mins. So I always try for 30 mins, except when eating out, when I need to see the food to gauge the insulin dose.

@superdom, HbA1c is one indication, but consistency is just as important and may be more so. Lots of evidence that it's swings in BG that cause the complications. Masses around to read on that subject. Monitoring your standard deviation may be the best thing you can do for yourself.

My doctors said that you should do it about 15 minutes before you eat, but it probably varies for each person and how much they eat (maybe).

jasmine1616 said:

My doctors said that you should do it about 15 minutes before you eat, but it probably varies for each person and how much they eat (maybe).

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There's a lot of Libre/CGM anecdotal evidence that shows that 15 mins isn't really enough for most people, and there are many reasons for this.

tim2000s said:

There's a lot of Libre/CGM anecdotal evidence that shows that 15 mins isn't really enough for most people, and there are many reasons for this.

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Well it can work both ways, one morning I woke to a bg level of 4.4mmol and bolused 20mins before as per normal, sat and had breakfast then a short while after felt a hypo coming on, on looking at the Libre graph my bg levels at dropped into the low 3's so I know in future not to bolus too far ahead if I'm in the low 4's.

Bolus timing does vary depending on food eaten and other considerations like bg levels, that is one lesson I've learnt from the Libre

noblehead said:

Bolus timing does vary depending on food eaten and other considerations like bg levels, that is one lesson I've learnt from the Libre

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Totally. Very low carb meals I bolus just before I eat as the bg level increase is timed very differently.

It depends on what I eat and what my levels are. Libre shows you can safely push it to 30 -40 min (not for low carb though). Dafne says just before eating ( or even after) which is a nonsense I think.

When I was first diagnosed I was told to Jab just before or after meals. Having the Libre has taught me my system needs at least 30 minutes for the Novo rapid to kick in.

This is all extremely interesting. I wish I had a Libre just for curiosity. I have been blousing 10 min prior and it seems to make a difference. All my meals are very low carb as well. It has made a BIG difference in my fast bump up with BF being just guac and celery. I would still bump. And the lower I am before I eat the bigger difference. I would be afraid to go more than 10 min as I wouldn't want to go low. Since I stopped eating nuts things have lower as well. I am waking up around 75 now instead of 85 or 90. I really don't raise for 3 hours and I think Novolog has worn out by then.
Great thread and lots of good thoughts/ documented info! This may be the key I was missing.

5 mins before

General opinion is novorapid and its ilk take up to 45 mins to properly kick in. A recent post compared graphs for bread/potato/rice etc against speed of BG rise - essentially they all spiked quickly. In this case a 40 minute pre-bolus would sync BG rise and insulin activity. If meal is v fatty or you are going lower carb/fat content and protein will cause slower rises and you will need to reduce the pre-bolus time to compensate or even split doses. Caveat- we all have individual responses and things diabetic can vary by time of day, day of week, full moon, wind direction etc. as we know!

P

steve_p6 said:

General opinion is novorapid and its ilk take up to 45 mins to properly kick in. A recent post compared graphs for bread/potato/rice etc against speed of BG rise - essentially they all spiked quickly. In this case a 40 minute pre-bolus would sync BG rise and insulin activity. If meal is v fatty or you are going lower carb/fat content and protein will cause slower rises and you will need to reduce the pre-bolus time to compensate or even split doses. Caveat- we all have individual responses and things diabetic can vary by time of day, day of week, full moon, wind direction etc. as we know!

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Ps I have good hypo awareness, on Libre so can see if i've mistimed and fix, am also now getting better appreciation of that carb/fat/protein balance and am quite comfortable that I have the tools to sail close to the wind. If you dont have any of the above then you have to follow much closer to the standard NHS advice I think.

I basically eat the same macros at each meal so I should be able to figure this out pretty quick. I am 5% c (veggies only), 15% protein and 80% fat. Even the 10 minutes prior makes me FEEL so much better. At BF when I was low I would start eating then take it and I got a HUGE bump. !0 min prior seems to be working really well.
I can't thank you all enough. This is a GREAT forum on so many aspects

steve_p6 said:

Caveat- we all have individual responses and things diabetic can vary by time of day, day of week, full moon, wind direction etc. as we know!

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Indeed

It's always best to find out what works for you as an individual rather than what works for someone else, bolus timing can be complex subject.

@ewelina, when the analogue insulins like Novorapid first came on the market we were assured that you could inject just before or even after eating and the insulin would deal with the postprandial spike, it's through forums like this, our own personal experiences and reading books like Think Like a Pancreas that we know this isn't so for the majority of people.

noblehead said:

Indeed

It's always best to find out what works for you as an individual rather than what works for someone else, bolus timing can be complex subject.

@ewelina, when the analogue insulins like Novorapid first came on the market we were assured that you could inject just before or even after eating and the insulin would deal with the postprandial spike, it's through forums like this, our own personal experiences and reading books like Think Like a Pancreas that we know this isn't so for the majority of people.

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I don't know what we would do without this forum. Its rather sad we cant rely on nhs advice

ewelina said:

I don't know what we would do without this forum. Its rather sad we cant rely on nhs advice

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At the end of the day we manage this condition ourselves 99.9% of the time, the NHS has it's place as does great forums such as this.