How early before your meal do you inject?

tim2000s

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I've just read Nick Oliver's book about pumping and CGM, and interestingly, it's the first literature I've seen from a medical professional that actually talks about delaying insulin for longer than 15 mins for certain high carb meal types. While it's aimed at Healthcare Professionals as a bit of a guide to what pumps and CGM are and how you should deal with them with patients, it's good to see someone finally acknowledging that maybe, just maybe, bolusing is more tricky than many HCPs imagine.

The book Pumping Insulin was the first book where I read about injecting way before eating, the timing of insulin doses is fantastic tool to prevent postprandial spikes and should be discussed more often in hospital and gp clinics.
 
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LucySW

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Also Tim, isn't it about time that HCPs started to talk about T 1s not only recovering from post-meal spikes, but avoiding them, and that that is desirable ?!!

Those who want to try could knock at least 2 mmol off their A1c. The health improvement that would represent!

Sure, some people won't want to make the effort. But most T 1s don't even know they can try. Talk about pessimism, and complacency, on the part of HCPs ...
 
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PC16

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I didn't even think about timing - never been told any of this - just to have QA before every carby meal - my meter works out how many units i need from pre set time blocks issued by my nurse - I feel that there is too much info and knowledge out there to digest (let alone the carbs i eat lol) for one person especially when new to all this - [T1 one year on]
 

LucySW

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Yes, there is a lot, but with time it all settles down and simplifies and makes sense together. I'm banging on about this here, not to get people to feel dissatisfied or worried, but just to raise an issue that people really might want to think about at some point, when and if they're ready.

There's a time and a place for all this.

Getting diagnosed was an appalling shock for me, life-changing. (Because I want to be well.) I had time to read, and read, and read; so I did. Now, quite a long time later, I see for myself more clearly and I know what I'm interested in. We all have different aims. I'm just saying that this is a major issue for people to think about, when/if it suits them.
 
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tim2000s

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Also Tim, isn't it about time that HCPs started to talk about T 1s not only recovering from post-meal spikes, but avoiding them, and that that is desirable ?!!

Those who want to try could knock at least 2 mmol off their A1c. The health improvement that would represent!

Sure, some people won't want to make the effort. But most T 1s don't even know they can try. Talk about pessimism, and complacency, on the part of HCPs ...
Absolutely @LucySW. What I have found is that the registrars don't seem to know while the consultants do have some idea.
 
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tim2000s

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I didn't even think about timing - never been told any of this - just to have QA before every carby meal - my meter works out how many units i need from pre set time blocks issued by my nurse - I feel that there is too much info and knowledge out there to digest (let alone the carbs i eat lol) for one person especially when new to all this - [T1 one year on]
This is the tricky point that some of the senior diabetologists to which I have spoken allude.

There is a call, on one hand, from both PWD and HCPs to provide in depth education and advice around carb counting and administering MDI at an early stage of diagnosis, whilst having equally as many saying that the first six months is a period of coming to terms with the condition and the emotional and psychological effects are such that the amount of information that would require processing just can't be taken in. It's an unpleasant paradox.
 
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LucySW

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What they could do though, is give the very basic picture for the first year, then say at Point X (to be defined - one year, two years?): Now you've got the hang of this, there's a lot better that you can do, are you interested?
 

tim2000s

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PC16

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Thanks lucySW and tim2000s - I think you are both spot on with what you say - time is everything not just how long b4 you inject but for everything - so first things first i need to cut down on carbs!
 

LucySW

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Kristin251

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I was DX'd 1.5 years ago. A1C yesterday 5.1. Had a bout of infection with higher numbers for 3 weeks so happy with 5.1. Most days without infection under 5 according to my meter.
I really wish I would have at least heard of the blousing more before meals earlier as it would have saved me lots of discomfort and frustration. 10 min prior seems to be great for me at this point. Still working out fine details but has already made a big difference. I don't eat carbs other than veg and all meals are 80% fat so I think I am getting close to the bulls eye. I find the CGM info very interesting to say the least.
Thank for every bodies in put and info. Priceless info for me
 

petepontiac

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I have read the thread all the way through and I have learned a lot. I am going to try some of the suggestions, at the moment I am managing pretty well
 
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Kristin251

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I was managing very well as far as numbers but this has tweaked it even more so. I am still at 10 min prior and seem to be getting things closer and closer. it has helped hugely with BF. I always popped up right away. Now I stay within 5 points for 3 hours. Then for some odd reason I go up 10-15 but I am accepting this as another bolus would take me to low. It corrects at lunch as well. With this I am staying between 85-100 95% of the time but I feel so much better. I am very sensitive to the effects of insulin and moving even a little.
I found the CGM info very useful
 

14021954

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I have been diabetic for 39years. I have been reading different messages lately and honestly can say I am totally confused by all of the comment
I am going to stop reading altogether. A little information can be a dangerous thing.
 

hels

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Depends on my current BS, if I have active insulin on board, what I'm going to eat (or have already), plus various other factors I may think of.

I have many graphs going on in my head and my dose and its timing are decided from analysing them quickly.
 

azure

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I have been diabetic for 39years. I have been reading different messages lately and honestly can say I am totally confused by all of the comment
I am going to stop reading altogether. A little information can be a dangerous thing.

What in particular is confusing you? Please do ask :)
 

Ocho8

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What Is 85 - 100 or 95% ?
I though blood sugars range from 1.8 to 44.
1.8 extremely low and 44 extremely high.
With around 5.7 being Ideal.
Is the other scale new, American or used on pumps?
 

azure

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I was managing very well as far as numbers but this has tweaked it even more so. I am still at 10 min prior and seem to be getting things closer and closer. it has helped hugely with BF. I always popped up right away. Now I stay within 5 points for 3 hours. Then for some odd reason I go up 10-15 but I am accepting this as another bolus would take me to low. It corrects at lunch as well. With this I am staying between 85-100 95% of the time but I feel so much better. I am very sensitive to the effects of insulin and moving even a little.
I found the CGM info very useful

As I was posting that converter, I used it to look at your figures : D

I woukdnt worry about going up 10-15. That's a tiny amount, and could be due to a normal variation in meter readings.