I've ordered that book from the library I think you may have mentioned it in another thread of mine. It must be popular as its still out... I will ask the endocrinologist on the 10th re info on carb counting too. How do you mean "when" to bolus and "how" much? I was on 3 apidra each meal time... and the saying was.... jab an eat. Don't eat don't jab. Thank you for your advice. I will research myself also re carb counting and look at your link.
Ah, the book is so good I mentioned it twice
Seriously, it has a lot of info but is in a friendly, easy to read tone.
Sorry if I'm saying things you already know re bolusing, but the important thing I had to get in my head when I was diagnosed was that insulin isn't like other meds where the Dr gives you a dosage, you just take that dosage and everything is fine. The amount of insulin you need will vary - particularly the bolus insulin. That will depend on your blood sugar, what you're about to eat, what you're going to do after the meal (eg exercise)
The amount of carbs in your meal, and, to a lesser extent, the protein will affect how much insulin you need. Hence the crucial importance of carb counting. When you don't have Type 1, your body will deal with whatever you eat perfectly, but for us we have to 'be our own pancreas' and try to match our insulin to our food.
When I was first diagnosed, I was initially on set doses of insulin for meals like you. BUT the crucial difference is I was told how many carbs I needed to match that dose of insulin. If I hadn't known that, I could have eaten lasagne and chips one night (lots of carbs) and had an after meal blood sugar of 15, and then the next night decide to have a tuna steak and salad (minimal carbs) and have a big hypo before I even got round to testing my after meal blood sugar. Knowing how many carbs to have for my set insulin dose meant I avoided both highs and lows.
I also mentioned "when" to have your bolus. I'm not familiar with Apidra and have never used it, so this may be different for you, but the insulin I was on was Humalog. I was told to inject it right before I started to eat, but as many others have found, that doesn't usually work and causes a spike in blood sugar because even very fast acting insulins take a while to work, and so your blood sugar goes up. Most people find injecting Humalog more in advance of your meal stops the spike. Often people come on here and say things like "I can't eat toast because it spikes me" when actually they could eat toast if they simply had their bolus a little earlier.
Although "don't eat, don't jab" is true - you certainly don't want to have your meal time injection if you're not going to eat - you might also need to use your fast acting insulin in a correction dose. This is to bring down a high sugar. Do not do this until you've been taught how to obviously because you need to know what you're doing, but that is an occasion where you could take fast acting insulin without food.
But for "when" I simply meant timing your pre-meal bolus accurately to prevent spikes in your blood sugar.