Split bolus for most foods?

[JMoli]

Hi, I was wondering if anyone else has to split bolus for most foods/meals? So far in my experiments the only carbs I can pre-bolus for are bread, tortilla wraps and boiled potatoes!? I’ve not done too much experimenting since diagnosis due to fear of hypos and constantly changing carb ratio but tried oven chips (on their own) and breaded meat/fish, pasta (disaster) baked potato and recently a vegan cheese-free pizza and consistently go low after eating then high five-six hours later.
I want to try and work out how to eat things other than potatoes and bread obviously, should I inject half the bolus with the food then inject the other half when I see a rise or just guess at 1.5 hour later and tweak depending upon how it goes? I’ve deliberately not eaten too much protein or fat with my experiments and am dairy intolerant now so no cheese to slow things down. Thanks

 

[ert]

I do it for everything. It's sugar surfing. Sometimes I don't need the second injection, especially if I walk straight after eating.

 

[KK123]

Hi, I was wondering if anyone else has to split bolus for most foods/meals? So far in my experiments the only carbs I can pre-bolus for are bread, tortilla wraps and boiled potatoes!? I’ve not done too much experimenting since diagnosis due to fear of hypos and constantly changing carb ratio but tried oven chips (on their own) and breaded meat/fish, pasta (disaster) baked potato and recently a vegan cheese-free pizza and consistently go low after eating then high five-six hours later.
I want to try and work out how to eat things other than potatoes and bread obviously, should I inject half the bolus with the food then inject the other half when I see a rise or just guess at 1.5 hour later and tweak depending upon how it goes? I’ve deliberately not eaten too much protein or fat with my experiments and am dairy intolerant now so no cheese to slow things down. Thanks

Hi there, my pattern is very similar to yours. After much experimenting I find that when I use the 'correct' amount of insulin for the carbs I'm about to eat, after 2 hours my levels are always back to what they were or within the holy grail of 2mmol's. Around hour 4 after eating they always start to gently rise again and depending on what I've eaten (usually a mixture of carbs/fat/protein) I know that if I want to stop them doing a 2nd rise I need to nip it in the bud by taking more insulin. I read that this was to allow for the protein a meal has. With regard to how much insulin, obviously you would have to work that out for yourself and although there is a method to work out your protein ratio I tend to add 1 unit for around 15g of protein. A very interesting link was posted recently about sugar surfing explaining it all (@ert, was it you??). For me I don't think it was a question of working out how much insulin for the carbs and then taking half before and half later, but working out how much insulin for the carbs, taking it all at once and then adding another unit or two to deal with the rise of the protein around 3/4 hours later. Be very careful about stacking though! My libre is really good for letting me know when the glucose is on the up so I can time it quite nicely. x

 

[JMoli]

Hi there, my pattern is very similar to yours. After much experimenting I find that when I use the 'correct' amount of insulin for the carbs I'm about to eat, after 2 hours my levels are always back to what they were or within the holy grail of 2mmol's. Around hour 4 after eating they always start to gently rise again and depending on what I've eaten (usually a mixture of carbs/fat/protein) I know that if I want to stop them doing a 2nd rise I need to nip it in the bud by taking more insulin. I read that this was to allow for the protein a meal has. With regard to how much insulin, obviously you would have to work that out for yourself and although there is a method to work out your protein ratio I tend to add 1 unit for around 15g of protein. A very interesting link was posted recently about sugar surfing explaining it all (@ert, was it you??). For me I don't think it was a question of working out how much insulin for the carbs and then taking half before and half later, but working out how much insulin for the carbs, taking it all at once and then adding another unit or two to deal with the rise of the protein around 3/4 hours later. Be very careful about stacking though! My libre is really good for letting me know when the glucose is on the up so I can time it quite nicely. x

Ah, thanks! That’s interesting about the protein - I didn’t know that. It’s all so complex isn’t it!?! I think non diabetics must assume we just inject and eat but it’s trying to assess so many things isn’t it. I’m definitely interested in sugar surfing too, will try and read up on that x

 

[JMoli]

I do it for everything. It's sugar surfing. Sometimes I don't need the second injection, especially if I walk straight after eating.

Thanks, I tried to get a copy but only available on kindle format and wouldn’t download for me but I’ll try and read up on it as I think it sounds exactly what I need

 

[MarkMunday]

You can also use Actrapid for low-carb meals. It acts over 8 hours. I use Actrapid for most meal boluses and only use Novorapid if I am eating lots of carbs.

 

[Marie 2]

I almost always split boluses. Rule of thumb for me, I take half about a half hour before and then the rest when I eat. It does depend what I eat. There are some foods that I might vary timing of the prebolus. That allows me to adjust my final dose to what I actually ate. High carb high fat I will take a third a half hour before, a third when I eat and a third a half hour after I eat.

Protein is different for me. If I eat something very high protein but low carb I have to take insulin for it. That is more unusual meal for me though. But if it is my "normal" more protein/carb balanced meal, I don't have to take anything for the protein.

But we can all vary and you have to figure out what foods effect you how. High fat foods not only slow down digestion of carbs, they can require a bolus for the fat, and it personally can make me insulin resistant for hours after.

Proper timing allows me not to go over 130/140 that often.

 

[donnellysdogs]

I don’t pre bolus but have a routine that works for evening food. I eat one meal per day...
Sounds odd but works for me:
Mornings:
2 units fiasp to stop getting out of bed rises.
11 units insulatard (kicks in later in afternoon when my levels rise)
Tea time: one normal bolus of Novorapid.doesn’t matter what I eat... no effects later. Any amount according to what I eat..
Bed time: 2.5 units tresiba
3-5.0 units insulatard depending what I ate earlier.
Roast dinner with Yorkshire pud, root veg and it would be 5 units, soup and strawberries and it would be 3 units.
I generally can fluctuate my meal times.. in evenings.
If I was eating midday or late afternoon say on xmas day it will be increased insulatard on my morning dose.
When I go back to work, my lovely milky coffees in afternoon and stress will increase so my insulatard will go up to 17 for mornings.
I rarely get hypo’s and rarely go above 7.0.

I’ve spent years figuring this routine for myself.
Yes effectively 4 insulin’s, which are easy to handle-one pack of the two night doses on bedside table Nd one pack of the morning insulin’s in pack on table too. Just have tea bolus around.

My superb tertiary care hospital told me that basically I just had to fire fight all the rest of my life with my bloods. Pump cannulas do not work in my skin. Failed after 5 years of use.
I did testing to see when my peak and troughs were, looked at insulin acting times and how I could get different insulin’s to work.. laid the insulin times over the peak times, took graph to consuktant and asked for the two basals initially.. worked out lots better but novorapid didn’t do much for getting up. So asked for fiasp too. Superb.
Brilliant results all the time nowadays. Never peak above 7.0 for evening meal or day food. Even if I have breakfast, for that I would increase the fiasp...
90% of my daily one meal eating is around 6pm, if I do have a snack during day it will be because I’m on holiday with my hubby and we have sat a breakfast out ...

I also have delayed emptying of stomach and slow colonic transit which means that food releases energy at odd delayed times..helps enormously with this.