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Type 1 Diabetes
Type 1 Morning Insulin Resistance
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<blockquote data-quote="Scott-C" data-source="post: 1960722" data-attributes="member: 374531"><p>It's well worthwhile spending time on it.</p><p></p><p>When I first went on novorapid, the doc said inject before meal, did so, ended up thinking regular bounces up to 10 to 15 was just "normal".</p><p></p><p>Found out about pre-bolusing a couple of yrs ago when I got libre.</p><p></p><p>I started looking at the daily graphs on the libre pc software each week, looking for the lowest post-meal rises and that gave me some good clues on ratios and pre-bolus timings.</p><p></p><p>Decided that about 20 mins worked for me, which ties in with the novorapid maker's advice that it takes 20 mins to start working (may differ for other insulins and people).</p><p></p><p>The upshot is that meals, which a few yrs ago, would have left me knocking 15, can be "tamed", so that I'll get a modest bounce to around 7 or 8, or add a few tweaks, and it's possible to have a gentle downward curve and then rise and no spike at all (as you found with the porridge, although that was probably taking it too far - I'd be getting messy too with 40 mins!).</p><p></p><p>After you find your sort of general guideline pre-bolus time, it's possible to add a few bells and whistles.</p><p></p><p>I'll start with my basic 20 mins, works most of the time, but I'll also pay attention to the general trend of what's been happening on the cgm graph for the last few hours.</p><p></p><p>If it's trending up, I might lengthen it as the insulin needs a bit more time to start dropping me before I hit it with food.</p><p></p><p>Or, if it's already trending down, I'll shorten it.</p><p></p><p>I'll also think about how "fast" the carbs are: a low GI meal would shorten it, and high GI would lengthen it.</p><p></p><p>One of the things which cgm and Sugar Surfing brings to the game is the idea of not being shy about doing corrections between meals.</p><p></p><p>I'll obviously try to figure out the correct bolus and timing for a meal, but if after an hour or two I'm getting clear signals from the cgm that I got that one wrong and it is starting to race too high, I'm not slow to fire in another couple of units to drag it back down.</p><p></p><p>If you decide to insulin-stack like that, setting up the Active Insulin symbol on libre is really useful for this sort of stuff. The code in the professional options section is CAA1C. Set it up, then enter each bolus shot and as time goes by, it'll tell you IOB. If I think I'm starting to go too high, and am trying to make my mind up about whether I should correct or not, knowing whether I've got roughly 1u or 5u iob is going to help with that decision.</p><p></p><p>This sort of stuff doesn't work all the time, T1 is too darned unpredictable for that, I still have fliers, but, all in all, it improves the odds.</p><p></p><p>Give it a go!</p></blockquote><p></p>
[QUOTE="Scott-C, post: 1960722, member: 374531"] It's well worthwhile spending time on it. When I first went on novorapid, the doc said inject before meal, did so, ended up thinking regular bounces up to 10 to 15 was just "normal". Found out about pre-bolusing a couple of yrs ago when I got libre. I started looking at the daily graphs on the libre pc software each week, looking for the lowest post-meal rises and that gave me some good clues on ratios and pre-bolus timings. Decided that about 20 mins worked for me, which ties in with the novorapid maker's advice that it takes 20 mins to start working (may differ for other insulins and people). The upshot is that meals, which a few yrs ago, would have left me knocking 15, can be "tamed", so that I'll get a modest bounce to around 7 or 8, or add a few tweaks, and it's possible to have a gentle downward curve and then rise and no spike at all (as you found with the porridge, although that was probably taking it too far - I'd be getting messy too with 40 mins!). After you find your sort of general guideline pre-bolus time, it's possible to add a few bells and whistles. I'll start with my basic 20 mins, works most of the time, but I'll also pay attention to the general trend of what's been happening on the cgm graph for the last few hours. If it's trending up, I might lengthen it as the insulin needs a bit more time to start dropping me before I hit it with food. Or, if it's already trending down, I'll shorten it. I'll also think about how "fast" the carbs are: a low GI meal would shorten it, and high GI would lengthen it. One of the things which cgm and Sugar Surfing brings to the game is the idea of not being shy about doing corrections between meals. I'll obviously try to figure out the correct bolus and timing for a meal, but if after an hour or two I'm getting clear signals from the cgm that I got that one wrong and it is starting to race too high, I'm not slow to fire in another couple of units to drag it back down. If you decide to insulin-stack like that, setting up the Active Insulin symbol on libre is really useful for this sort of stuff. The code in the professional options section is CAA1C. Set it up, then enter each bolus shot and as time goes by, it'll tell you IOB. If I think I'm starting to go too high, and am trying to make my mind up about whether I should correct or not, knowing whether I've got roughly 1u or 5u iob is going to help with that decision. This sort of stuff doesn't work all the time, T1 is too darned unpredictable for that, I still have fliers, but, all in all, it improves the odds. Give it a go! [/QUOTE]
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