3 ms·

I'm a T1D and I mostly agree with the author. I think this simulation is very interesting. I disagree with the author however on the following point: "injecti

I'm a T1D and I mostly agree with the author. I think this simulation is very interesting. I disagree with the author however on the following point: "injecting insulin ~15min before you start eating would do wonders for neutralizing the BG spike, the issue is, nobody does it, because what if you then get a smaller serving at the restaurant or it gets delayed?" My doc told me the same, which I think is insane. "Here is a hack that solves 80% of your problems but nobody does it, so don't bother." WTF? If you get a smaller serving, order some bread or eat some of your emergency snacks you should always have. If it gets delayed, do the same. You don't need to cover the whole insulin dose, just delay the hypo a little bit. Relax. We live in an industrial world where glucose bombs are available always and everywhere. You'll be fine. Injecting 15mins beforehand has made my life so much easier that I would not miss it for anything. Feel free to ask me anything.

mjaniczek 2y ago
You're definitely making me reconsider it, thanks! Along with the person in another thread saying walks after meals help as well. With a fully remote work these risky "oops I injected but there's no food yet" situations should not happen as often, considering the time-to-fridge is like 10 seconds.
- InvaderFizz 2y ago
  Knowing little about the subject. If Insulin is a 20 minute lag, and eating is a 20 minute lag. Shouldn't you just dose immediately before eating so they hit at the same time?
  - mjaniczek 2y ago
    It's a very rough rule of thumb, take these numbers with a grain of salt. It could very well be that some food activates in 5 minutes etc. Different insulin types also have different curves. Anyways there are studies about the "inject 15min before food" approach: eg. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2945151/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2945151/
  - tornadofart 2y ago
    You forget one very important rule: it's all vibes :D No but seriously: insulin starts to act after 20mins. Its action is more like a flat parabola. Glucose acts more in harsh peaks. So you want the glucose peak to hit when you are at the maximum of insulin action. Hence the 15mins delay. This is all roughly speaking, YMMV.
- tornadofart 2y ago
  It's hard at first. It is a habit to take, and you have to withstand a bit of social pressure first, when you're late with taking insulin and still want to wait. But I root for you, you can do it!!
- tornadofart 2y ago
  one more tip I want to share: when you have a dramatic hypo or your blood sugar is dramatically high, double-check with the old school prick-test device. Your CGM might exaggerate. That stopped some nefarious cycles of being too high, then too low etc. for me.
- RandomUser4976 2y ago
  Type 1 here. I also agree. With comment above. I have two thoughts that may be valuable for you. 1) You can do an extended pre-bolus before you eat. This gives you a chance the cancel the remaining insulin dose if you learn your meal will change for any reason n-minutes before or during your meal. Maybe the meal unexpectedly tastes bad, you can cancel the remaining insulin. Maybe the restaurant tells you they are out of the dish you order n-minutes ago. This is called different names in various insulin pumps; Extended bolus, temp basal, etc. 2) Pre-bolus and eat AFTER you see your blood glucose decrease for 3-4 readings. Pre-bolusing for static time like 15 minutes before eating does not work consistently because there are lots of variables at play before you eat that directly affect (a) insulin sensitivity and (b) blood glucose. (Environmental temperature, insulin temperature, injection site, adrenaline, stress, pain, previous meals, lipid levels, exercise, medications, illness, to name a few). Eating after I see my BG decrease for at least three consecutive readings has helped me stay in range (70-140) for 95-100% of the time and maintain a healthy A1C (less than 5). Cheers!
virtualr 2y ago
Same here, or more often I'll just wait to start eating if it comes early. I was selfconsious about it at first but staying in range is more important to me than any awquard feeling saying "please start, I just need to wait a few minutes", no one ever makes a fuss.
nimchimpsky 2y ago
[dead]

mjaniczek 2y ago

You're definitely making me reconsider it, thanks! Along with the person in another thread saying walks after meals help as well. With a fully remote work these risky "oops I injected but there's no food yet" situations should not happen as often, considering the time-to-fridge is like 10 seconds.

InvaderFizz 2y ago
Knowing little about the subject. If Insulin is a 20 minute lag, and eating is a 20 minute lag. Shouldn't you just dose immediately before eating so they hit at the same time?
- mjaniczek 2y ago
  It's a very rough rule of thumb, take these numbers with a grain of salt. It could very well be that some food activates in 5 minutes etc. Different insulin types also have different curves. Anyways there are studies about the "inject 15min before food" approach: eg. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2945151/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2945151/
- tornadofart 2y ago
  You forget one very important rule: it's all vibes :D No but seriously: insulin starts to act after 20mins. Its action is more like a flat parabola. Glucose acts more in harsh peaks. So you want the glucose peak to hit when you are at the maximum of insulin action. Hence the 15mins delay. This is all roughly speaking, YMMV.
tornadofart 2y ago
It's hard at first. It is a habit to take, and you have to withstand a bit of social pressure first, when you're late with taking insulin and still want to wait. But I root for you, you can do it!!
tornadofart 2y ago
one more tip I want to share: when you have a dramatic hypo or your blood sugar is dramatically high, double-check with the old school prick-test device. Your CGM might exaggerate. That stopped some nefarious cycles of being too high, then too low etc. for me.
RandomUser4976 2y ago
Type 1 here. I also agree. With comment above. I have two thoughts that may be valuable for you. 1) You can do an extended pre-bolus before you eat. This gives you a chance the cancel the remaining insulin dose if you learn your meal will change for any reason n-minutes before or during your meal. Maybe the meal unexpectedly tastes bad, you can cancel the remaining insulin. Maybe the restaurant tells you they are out of the dish you order n-minutes ago. This is called different names in various insulin pumps; Extended bolus, temp basal, etc. 2) Pre-bolus and eat AFTER you see your blood glucose decrease for 3-4 readings. Pre-bolusing for static time like 15 minutes before eating does not work consistently because there are lots of variables at play before you eat that directly affect (a) insulin sensitivity and (b) blood glucose. (Environmental temperature, insulin temperature, injection site, adrenaline, stress, pain, previous meals, lipid levels, exercise, medications, illness, to name a few). Eating after I see my BG decrease for at least three consecutive readings has helped me stay in range (70-140) for 95-100% of the time and maintain a healthy A1C (less than 5). Cheers!

virtualr 2y ago

Same here, or more often I'll just wait to start eating if it comes early. I was selfconsious about it at first but staying in range is more important to me than any awquard feeling saying "please start, I just need to wait a few minutes", no one ever makes a fuss.

nimchimpsky 2y ago

[dead]