Prebolusing and waiting for sugar to come down

[WestinsMom]

Okay, I think this may have been covered before but here I go. I prebolused Westin (15 minutes) but his starting sugar was 180. I heard the cgms alarm go off in the car on the way to work and he was over 300 around 340 if I remember correctly! Now mind you, we are experimenting with superbolusing the Carnation Instant Breakfast. Yesterday it worked wonderful. His high point was in the 180 range. He started around 100. So did his spike multiply due to the higher starting point?

I thought that maybe his cgms was really off as this morning when we got up his isig was lower than expected. His cgms was showing 126 and he was really 180 and very stable. I thought it might be because of the fluid not moving around well, and I always give him time to get moving before I calibrate. So I calibrated at 180 figuring it was enough time and maybe our sensor was dying. So when I heard that he was 340ish I thought, oh that darn fluid...I didn't give it enough time. But now that we are at the office I checked him and his cgms said 244 with two arrows going down and his bs said 241. So I think I can believe that he really spiked up that high.

So again, did his spike multiply due to the higher starting point?

[Lee]

I think that yes - if he is higher going in, then the spike would naturally be higher - here is the Prebolus times given to us by our doc...http://www.holdthatpic.com/photos/3167/33144.jpg (http://www.holdthatpic.com/)

It is hard to always follow, but I have definitely found the more I stick to it - the less likely the spike!

[twbeckman]

I would think the spike was indeed that high! Breakfast is a special challenge for us too--always battling the spike but having a huge low 2-3 hours later. We use the pre-bolus and dual wave also trying to flatten it out, can't say w/ consistent success though! Today I think the pre-bolus was ahead of the spike b/c he had "the look", know those Lucky Charms were going to hit his system any minute though! If I could just convince him that Fiber One tastes just as good:rolleyes:

[twodoor2]

I definitely think the chart above also depends on the DIA and the time of day. For Elizabeth, I could easily add at least 10 minutes to all the above values. It really takes a while for the insulin to start working in her, with it obviously taking the longest during the morning (highest insulin resistance at that time). If she's 200 at morning, for example, I have to wait around 40 minutes to feed her breakfast after her bolus.

I think that the chart is a great starting point, but you need to experiment with your child on the best prebolus times. :)