Bolus Timing

[payam7777777]

How many minutes before/after start of a meal do you bolus?

[nantomsuethom]

It depends, If Thomas knows how many carbs he is eating he will bolus a few/5 minutes before he eats. If we go out to eat he will bolus after he eats, just in case he doesn't finish. At school he will bolus as soon as he figures out the # of carbs.

[lilituc]

5-20 minutes depending on current blood sugar. The action always works better if I wait 15 minutes, though.

[payam7777777]

Not yet fully tested but ours seems to be something like this:

20 minutes prior for breakfast
Right on the begining of lunch
10 minutes after begining of dinner

i guess it's because of the difference in BG raise when stomach/small intestine is full/empty.
i.e.

At breakfast stomach and small intestine are empty so [partially digested] food reaches small intestine quickly (where it actually can affect BG)

At dinner [partially digested] food reaches small intestine slower because stimach and small intestine are [at least partially] full.

And lunch is something in between.

[BrendaK]

Good question. I wish I was more comfortable with bolusing 15 minutes before each meal. But what we do is usually bolus 5 minutes before to right at the start of each meal. Sometimes I'll bolus for 1/2 of what I think Carson will eat then I'll give him the rest if he eats more than what I bolused for. Too often I have bolused for a meal, then he won't eat it.

If Carson really high right before a meal, I'll bolus 15-20 minutes prior. But tonight he was 87 before dinner, so I didn't want to bolus before (probably should have, though.)

[payam7777777]

John Walsh's Presentations
http://diabetesnet.com/diabetes_presentations/BeginningPumping-0706_files/BeginningPumping-0706.ppt
http://www.childrenwithdiabetes.com/presentations/Pump-Begin-CWD-0904a.ppt
http://diabetesnet.com/diabetes_presentations/AdvPump-JWalsh-CWD-0705.htm
http://diabetesnet.com/diabetes_presentations/AdvancedPump-0706_files/AdvancedPump-0706.ppt
http://diabetesnet.com/diabetes_technology/insulin-pumps-advanced.html
http://diabetesnet.com/diabetes_presentations/DMCare-Past-Future-0904.html
http://diabetesnet.com/diabetes_presentations/super-bolus.html
http://diabetesnet.com/diabetes_presentations/AdvDevices-JWalsh-0705.ppt

[payam7777777]

Good question. I wish I was more comfortable with bolusing 15 minutes before each meal.


BG raise is much faster than rapid acting insulins. (Refer bto John Walsh's slides) while the onset of action of Novolog/Lispro is ~15minutes.


Be careful though.


See the attachment, please.

[ramrummy]

Husband boluses with actrapid anywhere between 15 minutes before to after the meal . 7 yr old uses novorapid - at school 5 - 10 minutes before meal, at home same if I am sure he will eat it all, or part before and rest after.

Actrapid 15 -20 mins before it starts working, Novorapid (Novolog) 10 minutes to get working.