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Great tip for prebolusing/lead time from endo

Discussion in 'Parents of Children with Type 1' started by BrendaK, Aug 8, 2011.

  1. BrendaK

    BrendaK Neonatal Diabetes Registry

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    Saw the endo this morning and the CDE gave us a great tip for remembering how much lead time you need for prebolusing. She said she came up with it in the shower, LOL!

    Anything 80 -150 you need 15 minutes.

    Anything over 150, you take the first 2 digits and that's your lead time.

    For a 213, it would be 21 minutes

    305, 30 minutes

    183, 18 minutes

    I had never heard this and thought it was a great tip for a KID to remember. Carson got it right away and is going to start trying it.
     
  2. StillMamamia

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    Thanks!:)

    mts
     
  3. Christopher

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    I don't know if that was Nancy or not, but she always comes up with good stuff like that. :cwds:
     
  4. Sarah Maddie's Mom

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    That's a great tip! Thank you, and your CDE ;)
     
  5. wilf

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    I like this very much. THanks for sharing! :)
     
  6. frizzyrazzy

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    that's really a great idea!
     
  7. swimmom

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    We like this idea and are going to try it. Thanks!
     
  8. dqmomof3

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    Thanks for sharing that tip! Great idea.
     
  9. BrendaK

    BrendaK Neonatal Diabetes Registry

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    Yes it was Nancy -- Love her!
     
  10. 5kids4me

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    A few weeks ago someone suggested this in a facebook group, we have been using it ever since. Good advice!
     
  11. Jensmami

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    That is great advice, especially the minutes for bg over 150. However we use Apidra and with a slow digesting food, a blood sugar of 80 and 15 min pre bolus could drop her low. Even more so if she is already dropping.
     
  12. BrendaK

    BrendaK Neonatal Diabetes Registry

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    I should have mentioned these are the guidelines for Novolog/Humalog, not Apidra ;)
     
  13. selketine

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    I used to always prebolus William's breakfast because he spiked afterwards - and if he woke up around 130 or so - for example - I prebolused by 15 mins.

    Only after going on the cgms did I realize that he was going low about the time he finishes breakfast and while I'm taking him to school - and the first part of school. He dips down to the 50's and 60's before going up on his spike.

    While pre-bolusing can be really useful, I REALLY discourage people from prebolusing based on a formula of any type and to be very careful with it - especially if you don 't use a cgms. I even used to test William before giving him food to make sure his BG was ok - but I didn't test him right after.

    If William was 80 and I prebolused his meal he'd be in the 20s while he was eating or just after.
     
  14. BrendaK

    BrendaK Neonatal Diabetes Registry

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    I do agree, be very careful, and YDMV. I should have also said that these are guidelines for older kids that are entering puberty.... Carson's insulin needs have gone WAY up and the endo said that this is the age where prebolusing starts to play a big role.
     
  15. bnmom

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    That is such a great, easy tip! Thank you :)
     
  16. Beach bum

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    Interesting, I'm going to try it next time...
     
  17. Susanne

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    Love it! It makes it very easy to remember.

    Lately, though, we had issues with slow digestion, at dinner time (pasta, low glycemic foods...). Often, I cannot pre-bolus anymore if Sophia is under 200 because she will go low within one hour. Is anyone else experiencing this?
     
  18. Jacob'sDad

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    It sounds good and sound like it might work for Jacob even though he uses Apidra because his digestion is really fast.

    Now...Let's get real world here. How would this work under some real world situations? Let's assume that some who try it will not have a CGM to tell them what BG is, so they would have to do a finger poke.

    So would you always poke 1/2 hour before eating just in case BG is over 300? Isn't BG sometimes changing before a meal? I mean Jacob could be 250 and 1/2 hour later be 150 especially if he had a correction.

    If you did poke right before meal time and BG was 240, would you them tell them that they had to wait 24 minutes to eat? Would every one else wait too?

    Really, I think it sounds like a good idea, but I'm just trying to figure out how to put it to good use.
     
  19. BrendaK

    BrendaK Neonatal Diabetes Registry

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    Prebolusing is very very hard with an 11 year old boy who is eating constantly. BUT, we are learning that if we DO prebolus consistently, then there aren't those fast changes (250 down to 150 in 30 minutes like you mentioned above). If we don't prebolus and he's eating all day, then yes there are those big swings and the insulin is always chasing the food.

    So, yes, tonight we checked blood sugar 30 minutes before dinner. He was 130, so we waited 15 minutes, bolused, then ate 15 minutes later. It sounds complicated, but it was easy. It takes a bit of work to get dinner on the table, so we bolus for dinner, then get the table set, salad made, drinks on the table, etc. DH and Carson did the bolusing, getting dinner on the table, while I picked the youngest up from gymnastics and we all made it to the table at the right time. So yes, for meals we are all eating together, but it doesn't seem like a big deal to wait. It's not like we are sitting around looking at the timer, we're all getting ready for the meal.

    Snacks are much harder. Especially for a grazer. But the endo did talk to Carson and he is on board to try and prebolus for snacks too. He is loving making his own "fancy" snacks like smoothies, mini pizzas (on a tortilla), and if he knows what he wants, boluses, then he has plenty of time to make a snack.

    School is going to be the hardest, we really want to prebolus for lunch and snack this year. We may buy him his own sports watch with a timer.

    I would have never ever done it like this when he was younger, but he is 11 now and the one predictable thing is that he WILL EAT! I'm hoping it makes a difference with not having the huge blood sugar swings. He's at the very beginning of puberty and just this week his I:C ratio has gone to 1:10 (it was 1:20 2 weeks ago). Basals have been ramped up also.
     
  20. Sarah Maddie's Mom

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    I agree, Brenda ... pre-bolusing is just hard! And at school we find it almost impossible. Lunch is short and if she prebolus' and waits then she misses recess, and that is just not going to happen.
     

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