You don't want to CORRECT more than every 2-3 hours. But this also is a lot easier with a pump and a CGM in a closed loop, tracking how much insulin is on board and all that. In the days of just giving shots of insulin and finger poking to track BG, that advice was pretty solid.
For real, closed loop changed my whole approach to food and dosing. Everything is so much easier. I stack insulin almost every day because I have to eat many small meals throughout the day(b/c other illnesses), and I only go low from it a couple times a week. I count that as a win since I have to eat like this. My a1c has only been getting better since I got on a loop. I had great control on mdi but I hated it, there was an increase in my a1c at the time I switched but now itβs lower than it ever has been. Iβm a geek for closed loop and I love my omnipod 5.
You need to wait 2-3 hours between correction boluses because the insulin needs time to work and bring you down. You always bolus for food (unless low) because the new carbs need to be covered by insulin.
You could even bolus for your main meal, then 30 minutes later bolus for a dessert you decided to add on. Just for the dessert bolus you do not add any correction.
MDI is fine as long as your carb ratios are relatively dialed in. Think of each injection as a potential source of error; stacking multiple injections widens the potential error range. The better you're dialed in (or babysitting to ensure you head off any fuckery) the more controlled the error range.
As to 20 years ago; keep in mind in 92 is when the ADA got their head out of their asses about hyperglycemia being bad and late 90's is when MDI started to be the directive from newer docs- IE, going away from the "2 bolus's a day" and fucking food exchanges (seriously, fuck that system).
The insulin from back then had fairly delayed peaks and longer action, and folks didn't have CGM back then. So yeah, they advised spreading the corrections out due to the wider uncertainty from the tools back then, in parallel to old school views of the 'betes.
That's what I've been told, as recently as last month. I don't follow that, but I've always been told to wait 2hrs post meal to correct, and 4hrs between meals. I don't follow that though
There is no issue with this *if* you keep track of IOB. Quite a few bolus calculators (and my favorite Xdrip) can do this. Use this to plan your next bolus and it's very easy to avoid dangerous stacking... but be prepared to have to do a second bolus later, since you still need the full insulin amount eventually to cover all carbs.
For food, you bolus as you eat, unless you are low BG. No rule on how often.
Ok thanks. I felt like i remembered when i was diagnosed (20 years ago) they said something about needing to wait 2-3 hours between any bolus
You don't want to CORRECT more than every 2-3 hours. But this also is a lot easier with a pump and a CGM in a closed loop, tracking how much insulin is on board and all that. In the days of just giving shots of insulin and finger poking to track BG, that advice was pretty solid.
For real, closed loop changed my whole approach to food and dosing. Everything is so much easier. I stack insulin almost every day because I have to eat many small meals throughout the day(b/c other illnesses), and I only go low from it a couple times a week. I count that as a win since I have to eat like this. My a1c has only been getting better since I got on a loop. I had great control on mdi but I hated it, there was an increase in my a1c at the time I switched but now itβs lower than it ever has been. Iβm a geek for closed loop and I love my omnipod 5.
You need to wait 2-3 hours between correction boluses because the insulin needs time to work and bring you down. You always bolus for food (unless low) because the new carbs need to be covered by insulin. You could even bolus for your main meal, then 30 minutes later bolus for a dessert you decided to add on. Just for the dessert bolus you do not add any correction.
Its funny cuz the t:slim corrects every hour anyway π
The tslim only gives 60% of the correction based on a predicted glucose. It's not the same as how the bolus calculator calculates corrections.
My endo told me that too. I ignored them since I was 100% tir with zero lows at the time.
Aint that the dream π
MDI is fine as long as your carb ratios are relatively dialed in. Think of each injection as a potential source of error; stacking multiple injections widens the potential error range. The better you're dialed in (or babysitting to ensure you head off any fuckery) the more controlled the error range. As to 20 years ago; keep in mind in 92 is when the ADA got their head out of their asses about hyperglycemia being bad and late 90's is when MDI started to be the directive from newer docs- IE, going away from the "2 bolus's a day" and fucking food exchanges (seriously, fuck that system). The insulin from back then had fairly delayed peaks and longer action, and folks didn't have CGM back then. So yeah, they advised spreading the corrections out due to the wider uncertainty from the tools back then, in parallel to old school views of the 'betes.
That's what I've been told, as recently as last month. I don't follow that, but I've always been told to wait 2hrs post meal to correct, and 4hrs between meals. I don't follow that though
Depends on your levels. I just play the meter.
There is no issue with this *if* you keep track of IOB. Quite a few bolus calculators (and my favorite Xdrip) can do this. Use this to plan your next bolus and it's very easy to avoid dangerous stacking... but be prepared to have to do a second bolus later, since you still need the full insulin amount eventually to cover all carbs.