How long before eating should you enter carbs into pump?

Technology & Management
1

Hi, Can anyone advise as to whether it is recommended to enter the carb amount into the insulin pump a certain time (i.e. 15 minutes) before eating. I notice my daughter always goes out of range after eating.

2

Hi @cloughfamily Leigh and welcome to TypeOneNation. 15 minutes before eating can help a spike but it’s a dangerous game. When carbs are mixed with fats and or protein, absorption slows down so that 15 minutes head start would be really bad in those cases. If you start with good blood sugar before a meal then At 2 hours after the meal she’ll be about 50mg/dl higher than her before meal blood sugar. You can’t measure that with a CGM because CGM lags actual blood sugar when blood sugar is changing. I always recommend “Think Like a Pancreas “ as a great reference.

3

My endo told me not to bolus until I eat. But if I’m on the high side of normal I’ll bolus a little in advance to avoid too large of a spike. I know how my body responds so that works for me - i recommend people follow their doctor’s advice and discuss the spikes and other issues so you can work in needed adjustments to her routine.

4

@cloughfamily Welcome Leigh to the JDRF TypeOneNation Forum. I agree with what both Joe and Dorie wrote and I’ll add a bit more.

Much depends on your daughter’s body and how quickly she responds to insulin [can vary at different times of the day] and how rapidly the foods being eaten release their glucose into her body. Your daughter will need to know her own body well and the way this is accomplished is through experimenting - very carefully and when knowing that she will eat ALL the carbs you have counted.

For me personally, I got along well for decades when regulating by MDI and later with pumps without pre-bolus for meals and now only for a maximum of 15 minutes. As a rule, I do not bolus at a restaurant until after the meal is served and it has passed my taste-test.

5

Hi Leigh:
Assuming that your daughter is at a decent pre-meal blood glucose level, I would recommend that you double that 15 minute time frame to 30 minutes.

Also, take the time and effort to properly adjust the basal hourly rates.

And of course… ultimately, it’s all about trial and error.

Good luck