I seem to have lows after I do a correction for a high along with my meal bolus. My Pump Educator asked if I was waiting 15 minutes after my bolus to eat. I don't remember ever being told that....but I will try it and see if it helps.
However, in a restaurant I wait to bolus until my meal arrives to ensure that I actually have the food and to see portions, etc. I am wondering if the PDM has some sort of option to delay the bolus for a short time.
You can use the "extend" feature to deliver a portion now and spread the rest out over a period you choose. So you could for example, push "extend", deliver 0 now and extend the bolus of the next 1/2 hour, or hour, etc. (15 minutes is not a choice, unfortuantely). Or you could deliver 20% now, or 50% now and extend, etc
But the low might also be due to incorrect I:C or correction ratios ? Or dop they work fine individually ?
Actually the Pump Ed. had me change my correction factor from 60 to 70. Thanks for the info on the extend.... ☺
If you wait 15 minutes after bolus to eat, then your insulin will kick in that much faster, without food on board. The time waiting would be to your advantage is if you are experiencing post meal highs for example: high at 1 hour, 1 1/2 hour mark but good numbers at 2 - 3 hours. Then you would need to give the insulin a little bit of a head start over the carbs.
There is no way on earth I would wait 15 minutes after a fast-acting insulin bolus to eat *unless* my blood sugar was at least 160mg/dl.
The delay you need depends on your blood sugar and the type of insulin, 15 minutes is standard for non-GM 'human' insulin ('regular', though that's ambiguous and misleading).
We can delay the bolus easily; we just wait ;-) The problem is delaying the food. As you say, waiting 15 minutes in a restaurant after you have seen the food until you eat it is a problem.
What I do is manage restaurants in two steps:
1) Right at the start, after I sit down, I do a BG test and a correction, as required. I also add some nominal amount of food - about 20g - unless my BG is low (in which case I start asking for the BREAD.)
2) When I can see the food on the plate in front of me I do a bolus of an appropriate amount minus 20g. I don't do a BG test; it's irrelevant and complicated by the previous speculative 20g bolus. (So on the Omnipod PDM I say 'no' to the 'use bg reading' question.)
When the restaurant messes up, I ask for the BREAD (if it hasn't arrived already), do it, and sit back and think of England. When, eventually, the real food arrives I do the bolus but without the 20g, because I've cancelled that out with the BREAD. If necessary I might do a correctiont too, but by that point it just depends on how I feel.
John Bowler jbowler @ acm.org
Hi sandy, i agree with your CDE about lowering your correction factor and like others seem to have suggested in my experience it helps to delay eating only if your bs is high kind of a pain especially with a hungry 13 year old but i try to have him test while i am still cooking so we can bolus then if he is high if he is normal or lowist we just wait until right before he eats, hope things get better! amy