Author Topic: pre-bolusing timing  (Read 411 times)

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Offline himtoo

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pre-bolusing timing
« on: 17 August 2017, 10:55:00 PM »

hi all pumpers


when you do a bolus for a meal -- and look to make adjustments in the timing of the dose-- do you use the start time of the bolus or the finish time of the bolus to calculate the amount of time you have pre-bolused ?? ( if that all makes sense )


on MDI your entire dose goes in all at once -- on a pump a 10u bolus can take 4-5 minutes , a 20u bolus nearly 10 minutes ---


also -- how much do you take into account your pre-meal reading as to how soon before your meal bolus ??
T1 Dia Aug 1972 -pumping omnipod since 29/09/15  Losartan 100mg , simvastatin 40mg,Furosemide 40mg, Omeprazole 80mg , Doxazosin 8mg
Hba1c - 06/2013 6.1 02/2014 43(6.1) 07/14 42(6.0) 08/14 40( 5.8 ) 12/14 39 (5.7) 08/15 41 ( 5.9) 10/15 44 ( 6.2 ) 03/16 49 (6.6)
cholesterol --nov 2011 4.3 june 2012 4.4 June 2013 4.1 Feb 2014 4.1 dec 14 4.5 oct 15 4.4
Dafne grad. necrobiosis lipoidica on legs
laser treatment on both eyes 2002 and 2012, injections left eye 3 , wearing Noctura mask since oct 2014

Offline Pattidevans

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Re: pre-bolusing timing
« Reply #1 on: 18 August 2017, 08:19:10 AM »
Hi Paul... nice to see you.


It's all a matter of trial and error.  A Libre sensor should help.  Lots of people watch the sensor until the line starts to dip and then eat at hat point after their dose.  I am surprised that your boluses take so long - mine drip in at 0.1u per second, therefore a 10u bolus would take 1 minute 40 seconds.


I find starting a bolus 30 minutes before breakfast helps but I had to find that out by gradually moving backwards from 10 minutes.  Does that help at all?
Patti


Type 1.  Mis-diagnosed T2 May 2003, finally had CPeptide test 15/7/11 and proper diagnosis 1/9/11.  Now pumping Apidra with Roche Spirit Combo pump. Hba1c 6.1 April 2016.


© 2015 Patti Evans

Offline himtoo

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Re: pre-bolusing timing
« Reply #2 on: 18 August 2017, 01:44:56 PM »
my bolus does not go in quite so quick as yours :) -- I did a quick online search and came up with omnipod delivers a bolus in 1 unit every 44 seconds

I pre bolus almost all the time and normally achieve fab 2 hour post prandial rises in BG

I was just wanting to see what others do and to enquire about the timing including the bolus time or not.

obviously as yours goes in so quickly it is not an issue.
T1 Dia Aug 1972 -pumping omnipod since 29/09/15  Losartan 100mg , simvastatin 40mg,Furosemide 40mg, Omeprazole 80mg , Doxazosin 8mg
Hba1c - 06/2013 6.1 02/2014 43(6.1) 07/14 42(6.0) 08/14 40( 5.8 ) 12/14 39 (5.7) 08/15 41 ( 5.9) 10/15 44 ( 6.2 ) 03/16 49 (6.6)
cholesterol --nov 2011 4.3 june 2012 4.4 June 2013 4.1 Feb 2014 4.1 dec 14 4.5 oct 15 4.4
Dafne grad. necrobiosis lipoidica on legs
laser treatment on both eyes 2002 and 2012, injections left eye 3 , wearing Noctura mask since oct 2014

Offline sedge

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Re: pre-bolusing timing
« Reply #3 on: 18 August 2017, 08:58:31 PM »
I didn't know that Omnipods were that slow either - I wondered what the heck you were on about - I never looked it up or timed it but both the Combi and the Insight you just hear and fell the pump going click click click until the whole bolus has been delivered, just seconds every time.  No slower than with a pen really.
Jenny

T1 DX 1972, pumping Novorapid 24/05/11

HbA1c - 7/07 8.7, 1/08 7.8, 9/08 8.4, 3/09 7.3, 7/09 7.2, 12/09 7.3, 11/10 8.1, 2/11 8.6, 9/11 6.5 2/12 6.4  5/12 50/6.7  11/12 52/6.9  01/13 46/6.4  06/16 46/6.4  12/16 45/6.4

Offline Pattidevans

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Re: pre-bolusing timing
« Reply #4 on: 19 August 2017, 10:58:10 AM »
Sorry Paul, didn't mean to question your insulin delivery.  Thing is, most of us only have experience of our own pump, so we find it difficult to understand that someone else's pump behaves quite differently.


Out of interest do you have a link to the information about delivery time?
Patti


Type 1.  Mis-diagnosed T2 May 2003, finally had CPeptide test 15/7/11 and proper diagnosis 1/9/11.  Now pumping Apidra with Roche Spirit Combo pump. Hba1c 6.1 April 2016.


© 2015 Patti Evans

Offline himtoo

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Re: pre-bolusing timing
« Reply #5 on: 19 August 2017, 10:29:38 PM »
T1 Dia Aug 1972 -pumping omnipod since 29/09/15  Losartan 100mg , simvastatin 40mg,Furosemide 40mg, Omeprazole 80mg , Doxazosin 8mg
Hba1c - 06/2013 6.1 02/2014 43(6.1) 07/14 42(6.0) 08/14 40( 5.8 ) 12/14 39 (5.7) 08/15 41 ( 5.9) 10/15 44 ( 6.2 ) 03/16 49 (6.6)
cholesterol --nov 2011 4.3 june 2012 4.4 June 2013 4.1 Feb 2014 4.1 dec 14 4.5 oct 15 4.4
Dafne grad. necrobiosis lipoidica on legs
laser treatment on both eyes 2002 and 2012, injections left eye 3 , wearing Noctura mask since oct 2014

Offline Pattidevans

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Re: pre-bolusing timing
« Reply #6 on: 20 August 2017, 09:57:50 AM »
Thanks for the link Paul, it was very enlightening.  I don't suppose this aspect of the omnipod was pointed out before you got it, was it?  It could be a big factor in choosing a pump IMHO.  I am glad mine delivers much in thE same way as an injection, cos it makes calculations so much easier not having to factor in length of bolus.  Could you set it to 0.1 instead?  Would that materially alter your doses?  On the Roche pumps 0.1 is the finest titration of dose you can do for a bolus, though the pump will use 0.01u per hour increments for basals.
Patti


Type 1.  Mis-diagnosed T2 May 2003, finally had CPeptide test 15/7/11 and proper diagnosis 1/9/11.  Now pumping Apidra with Roche Spirit Combo pump. Hba1c 6.1 April 2016.


© 2015 Patti Evans

Offline himtoo

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Re: pre-bolusing timing
« Reply #7 on: 20 August 2017, 09:58:07 PM »

I could reset to 0.1u rather than .05u but I did not realise other people delivered faster boluses TBH
it has never actually affected my Bg's to my knowledge -- I have just been used to how I seem to do me own pump

no Patti -- speed of bolus was not discussed at time of choosing pump

if 0.1u halved the bolus time that would be closer to other pumps
so about 2.2 min for a 10u bolus 

I will have a play with my settings to see what it does for sure.


have just had a look at my settings and I have a choice of .05u , .1u , .5u , or 1.0u increment
I have adjusted mine to .1u -- that should speed things up  :)
T1 Dia Aug 1972 -pumping omnipod since 29/09/15  Losartan 100mg , simvastatin 40mg,Furosemide 40mg, Omeprazole 80mg , Doxazosin 8mg
Hba1c - 06/2013 6.1 02/2014 43(6.1) 07/14 42(6.0) 08/14 40( 5.8 ) 12/14 39 (5.7) 08/15 41 ( 5.9) 10/15 44 ( 6.2 ) 03/16 49 (6.6)
cholesterol --nov 2011 4.3 june 2012 4.4 June 2013 4.1 Feb 2014 4.1 dec 14 4.5 oct 15 4.4
Dafne grad. necrobiosis lipoidica on legs
laser treatment on both eyes 2002 and 2012, injections left eye 3 , wearing Noctura mask since oct 2014

Offline Pattidevans

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Re: pre-bolusing timing
« Reply #8 on: 21 August 2017, 08:38:33 AM »
Excellent.  Well if nothing else this conversation was worth it for that alone 😁.  I rarely seem to have a bolus over 10 these days. Not since the DSN altered my ratios.
Patti


Type 1.  Mis-diagnosed T2 May 2003, finally had CPeptide test 15/7/11 and proper diagnosis 1/9/11.  Now pumping Apidra with Roche Spirit Combo pump. Hba1c 6.1 April 2016.


© 2015 Patti Evans

Offline everydayupsanddowns

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Re: pre-bolusing timing
« Reply #9 on: 22 August 2017, 02:10:10 PM »
Medtronic have a slow and fast setting. I have always used slow, and experimented with fast once or twice but found it stung a bit. So I went back to slow.

Having said that I generally split any large boluses (upwards of 7u) so that at least some of it fades in over half an hour.

In either case I'd generally start my 'prebolus timing' from the point of button pressing rather than delivery finish.
Mike

Type 1 since: 1991 Last HBA1c: 45 (6.3%)  Total Chol 5.0 (1.9HDL / 2.8LDL / Trigs 0.7)
Pumping NovoRapid in a MiniMed 640G
Blogging at: www.everydayupsanddowns.co.uk

Offline Pattidevans

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Re: pre-bolusing timing
« Reply #10 on: 22 August 2017, 10:35:30 PM »
I am noting your response Mike, in November I have the choice of Medtronic or Animas.  Interesting that bolus timings can vary, not a question I would have thought of prior to this thread.

Patti


Type 1.  Mis-diagnosed T2 May 2003, finally had CPeptide test 15/7/11 and proper diagnosis 1/9/11.  Now pumping Apidra with Roche Spirit Combo pump. Hba1c 6.1 April 2016.


© 2015 Patti Evans

Offline himtoo

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Re: pre-bolusing timing
« Reply #11 on: 22 August 2017, 10:59:57 PM »
himtoo gets a bonus point for raising a great topic !!!!!! ;) ;) ;)
T1 Dia Aug 1972 -pumping omnipod since 29/09/15  Losartan 100mg , simvastatin 40mg,Furosemide 40mg, Omeprazole 80mg , Doxazosin 8mg
Hba1c - 06/2013 6.1 02/2014 43(6.1) 07/14 42(6.0) 08/14 40( 5.8 ) 12/14 39 (5.7) 08/15 41 ( 5.9) 10/15 44 ( 6.2 ) 03/16 49 (6.6)
cholesterol --nov 2011 4.3 june 2012 4.4 June 2013 4.1 Feb 2014 4.1 dec 14 4.5 oct 15 4.4
Dafne grad. necrobiosis lipoidica on legs
laser treatment on both eyes 2002 and 2012, injections left eye 3 , wearing Noctura mask since oct 2014

Offline himtoo

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  • Prince of Protein
Re: pre-bolusing timing
« Reply #12 on: 22 August 2017, 11:02:20 PM »
Medtronic have a slow and fast setting. I have always used slow, and experimented with fast once or twice but found it stung a bit. So I went back to slow.

Having said that I generally split any large boluses (upwards of 7u) so that at least some of it fades in over half an hour.

In either case I'd generally start my 'prebolus timing' from the point of button pressing rather than delivery finish.
that has been my choice as well mike -- I prefer to count for the start point rather than the finish

it is amazing the small detail that can have an affect on our Bg's !
T1 Dia Aug 1972 -pumping omnipod since 29/09/15  Losartan 100mg , simvastatin 40mg,Furosemide 40mg, Omeprazole 80mg , Doxazosin 8mg
Hba1c - 06/2013 6.1 02/2014 43(6.1) 07/14 42(6.0) 08/14 40( 5.8 ) 12/14 39 (5.7) 08/15 41 ( 5.9) 10/15 44 ( 6.2 ) 03/16 49 (6.6)
cholesterol --nov 2011 4.3 june 2012 4.4 June 2013 4.1 Feb 2014 4.1 dec 14 4.5 oct 15 4.4
Dafne grad. necrobiosis lipoidica on legs
laser treatment on both eyes 2002 and 2012, injections left eye 3 , wearing Noctura mask since oct 2014