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Poll Results

 

When do you usually bolus for a meal?

 
     

Well before the meal

 
 

17%

 

5

 
     

Just before the meal

 
 

35%

 

10

 
     

As the meal begins

 
 

21%

 

6

 
     

After the meal

 
 

7%

 

2

 
     

Before and after (e.g., pizza)

 
 

14%

 

4

 
     

Other

 
 

3%

 

1

 


Total votes: 28

 

How often do you worry about nighttime hypoglycemia?

Poll dates: January 25 - February 1, 2017
Total Votes: 28

Pre-bolusing before meals is very important to overall glucose control, as shown by a study published in 2010 (Timing of meal insulin boluses to achieve optimal postprandial glycemic control in patients with type 1 diabetes). Based on this study, a bolus of rapid-acting insulin 20 minutes prior to a meal results in significantly lower postprandial glucose levels than when the mea bolus is given just prior to the meal or 20 minutes after the meal.

This graph, from the study referenced above, clearly shows the dramatic impact of pre-bolusing on post meal glucose levels:

Graph

Another study (Poor adherence to integral daily tasks limits the efficacy of CSII in youth) from 2011 reported on the impact of missed meal boluses. To summarize:

  • Missing breakfast boluses twice a week results in a 1.0% increase in HbA1c
  • Less than two food boluses on any day within two weeks results in a 0.8% increase in HbA1c
  • Seven or more boluses per day for half of the days results in a 1.0% decrease in HbA1c

Unfortunately, just 17% of our readers report bolusing well ahead of a meal.

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Last Updated: Wednesday February 01, 2017 18:34:14
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