Friday, March 7, 2014

Pre-Bolusing Lunch At School

We have all heard the helpfulness of pre-bolusing for meals at least 15-20 minutes in advance, to keep your carbohydrates from spiking your blood glucose above the tipping point of 250mg/dl.

I get it.  Why not give the insulin a running start?  It does help.

The reality though is that there are certain times where you do not have 15 minutes to spare.  One of those times is during lunch at school.

Oldest daughter gave me a breakdown of her day.

6:00 - 6:30 a.m. Getting ready for school.
6:30 - 7:00 a.m.  Eating, brushing teeth, out the door.
7:15 - 7:30 a.m. At school, locker and desk.
7:30 - 8:30 a.m. First Hour
8:30 - 9:30 a.m. Second Hour
9:30 - 10:30 a.m. Third Hour
10:30 - 11:30 a.m. Fourth Hour
11:30 - 12:30 p.m. Locker, Office to Test, Lunch
12:30 - 1:30 p.m. Fifth Hour
1:30 - 2:30 p.m. Sixth Hour

End of day.  And somehow, I am missing an entire 7th hour made of of minutes shaved off the hours that I have posted.  So you get in a nutshell that the kid is running around the building from class to class and trying to squeeze in t1d.

It is not easy nor is there extra free time to wait around for 15 minutes for insulin to work.  Not to mention that she is HUNGRY by the time lunch hits.  It's easy to forget that the older kids who used to be overwhelmed with extra food in the classroom from school parties and birthday treats, suddenly are without for most of the day.  Or that their bodies are morphing into what will soon be adult shapes and sizes.  I'd be hungry too.

Motivated by her recent clinic appointment and wanting to strive for better, our oldest daughter and endocrinologist found a solution. They discovered that our oldest could squeeze in an extra 5 minutes just by employing one new, small change.

Instead of placing her carb count sheet into her lunch box, which had been the norm for years, we moved it into her blood sugar test kit in her purse.  In this way, she no longer has to bolus in the cafeteria, but can do it before she even arrives there.

That gives her five extra minutes of insulin working before she even takes a bite.

One simple change and hopefully, even tighter numbers.

Is it perfect?  Is it text-book worthy?  Probably, not.  But it might be better and that is good-enough.

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