# Pre-meal, split dosing or post meal



## Fandange (Feb 28, 2011)

Hi Guys,

Byron had clinic today and his HbA1c is down to 6.6% (YAY!!!) and he is generally Mr Constistency (although still honeymooning...) and growing very tall 179cm!!!

I was chatting with the consultant about the boys' Novorapid. They mostly have their injections after their meals, as we never know how much they will want to eat at each meal. She said we should dose before, and I understand the theory behind that, but in practice, it just won't work  - for Bede in particular.
So, I asked about split dosing and she was discouraging about that, too. What suggestions do you guys have for this one? I've read that plenty of you do split your doses. Is there any reason this would be discouraged?

Thanks


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## Adrienne (Feb 28, 2011)

No none that I could think of except maybe your doc is thinking about too many injections and lumps etc.

What was she suggesting you do then?

Yes it is absolutely 100% better to bolus up front.  With a pump, it is easy peasy and at the FFL conference (Friends for Life) conference we went to one chap asked what about if on injections.  The advice was the same.   Make a downpayment of insulin before eating and count the carbs and give the rest when you know what they have eaten so during or after but always give that downpayment of insulin beforehand.


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## MeanMom (Feb 28, 2011)

Sounds like what you are doing is working but if they will split the dose it makes sense to do so. K doesnt like to have two injections but we are moving in that direction - sometimes inject before, mostly after (but straight after - no messing) She always injects before breakfast unless levels below 5

Well done for HbA1c!


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## Northerner (Feb 28, 2011)

Are they likely to not eat what is put in front of them Ange? I used to eat like a horse at their age!  I tend to inject 15 mins before these days, unless I am low in which case I inject just before eating. I suppose a lot depends on how much less they might eat than expected. I occasionally inject too much and find my appetite lacking, but usually just nibble a few jelly babies or biscuits to make up for it over the ensuing 3-4 hours.

Excellent HbA1c by the way - well done Byron (who is now taller than me!)


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## Adrienne (Feb 28, 2011)

Northerner said:


> Are they likely to not eat what is put in front of them Ange? I used to eat like a horse at their age!  I tend to inject 15 mins before these days, unless I am low in which case I inject just before eating. I suppose a lot depends on how much less they might eat than expected. I occasionally inject too much and find my appetite lacking, but usually just nibble a few jelly babies or biscuits to make up for it over the ensuing 3-4 hours.
> 
> Excellent HbA1c by the way - well done Byron (who is now taller than me!)



Good idea


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## Fandange (Mar 1, 2011)

Thanks for the responses, guys.

I like the idea of topping up with J.Babies (are you a shareholder in the company, Alan?) I guess we just have to keep trying things until we find what works (until that doesn't work anymore, of course).

Never a dull moment with the big D


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## Northerner (Mar 1, 2011)

Fandange said:


> Thanks for the responses, guys.
> 
> I like the idea of topping up with J.Babies (are you a shareholder in the company, Alan?) I guess we just have to keep trying things until we find what works (until that doesn't work anymore, of course).
> 
> Never a dull moment with the big D



Here's a picture of Grandad Bertie, draw your own conclusions...


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## Fandange (Mar 1, 2011)

Yeah, I can see the family resemblance - same nose....


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