We hope everyone had a restful holiday break! It’s 2025, and a new year comes with new goals. We are here to help you get started. Although there are more and more technological advances such as automated insulin pumps and continuous glucose monitors to help make blood sugars easier to manage, the basics of diabetes self-management still remain a cornerstone in achieving blood sugar targets. This newsletter will review some basics around matching your rapid-acting insulin to your meals.
Carb Counting
You may already be familiar with the basics of carb counting (i.e. reviewing labels, measuring with scales, using measuring cups and spoons, consulting restaurants’ nutrition information ) however most of carb counting work is taking the time and effort to figure it out (especially at the worst time – when we’re hungry!).
There are some popular apps that can help as well. Most recently, if you are a Dexcom user, there is an app that can help you carb count by simply taking a picture of your plate. To learn more about the app RxFood, visit: https://rxfood.co/
Another popular app for any ISO/Android user is Carbs & Cals.
If you need a refresher on carb counting, you can attend our free virtual workshop on carb counting!
If you use an automated insulin pump (Tandem with Control-IQ, or Medtronic with SmartGuard), you get the advantage of automatic basal rate adjustments and automatic corrections if your carb counting is slightly off. However, regardless if you’re on injections, pump or automated pump, carb counting and entering your carbs is one of the best strategies to help you achieve your targets!
If you are interested in learning more about the insulin pumps available, check out our Pump Ready/Ugprade workshop.
Glycemic Index, Balanced Meals and Protein
Carb counting is one thing, but the quality and type of carbohydrate matters too. The Glycemic Index (GI) is a scale that helps you learn how a food will impact your sugar levels. A food item or meal with a high glycemic index (white rice, white bread, most cereals, pineapple) is going to be absorbed in your body faster than your insulin can work! One strategy to help with this is to aim to have protein (meat, fish, Greek yogurt, eggs) and fibre (vegetables, whole grains, nuts, seeds) at your meals to slow down the release of the sugars and work better with the insulin. Another strategy that can work very well is pre-bolusing… which brings us to our next point!
To learn more about the Glycemic Index, you can review the LMC Glycemic Index Handout.
Pre bolusing
We’ve come a long way with our insulin over the years, but the fact remains that our rapid-acting insulin is still pretty slow.
- Apidra, Humalog and Admelog start to work in about 15 minutes
- Kirsty, Novorapid and Trurapi start to work in about 10 minutes
- Fiasp is the fastest onset at 2 minutes.
But remember: The onset does not mean that’s when the insulin is working at its best. It means that the insulin is starting to enter your cells, but will peak in 1-1.5 hours, which is when you can start to see a change in your blood sugars.
Let’s think about our higher GI food. If you know it will quickly increase your blood sugar, but that your Humalog will take 15 minutes to start working. What could you do to help match these? … Pre-bolus (i.e. taking it 15 minutes before eating)
Despite the type of rapid-acting insulin, taking your rapid-insulin before eating is ideal as it has a better chance to match the absorption of your food, versus taking it during or after. However, if you are eating a very low carbohydrate meal or a very low GI carb with your meal, taking it during or after could be a helpful strategy as well.
Like all learning in Type 1 diabetes (T1D), the goal is never to be perfect! These strategies are not easy to put into place. Often starting with 1 meal in your day, or 1 day in your week to practice these skills can be a great place to start.
Remember, your safety matters most! Make sure that you only bolus when you know when your food will be ready/prepared. Avoid pre-bolusing at restaurants or in situations when you are not preparing your own food.
Focusing on the basics of diabetes management is a great place to start when you want to re-focus on your T1D self-management. Carb counting and matching your insulin to your meal is no easy feat, however! Using available apps, attending workshops, and knowing more about the type of insulin that you are using, and how it works, can be a great place to start. Of course, reach out to your diabetes team if you need any guidance. We are here to help you achieve your goals in 2025!
