“Do you pre-bolus for your meals?”
“I do.” (I was happy to answer this question because I actually do pre-bolus. Pre-bolusing is my A1C’s saving grace.)
“Okay, that’s great.” She made a few notes in my chart. “How about for snacks? Do you pre-bolus for those?”
“I … um, nope. I am horrible at pre-bolusing for snacks.”
Unfortunately, hat is completely and utterly true.
Meals are easier to pre-bolus for because there’s time involved in making them. If I know I’m cooking chicken and green beans for dinner, I have 25 – 30 minutes to let that bolus sink in before the meal is even ready. Going out to eat at restaurants is easy, too, because I usually have an idea of what I’d like to eat, so I’ll bolus for the meal once we are seated at the table. (Pre-bolusing backfires at times, too, but as long as I’m not in the middle of the woods, I’ll take the risk.) A meal feels like an event, and therefore easier to accommodate.
Snacks feel like an accident. An unplanned moment. I don’t take an apple out of the basket and bite into it in a premeditated fashion, but more like a fluid movement without any thought involved. (A run-by fruiting by any other name …) It’s not until I’m done with a snack – apple, yogurt, nuts, protein bar … cupcake? – that I realize I haven’t taken any insulin to cover the carbs. My post-snackial blood sugars aren’t grateful for the misstep.
This would not be a big deal if I wasn’t such a grazer, but when 50% of my caloric intake throughout the day is on a whim, pre-bolusing for snacks matters. My A1C is currently in my range (under 7%) but I know if I can remember even half the time to pre-bolus for snacks, I bet my standard deviation will tighten up and blah blah blah other numbers as well.
Little, conscious changes will hopefully become habit.