Pre-Bolusing with AID Tech (Yep, Still Worth It)
So you’ve got an AID system… why are you still spiking like it’s 2007? This episode explains why tech doesn’t cancel out pre-bolusing, and how to make it work better with automation. Today, We’re Covering: What AID systems like Omnipod 5...
The episode, word for word
You ever think, "Wait, if my pump's automated now... why am I still spiking like I'm in 2007?"
Yep. Let's talk about it.
Hey, I'm Neil, and this is Your Best T1D Year podcast. My new book, Type 1 Diabetes: True Stories is out now on Amazon & Kindle.
I've had type 1 since the early '90s, and I've lived through the evolution from long-acting shots to hybrid closed-loop systems. And still, pre-bolusing hasn't been replaced. Just... redefined.
Let's give tech its flowers: automated insulin delivery (AID) systems like Omnipod 5, Tandem's Control-IQ, and the MiniMed 780G are incredible at:
Preventing overnight lows
Smoothing out gradual trends
Auto-correcting missed small spikes
But here's what they don't do well:
Anticipate a fast food spike before it hits
Handle sudden glucose surges from meals with 50+ carbs
Know that dinner's ready in 12 minutes and the pasta just got drained
That's where you still matter.
When you pre-bolus with an AID system:
You're reducing the workload on the algorithm
You're preventing that high spike that needs three corrections to fix
You're allowing the system to stay in range instead of chasing
And that's key, AID works best when it's not playing catch-up.
Real talk? On my loop system, I can let it auto-correct all day... but if I skip the pre-bolus at dinner, I still spike like I'm throwing a party for my pancreas.
With AID, your timing may shift:
Instead of 15, 20 minutes pre-meal, maybe it's closer to 10, depending on how aggressive your system is
Some people split the bolus, doing half before and letting the pump handle the rest
Others pre-bolus when they see the food being plated, not just when it's talked about
It's not one-size-fits-all. But it is worth experimenting.
The tech is smart. But it still needs a driver.
You pre-bolusing? That's you giving it better directions.
New episodes drop every Monday, Wednesday, and Friday.
I've seen a lot of things try to patch the broken healthcare system, but Blue Circle Health built something better. Better numbers. Lower distress. Actual human support. They cover diabetes education, prescription access, tech support, and emotional health, all free. You don't have to figure this out alone. Learn more for free at bluecirclehealth.org.
You're not overcomplicating this, you're just leveling up.
And that's the kind of effort that adds up over time.
55 - June 20
Friday, June 21
This is the script as read on the mic, lightly tidied for reading. Education, not medical advice. Talk to your care team before you change anything about your insulin.