Pre-Bolusing for a Picky Toddler with Type 1 Diabetes | Combo Bolus

Your toddler asked for the macaroni, then looked at it like you served packing peanuts and demanded the one other food in the house, and you've got insulin on board for a meal that just got canceled. This episode is for the parents dosing into pure chaos.

Neil pulls the playbook straight from the pediatric diabetes guidelines. The split: dose for the part you're sure they'll eat, then give the rest after. ISPAD recommends a combo or dual-wave bolus for uncertain eaters, part before, the rest over 20 to 40 minutes once you see what got eaten. And there's good news in the research, a systematic review found that pre-meal dosing, when you can pull it off, lowered the after-meal peak and even lowered A1C, with no increase in lows. Keep fast carbs on the table, always.

In this episode:

The split-dose strategy for a kid who might not finish
The ISPAD combo/dual-wave bolus for uncertain eaters
The research: pre-meal dosing lowered peaks and A1C with no extra lows
Why fast carbs on the table are non-negotiable with little ones

This Week's Challenge: For the parents, try the split on one unpredictable meal. Dose for what you're sure they'll eat, then top up after. Notice how much less terrifying that is.

Helpful resources and newsletter: https://yourbestt1dyear.com

Connect with Neil: TikTok: https://tiktok.com/@the.betes Instagram: https://instagram.com/thebetes Facebook: https://facebook.com/neilgreathouse LinkedIn: https://linkedin.com/in/neil-greathouse-a607b912 Website: https://yourbestt1dyear.com

Books on Amazon: Type 1 Diabetes – One Day at a Time: https://a.co/d/6UHooWJ Type 1 Diabetes – True Stories: https://a.co/d/dfIlyI1

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