Mealtime insulin is one of the most complex parts of diabetes management. Carb ratios, timing, extended boluses, and post-meal patterns all interact in ways that can make even a well-planned dose miss the mark, and understanding why is the key to getting it right.

This week on Optimizing Diabetes Tech, we dig into mealtime bolusing from every angle. We cover how to read post-meal glucose patterns to distinguish a timing problem from a dosing problem, how to adjust insulin-to-carb ratios safely, when and how to use extended boluses for slow-digesting meals like pizza, and how different insulins, from Humalog to Fiasp to inhaled Afrezza, change the timing equation entirely. We also get into carb counting strategies, pre-bolusing for unpredictable eaters and kids, and how AID systems provide a safety net without replacing the need for good bolus technique.

ODT is our recurring series focused on using diabetes technology more effectively. Each episode, I am joined by CDCES Gary Scheiner, the Founder of Integrated Diabetes Services, where we dive deep into practical topics and answer listener questions.

If you are looking to upgrade your diabetes treatment, I highly recommend the team at Integrated Diabetes Services, where Gary and his team provide personalized diabetes coaching, insulin pump setup and optimization, and CGM and open source AID training. I have worked with them myself on optimizing settings on Loop. Let them know we sent you.

On the next ODT, we're covering hypoglycemia management, how to use your tech to prevent lows, treat them more effectively, and set up alerts and sharing features that keep you and the people around you safer. You can send in your questions here.

For now, you can watch this week's episode with the video below or listen with the podcast player above.

Disclaimer: Diabetech content is not medical advice—it’s for educational purposes only. Always consult with a physician before making changes to your healthcare.