It's different for us all of course, but I am curious to know how everyone takes high fat in to consideration when bolusing. I guess it's the pizza thing, but even good fats drive my #'s way up regardless of the carb count.
Yes, probably different for everyone. My dn (dear niece) does not have a problem with high-fat foods unless they are very high fat, like Pizza or Chinese. She is such a healthy eater, though, that I'm not sure she eats high fat unless it is a very special treat. For Pizza, I try to order extra thin crust. I cut off the back piece of the crust and bolus 40 grams per slice (slice would probably be more like 30 grams with the crust cut off), dual-wave, 60/40 over 2 hours. Sometimes this works; sometimes it doesn't. Chinese take out, she only eats chicken and brocoli and Lo-Mein. I ask them to make the chicken with the regular sauce, but steam the brocoli crisp and add the cooked, crisp brocoli to the chicken and sauce last minute. That way the Chicken and Brocoli has the sauce she likes, brocoli absorbs the sauce but less grease. Typically, they used to stir fry the brocoli in the fat with the chicken and it was just loaded with grease. I bolus for Chinese 60/40 over 2 hours as well. If eating at home, I do not eat their sticky rice. I make my own Uncle Bens Converted white rice in the microwave. Sticky rice can be 80 grams a cup! For Friendly's -- which we had yesterday afternoon -- I have no recommendations. She was 450 two hours after eating, full correction plus 40 percent plus temp basal did not bring her down, 425 again and another correction before she would budge. My solution for Friendly's? Won't be going there often. Not in our town, thank God. You have to experiment, and if it doesn't work, change your eating habits and indulge in high fat less often.
Do you think it's only in combo with carbs that fat is a problem? Would your dn be OK with fatty Chinese beef and broccoli but no rice? If I just eat cheese, should I be OK, but with a bit of crackers....watch out? Steak OK....steak and potato....trouble? Can anyone eat pita chips and humus?
I'm going out tonight for chicken wings, blue cheese dressing and lite beer....I'll let you know what happens!
2 lite beers, lots of wings and celery and blue cheese dip........2 units of Humalog.......BS at 93 one hour later..........63 at 2 hours...........99 at 6 hours. So, what do I take away from that? Seems easy. Of course, another restaurant may have more sugar in it's wing sauce and my results would be different.
I have been reading the posts about avoiding carbs, and not worrying about fat being the healthier way to eat, but I know that fats and proteins need to be taken into account when dosing insulin.
If I'm eating a lot of stuff that is really high in fat, I approach the situation a couple of different ways. I stretch my bolus out with a dual wave bolus: 40% at first and I'll stretch the the other 60% over a 2 hour period. Fats have a tendency of slowing the digestion of food. Another thing I'll do is increase my basal rate. If my basal rate is .55 U/H I'll increase it to 1.0 U/H for about 5 hours. I know fats aren't supposed to noticeably raise blood sugar, but they do for me. I only notice this when eating extremely fatty stuff / meals.
The only thing that I've really noticed is that the fat will delay and slow down the absorbtion of carbs. Thats why I do the dual wave bolus. If I were eating foods with a lower glycemic index, I would reduce the initial bolus to 25% intead of 40%. Foods with a lower glycemic index are by nature going to absorb slower and effect blood glucose more gradually. High fat content compounds that effect. With high fat content though, the carbs can "kick in" with a vengeance hours later.
Thanks, again. I am not yet pumping (hope to be this year) but have no problem with multiple shots. I only inject 1 unit for each 15 g's, tho and with the pen can do no less than one unit, so it's a bit harder to stretch out the dose.
Tonight I am having steak and lots of veggies......bad weekend for fat......we'll see what happens.
You can take half-units with some pens by rounding up your bolus on the meter (for example, setting it to 4 if you want to take 3.5 units) and tapping the plunger slightly to expunge half a unit before taking the actual injection. This has helped me a lot ever since I figured out how to do it, even if it is slightly imprecise.
Gabe....makes sense. I notice that when I do the 1 unit check first, different amounts come out. Sometimes it's a drop, sometimes a lot shoots out. I'm wondering if the dosing is fairly inaccurate at any given time.
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