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Permalink Reply by Gerri on January 10, 2010 at 9:37pm

Less insulin=better control when insulin is matched & timed appropriately to food. Dr. Bernsteins adovates low carb with correspondingly lower insulin doses. Less insulin means less serious miscalculations & mistakes are easier to correct--law of small numbers. Not sure what you mean about better control by using more insulin not following Dr. B's rule.

Don't know how much insulin you took to cover your 70 carb lunch, but it was probably too much to be low all day. Or, you were active after lunch, or had one of those episodes where your own insulin kicked in for a while.

Fats slow digestion & the effect can show up many hours later, yep. It's hard to know if it's the type of fat effecting you differently unless you know the exact amount you had for each meal to compare. Fat in meat effects me more than the fat in cheese, even though they're both animal fat. It's the higher protein in meat that does it & meat is harder to digest than cheese.

It's tricky to time insulin to high fat meals. You may need to take insulin later with high fat meals. Only way to know is to experiment with timing & doses by testing a lot.

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Permalink Reply by carolyne hart on January 11, 2010 at 1:29pm

There's a lot to think about. I have had better control taking normal boluses with eating carbs instead of fat. My carb ratio is twenty to one so even with seventy I'm only taking 3.5 units of humalog. I have recently been introduced to dual waving and waiting for meals and have limited experience, but I see why the dual wave goes so many hours. It is a much bigger and longer experiment to bolus for fat and I'm concerned about overlapping insulin, having to wait too long to eat again. It is many hours before I return to normal and it takes twice as much insulin to correct. I guess I would rather eat lots of veggies and grains and beans instead of lots of meat anyway. But I do understand the lower risk idea. Do you dual wave or just take your insulin later? Do you dose for the carbs separately?

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Permalink Reply by Gerri on January 11, 2010 at 2:01pm

Is a lot to take into consideration. You're quite insulin sensitive & that's great! Wish I had a ratio like yours.

Since you're recently diagnosed, you may still have some insulin production that may account for your ratio & your low. Not to worry you & just to prepare you, but this will probably change with time. In many ways the honeymoon period is hard because it adds another unpredictable factor. Makes it more difficult to know ratios & corrections & outcomes.

What was in the salad that was really high fat?

You're right that it's more of an experiment to bolus for fat. Don't let just two bad results determine what you do. Know it's tempting because we all hate lows & highs, but you need a longer timeframe to see a pattern. If the same thing keeps happening, then change. Yesterday could have been a fluke.

You should be able to calculate how much insulin you have on board so you don't stack insulin, but know what you mean about waiting to eat & holding your breath seeing what will happen. I don't have a pump, so can't answer your dual wave question. Sure someone else can tell you. I've learned a lot about pumping from reading discussions here & most people dual wave for high fat. I do something similar with injections by taking a small bolus dose & then another later when digestion will hit. Not that I get it right, but took a ton of testing & experimenting to know how food effects me. Fish, chicken & dairy don't slow down my digestion, but red meat does. I don't eat large portions of any kind of meat, 4-5 ounces tops.

One thing they don't tell us is that about 58% of protein turns to glucose, just at a slower rate than carbs. Would be a major pain to figure this out!

I hear you on not wanting to play the high/low game with meat & it does seem easier right now with carbs from veggies, grains, & beans, but you'll be able to figure this out. The problem with eating a carb heavy diet is that when your ratios do change, you'll be taking a lot more insulin.

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Permalink Reply by carolyne hart on January 11, 2010 at 8:42pm

Thanks for the information and sharing your experience. How do you bolus for protein? How long do you wait to bolus after you eat chicken or dairy? And you bolus later for fat but do you bolus more for that as well?

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Permalink Reply by Brian (bsc) on January 11, 2010 at 7:16am

Fat in itself does not raise your blood sugar. Fat when eaten with carbs can markedly delay the absorption of the carbs and delay the overall glucose rise. High levels of fats have been claimed to increase insulin resistance, but I've not had any personal experience with that. When eating at a restaurant, you need to also be aware that despite claims from the wait staff and the restaurant that meals do not contain carbs, you can be the victim of serious stealth carbs. Often a restaurant will have extensive carbs in their food and mistakenly answer queries about carbs with "yes it is sugar free." Also, sometimes, claimed nutritional info from a restaurant can just be plain wrong. A dish prepared corporately and tested may have been totally carb free, but the individual restaurant or cook prepared it differently, and your zero carb salad actually had 30 or 40 grams of carbs.

To test the whole fat thing yourself perform a human experiment. Fast for 4-6 hours, drink a 1/4c of olive oil (I prefer butter) without a bolus and see how your blood sugar rises. My bet is that you don't see any rise.

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