I've had type 1 diabetes since I was six, or for 37 years. My last Hba1c is 9.0. My carb ratio is 1:5 IS = 1:25 and without food, my basal rates run like a flat line.
Within the last 3 weeks, I have started using the CGM from Medtronic Minimed and have had amazing data feedback. I always knew that pizza and wings raised my blood glucose for unusually long periods of time and also if I ate later in the evening like after 8pm I would always wake up with BG's over 300.
Here is my trouble and I hope others can feel the pain or possibly chime in for solutions....
Last night I ate 10 hooters chicken wings (50 carbs) a bowl of clam chowder (guessing 50 carbs) and a couple Miller Lites (3.2carbs/beer) = 106.4 carbs. Logically, I would give 21 units of bolus. Well, I started out giving 17 and later needed to correct with 14units.
At 3:45am bg was 206. recommended 4 correction.
At 6:45am bg was214. recommended 4.3.
At 7:30am bg was 249. recommended 2.5
At 8:20am bg was 258. recommended 5.6
At 9am frustration set in and I bolused 10 unites
11am bg finally down to 100.
That is a total of 57 units for 10 wings, a bowl of soup and 2 light beers.
Am I alone in this struggle with late night and/or fatty food insulin dosages?
I hear you. Certain foods are just plain weird for me. Are you pumping or is this bolusing with an actual shot? While I was pumping I would take 50% of my bolus immediately and then usually run the rest over about 2.5 hours (I found this worked especially well for pasta - fettuccini alfredo yum!). I would calculate my total carbs, and then typically add a "fudge factor" of about 25%. So if I thought I needed 4 units, I would take 5 or 5.5. Things just got strange for me with certain foods and unfortunately, there are no hard and fast rules. You have to work out for yourself which are the weird ones and what you have to do about it.
Does your pump have a "Combo Bolus" or "Extended Bolus"? Foods like pizza, pasta, or anything high in fat are what I use this setting for. Everyone's needs will be a little different, but for me I find a 80/20 split (meaning, I get 80% of the bolus up front, with the remaining 20% given over the extended period of time) over 3 hours works pretty well with those kinds of foods. You'll have to play around with it for a while to find out what combination of factors work for you.
I should also mention that, since insulins like Humalog and Novolog have an active period of 3 - 4 hours in your system, even when you're getting the last of your bolus at the 3-hour mark, that last bit of insulin can help you for the next several hours.