Hello-
I’m hoping I can get some suggestions around how people successfully dose for a high carb/high fat meal.
I rarely eat pasta (just isn’t my thing and I never really want it often) so I’ve never managed to get a good grasp on how to successfully dose for it. I either hang low for the first two hours and then spike like crazy or I need all my insulin up front and if I don’t I go pretty high by hour 2.
Tonight my boyfriend is making spaghetti carbonara which I’ve literally never had in my life so I have no idea what to expect for it.
I’m assuming I want to do a dual bolus with my pump, but was also hoping others could share their experience about when they notice the spikes from meals like this (obviously I know my bodies different and could need something else completely) but any tips to avoid that spike into the high 2s low 3s would be great!
Hi Taylor @Tee25! As long as the sauce doesn’t have sugar in it, I usually wait to bolus until after I eat or halfway through eating. Pasta takes a while to get through my system and I almost always go low if I pre-bolus with pasta. I also have a fat spike a couple of hours after I eat. My doctor said to bolus for the spike when I see it (I try to keep on top of my blood sugar numbers for 2-4 hours after I eat pasta). I hope this helps!
Thanks! So do you take your entire dose when you’re done or only part after and then take the rest when you see the spike? Or when you see the spike that’s just an additional correction you take?
hi @Tee25 real pasta (plain) is a medium-speed carb. not necessarily hard to bolus for. it’s what you put on it that causes most of the fun. Olive oil, animal fats, even cheeses, etc., can cause so much insulin resistance that you may need double or triple the insulin for the amount of carbs listed… and you may need it for 4 full hours afterwards.
carbonera has pork fat in it, sometimes substantial amounts of pork fat. delicious but it could affect your blood sugar for that full 4 hours.
I eat these things and typically bolus for at least half the actual carbs up front. then it’s either a “square wave” or extended bolus or even an increased basal rate for about 4 hours. it’s kind of easy to watch with a CGM, but you can do it with hourly finger sticks too. You aren’t going to die if you are high for 4 hours, and you can figure this out, if you want to. I like pasta, with my various delicious sauces on it, and I’ve just used trial and error and error and error to get it right (actually… “good enough”) anyway, good luck, but maybe more importantly Bon Appétit
@Tee25 I take the full bolus either halfway or at the end. If If I am eating quickly, I bolus at the end. If we are having a leisurely family meal, I check my blood sugar halfway and bolus then. My fat spike comes when my blood sugar is on a downward trend. I see it come down, then it starts moving up. At that time, I take a bolus for the fat that is hitting my system. I discovered that if I bolus for the fat spike up front, I go low and I don’t have enough insulin in my system to catch the spike. That said, I am MDI. You probably have more options and flexibility if you are on a pump!
Hi. How do you count the amount of insulin when you bolus for the fat? I will try that next time I decide to eat like that.
I have been seeing this same deal when I have certain foods and find it hard to manage. I over bolus, go low then go high from too many glucose tabs!
I had to ask how dinner with your boyfriend was! I hope the tips helped, at least to give you a framework for next time you have the meal. As you know, sometimes you just have to adjust.
Thanks for asking! So overall it went pretty good for a first stab.
I didn’t go above 117 with a 60/40 split extended over 2 hours but did drop low before bed. There was some light physical activity after dinner, so not sure if that was part of it or if I just over estimated the fat/carbs in it. I cautiously treated with a couple of jolly ranchers and am now up at 5 am treating a low
As much as I was anticipating a high, I really wasn’t expecting any lows but that’s diabetes for you!
I think I’d try either more pasta next time or less insulin but I guess I’ll have to try again to see!
Hi Cathy @HopeFloats2020 For me it is trial and error. There are also factors such as how tired I am, how late at night it is, etc. If I didn’t sleep well the night before and it is after 9pm, I will give myself more insulin than if I am rested and it is 2pm. Also, a meal with a lot of fat will need more insulin than one with a moderate amount of fat. I started with a couple of units and then after trial and error (over a couple of weeks) I figured it out. Most days I can give myself a good correction dose of insulin. That said, there are also days when my calculations are off and I have no idea why…… Sometimes my blood sugar has a mind of its own……
Sometimes my blood sugar has a mind of its own……