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[IP] Re: how to ruin a perfect day of #'s

>What did we do wrong?

>he got a cup of ice-cream with some chocolate sauce on
>it. Pretty innocent I thought. Looked up in my book and estimated about 45
>carbs for the whole thing.
>2 hours later he was 401!  We gave conservative .5 units thinking he
>would be down soon....then 1/2 hour later checked and he was 375. We did
>Is it the fat? or what???

I think fat would take longer to give the sort of rise we have here.  And
there seems to be a response to the .5 unit, so I would not presume a bad
site.  OTOH, I wouldn't necessarily rule out fat, knowing restaurant food,
but you didn't include the other stuff he ate.

>Where did we go wrong?

We know he had ice cream.  From a veteran ice cream and sauce measurer, 45g
of carbs is a scant 3 oz ice cream (~1/3 cup; 20g carbohydrate) topped with
just under 2 tablespoons (24g carbohydrate) of sauce.

Typical restaurant single servings are twice that and more, so I would
suggest you probably under-infused.  It sometimes helps me, if I cannot
accurately measure something, to put a vessel of known volume next to it for

Remediation for the 400+mg/dl:  Carbo or fat induced or both.  When I go
this high (encountering insulin resistance), I bolus twice as much as usual
to get myself down  quickly.  Once in a while this takes me too low, a
couple of hours later.  Then I eat a glucose tablet or three to get to

I don't worry too much about overtreating this sort of high, because I keep
testing and stay awake until it is resolved.  I just don't overtreat the
resultant low with fatty sugars.

And humalog is a lot more forgiving of low episodes than the longer acting

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