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Re: [IP] How do you bolus for pasta?

Natalie wrote:
Natalie's totally unscientific, unproven theory:

For me, big boluses don't seem to work for ANY food. I hypothesize that
it's because the insulin forms a bubble under the skin, and can only be
absorbed from the edges, so most of the additional insulin just sits
there, and the volume of the insulin bubble doesn't increase very much,
thus absorption is not commensurate.

I've tried taking half the bolus up front, and spreading the rest out
over an hour or two. Pasta is still difficult, but this technique does
seem to help.

The other thing that I observe in myself, is that portion size really
does matter -- eating larger portions and then expecting to be able to
get the same results with larger boluses just doesn't work. This fits in
with above theory. 
We can corroborate Natalie's theory, at least in Luke.  Large
boluses do not work for him on large amounts of carb.  Small boluses
spread out work just fine.  Our technique for pizza, refined this 
summer, is:  
              -  start with bolus for 1st 2 slices
              -  bolus for another 1-2 slices after he's eaten all of those
              -  complete the meal & do a square wave over 1 hr for the 
              -  we also add another 10g on the final carb total to help 
                 account for fat/protein factor
Luke's bg has come in range with this method for the past 2 months.
He's 6 & we have 2 other kids - we probably eat too much pizza.

We have found that if Luke eats > about 70g carb at any meal (typical is
about 50-60 for him) that this method works well for him.

We have also found that nothing works for him to bolus for a McDonald's
happy meal.  Fortunately, he has said that he's tired of feeling bad
due to the high bg after eating McDonald's, so we don't go there or to
any other fast food place anymore.  Our last vacation was filled with
much better food choices as a result.  It's been a great decision for
the whole family.

Shelly V, Austin, TX, mom to Luke, 6, pumping 3/01 & to Trevor, 11 &
Kate, 8

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