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Re: [IP] Fat Intake and Blood Glucose Highs

-----Original Message-----
From: Lori Smith <email @ redacted>

>Sometimes my daughter will eat a bedtime snack of high fat tortilla chips
>and cheese and will do a 'normal' bolus for the correct amount of carbs.
>bg's two hours later are in target but then two to three hours after that,
>her bg's are very high.  If you become more insulin resistant after
>consuming a fatty food, wouldn't those bg's start to climb steadily from
>moment they were consumed as opposed to dropping to normal range and then
>peaking suddenly?

No, because the insulin resistance doesn't start immediately -- it builds up
to a peak, too. I believe the IR curve lags behind the carb curve, which is
why the BGs are normal early on and go up later. I have observed the same
thing in myself: Last night I had a big piece of cake with a LOT of buttery
frosting -- BG was 160 2 hours after eating, great!, and I then bolused 2
units because I knew that the fat would affect me, but still, 3 hours after
that, I was 156, bolused another unit, and woke up this morning at 133.

>We have started doing a dual wave bolus in this situation to prevent the
>high bg's and it seems to be helping somewhat, although we're still
>experimenting with the correct amount of time to extend the bolus..i.e.
>three hours, etc. On a dual wave, do you give 60-70% of the carb count
>away, and then the remaining 30-40% over the next two-three hours?

YMMV! You will have to experiment to find out what works for you --
different people require different plans. In my own case (remember, I'm Type
Weird), it helps to decrease the initial bolus by about 2 units, and then
think of the remainder as an increased basal over several hours. I DIDN'T do
that last night, which is why I needed the corrections, but I usually do an
extra 0.5 - 1.0 unit per hour depending on how big the meal was.

But remember, this is only ME, and your requirements may be different.

>Also wondered, what constitutes 'high fat' classification to warrant doing
>dual wave and not normal. Is there a percentage (approximate of course)of
>total food carb count that would encouage one to use the dual wave and not
>normal bolus type?

I figure it's high-fat if it has a lot of protein or fat -- like pizza,
grilled cheese sandwiches, a hamburger and french fries, etc. On the other
hand a bowl of cereal and milk or a salad with dressing but no meat or
cheese, or a plate of spaghetti with tomato sauce is low - medium fat.

I don't actually calculate percentage, but I'm curious if others do -- at
the moment, I'm doing OK without going that far, but others may find it


Natalie ._c-
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