Re: [IP] Need help with bolus for high fat meal
- To: email @ redacted
- Subject: Re: [IP] Need help with bolus for high fat meal
- From: wieslaw maciorowski <email @ redacted>
- Date: Sun, 02 Nov 2003 22:48:36 -0600
- Reply-To: email @ redacted
- User-Agent: Mozilla/5.0 (Windows; U; Windows NT 5.0; en-US; rv:1.3) Gecko/20030312
We have come up with a very predictable system for dealing with high fat
and or high protein meals.
The key to success is to know exactly how many grams of carbs, fat, and
protein you are planning to consume.
Also, you need to determine what amount of of protein and fat you can
consume on average without affecting your blood glucose (for our 6 year
old it is 14 g of protein and 6 g of fat).
Another piece of the puzzle is knowning when you are going to see an
increase in blood glucose due carbs, protein and fat. For carbs it is
up to 2 hours after, protein is 1 to 4 hours, and fat is 4 to 9 hours.
When testing make sure that exercise, and prior meals are not a factor.
Starting about 1 hour after the meal begin checking your blood glucose.
Check every 20 -30 minutes. If you check every 30 minutes and your bg
increases by say 50 you can calculate the amount of insulin you need to
cover this amount of protein as follows:
amount of insulin you need to lower your bg by 50
* 2 ( to make it 1 hour insulin need)
*3 ( to calc the entire insulin need to correct for protein
- 3 hours)
/2 ( in my experience it takes twice as much insulin to
lower high bg than to keep them low.
I cover for protein using a 2 hour square wave.
Take good notes about food content, how you covered and what bg you had
so that you do not make the same mistake twice.
You can use the same approach to figure out how to cover for fat. The
key difference is that impact of fat is not proportional. So, if you
consume twice the fat you will need more than twice the amount of
insulin (BTW we use Novolog).
This approach may not be easy but gave us a lot of predictability (or at
least as much as one can get with insulin getting bad, sites not
working, growth spurts, and getting sick). Please let me know if you
have any questions.
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