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Re: [IP] Need help with bolus for high fat meal

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.

Good Luck,

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