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RE: [IP] Extra insulin for high fat foods

I would be interested in seeing the replies to this as well.  We thought
we had Meghan covered last night pretty good after we got her down from
267 5 hours after a high-fat dinner only for me to check her at 1:30
a.m. and find her 349!  Bolused 2 units and she woke up at a lovely 95.
I just can't imagine how it can kick in 8-9 hours later!

Mom to Meghan, 7 (dx 9/28/02, Animas 10/08/03) 
Nicholas, 10 (science fanatic and GameCube addict)
Married to Don for over 11 great years
Living in Melbourne, FL

-----Original Message-----
From: email @ redacted
[mailto:email @ redacted] On Behalf Of Sandra
Sent: Thursday, November 06, 2003 9:45 AM
To: email @ redacted
Subject: [IP] Extra insulin for high fat foods

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I know there has been a few posts lately regarding this.  I have a
specific questions regarding my 9 year old daughter.   Many of the post
see regarding the dual/square wave bolus indicate giving a partial bolus
(maybe 60%) when the meal is eaten and the 40% as a square wave.  But,
problem seems to require another train of thought.  When my daughter
a high fat meal (hamburg, mozz. sticks, pizza) I usually give her the
entire (100%) bolus.  Two hours later her count is usually perfect
(usually around 90-120...never too low).  BUT......then it starts rising
into the 300's for the next 4-6 hours.  I give her bolus after bolus and
it keeps her count consistent, but I have a really hard time getting it
down to a good number.   Now my question:    Should I start a square
bolus right when she's eating the meal (on top of the 100% bolus she
usually gets)? ! ;  Should I start it 2 hours after, when her count
starts rising?   How much should I be giving her  (I mean, an additional
2 units over a period of 6 hours doesn't seem like it would do
much)?  This is going to run into her bedtime, so I'm very leary of her
going low. 

Now, I know, I know, I know, that nobody can give me an exact answer.  I
know it's trial and error.  But I'm just kind of looking for a place to
start.  Your thoughts would be appreciated.



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