# Re: [IP] Boluses for high-fat meals and high protein meals

```----- Original Message -----
From: <email @ redacted>
To: <email @ redacted>
Sent: Wednesday, October 10, 2001 5:53 PM
Subject: [IP] Boluses for high-fat meals

> Until I joined this list, I never realized that high-fat and high-protein
> meals may be responsible for bg increases as late as 4-5 hours after the
> meal!  Now that I know this from your posts, and have been looking back at
my
> circled bg's (I circle my unexplained ones), I see that the ones I can't
> explain are due to this factor.
>
> So, here's my question.  How in the world do you decide even what to try
in
> terms of a bolus?  Unlike carbohydrates, we have no information on how
much
> insulin is required by a gram of fat or protein, right?  So I don't even
know
> how to guess!
>
> For example:  This morning I had an English muffin and a chicken-apple
> sausage.  I took 2 units for the English muffin.  Perfect bg's until 5
hours
> after breakfast, when I was 195, then rising to 246 thirty minutes later.
> Obviously it's the 13g of fat in the sausage.  :-|
>
> I don't think I want to do an extended bolus, because my bg was right on
> target until 5 hours later.  I'm thinking of giving a bolus 3-4 hours
after
> the high-fat meal (have no idea how much but I'll play with it)...would
that
> work?
>
> Any opinions/advice welcome!  I realize YMMV, but I could use some ideas.
>
> thanks!
> Leeann
> ----------------------------------------------------------
the sentence ymmv is key here. with fat and protein, you can't tell what
will happen. I add in the number of grams of protein multiplied by 4 and set
a dual wave bolus with the second wave being equal to the amt for the
protein delayed by 4 hours caution ymmv! if protein is negligable I don't
include it like some bacon or sausages at breakfast with pan cakes and
syrup. here the carbs from carbs is so much greater than protein it doesn't
matter. this will take lots of experimentation and you should see if you
need to do it at all, you might not! Significant protein is a Pittsburgh
Steak from Capital Grill or a Fillet from Ruth's Chris. Neither place is
recommended if you are having kidney problems. spot
.
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