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Re: [IPk] difficulty with glargine and humalog

Hi Fiona

Are you eating white rice/pasta? These are meant to "stick with you", 
according to my mother's now very defunct  outlook, but in fact they have 
quite a high GI... that means they'll hit you fast with a high glucose 
surge, particularly white rice (in my case anyway). If you've hit yourself 
with humalog which may take up to 90minutes to really kick in (in me, it 
takes about 60mins), the food may hit you well before the insulin comes 
into play, so that when the insulin hits, you go low.

I find that if I give a square or dual bolus equivalent to their worth (ie. 
a cup of cooked white rice is equal to about 40g carb, a cup of cooked 
white pasta is equal to about 35g CHO) over a 30 or 60 minute time period, 
I can keep sugars reasonably level. White bread also has a higher GI than 
most people realise. If you use the brown varieties of any/all of these 
things, the associated fibre slows absorption of glucose/digestion 
sufficiently that glucose is released far more slowly and thus you don't 
get the high and (potential) corresponding low.

There's a great resource I just this moment discovered in researching 
(actually confirming) GI numbers of these foods, at 
http://www.calvin.biochem.usyd.edu.au/GIDB/searchD3.htm It allows you to 
get the GI, carb amt etc for pretty much any food you can name. I need to 
rush off now and put it up on my site! *grin*

I have a feeling this has been no help whatsoever ...


At 07:20 AM 24/04/2003, you wrote:

>I don't know if anyone else has had this problem but I've had a peculiar
>experience four times now since being on glargine with bolus humalog.  It
>occurs in the evening when I have had a traditionally 'good' slow acting
>carbohydrate meal with pasta, lentils, rice, curry etc.  Following a large
>meal  with an appropriate bolus I have felt very hypo about 40mins to 1 hour
>afterwards.  I have had to correct  with a small amount of glucose  even
>though I think it would soon rise up again itself quite steeply as following
>this my bs continues to rise for a number of hours and if it wasn't night I
>would probably correct with a small bolus.  I presume this is the effect of
>the slow carbs and possibly delayed absorption due to increased fat and
>protein??  I've never had this happen on insulatard or what went before that
>but can see the pump being very useful in being able to cope with this.  The
>low circulating levels of glargine after the humalog wears off can't cope
>with the carbs still being absorbed, and humalog peaks before much
>absorption has taken place.  I just wish one found out these things other
>than by trial and error!!!
>DM type1 35yrs

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