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RE: [IPk] Dosing for protein and fats
Yes, indeed. It is slowly becoming accepted (see _The Insulin Pumping
Handbook_ published by MInimed)that protein can, in fact, impact your blood
sugar. Say, for example, that one unit covers 15g of carb for you. Then one
unit covers 30g of protein. So sometimes you might be talking about half or
a quarter unit of insulin, which you can't get with a pen.
Here's an example of figuring out the insulin covering both carb and
protein. 4oz of red lentils (which I eat regularly) have 19.9g carb and 8.9g
protein. So, I add 19.9 + (8.9/2)= 24.35. 24.35/16 (16 is how many g one
unit of insulin covers for me) = 1.52, so if I were eating _only_ the
lentils, I would square wave bolus 1.5 units over an hour because I use
humalog. If I were using soluble, velosulin, or actrapid, I would just
inject the insulin.
Since Sasha is going low if you inject extra actrapid, I think you would
have to split the dose. I would recommend giving the insulin for the protein
an hour or two later. This is probably another thing you won't want to tell
the doctor! I think there's a lot to be said for telling the doctor -
unless, of course, doing so might jeprodize the possibility of support for a
pump. Afdter all, your doctor doesn't seem to have much notion of what
actually happens in real life with diabetes, and being told what you're
really doing with the insulin and the successes you're having could help
wake the doctor up. It's horrible that you can't be honest with the doctor.
Any chance of getting a different one?
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