Do I still need mealtime insulin if what I'm eating has basically no carbs?

[bobneil]

I'm GUESSING yes because it all gets converted to sugar eventually, but here's the problem:
I just had a 2:45pm lunch with 11U of NovoRapid.

I know for a fact that my insulin's going to last another 3.5-4 hours, with most of its work done in the first 2. This is normally not an issue because my meals are ideally spaced 4 hours apart. However, I had a late lunch and now I'm supposed to go to an early dinner at 5pm at a restaurant. I know they have a fried veggies meal that is strictly cauliflower, broccoli, and chicken in a light sauce and it takes them ~10 minutes to prepare and bring out.

Do you think I could get away with eating that dinner on the last little bit of the mealtime insulin, since I'm going to be eating within the acting period of it? It has probably less than 20g carbs total.
The reason I'm asking all of this is because I don't know if I should take insulin at dinner while the lunch insulin is still wearing off - I was already at a 4.6 before I just ate, and I don't want to get a hypo or something later.

 

[noblehead]

You could just eat the low-carb meal without a bolus, if you find your levels are high later you could always take a correction dose.

 

[himtoo]

agree with @noblehead -- just keep testing and add a correction if needed -- enjoy !!

 

[bobneil]

Oh good, the site came back up in time for me to read this before I head out.

I'm going to take whatever I need for fruit and check later. Thanks!


EDIT: BG before eating was 5.3, I took a total of 8U to account for my fruit serving.This is exactly the same dose I had the last time I ate this meal, and it ended up fine there, just this time I didn't have 3 spring rolls with it.

Ate at 5:35pm. Felt fine until 7:15pm, symptoms of hypo. 7:35pm I measured a 3.0 so I really quickly ate some chocolate fingers and had two tablespoons of gatorade. Overdid it, because at 9:30pm I was at 12.2

It went exactly as I predicted - either not enough sugar at dinner, or my doses were too close together. I'm taking a correction dose once I get to around 11 pm, staying up late, and checking it... sigh

 

[tim2000s]

Hi @bobneil, one thing to be aware of is that while insulin stacking is not advised by medical professionals, the main reason for this is that it makes tracking your current insulin on board hard.

Insulin isn't multiplicative, it is additive, so if you have your ratios set up correctly, and you do stack, you won't end up with any issues as the bolus insulin you have taken will be used only on the carbs you've had it for. The way we confirm this is by checking glucose levels before eating, two hours after and four hours after. If, at four hours after eating, the bg level has not returned to the same level as prior to eating, then your I:C ratio is likely to be incorrect.

One thing to bear in mind, given how recently you've been diagnosed, is that your I:C ratios are likely to not be consistent. When you are newly diagnosed, the addition of exogenous insulin allows some respite of your pancreas, and as a result, it can spit out additional insulin in response to food, meaning that you head lower than anticipated.

 

[Robinredbreast]

Hi, how is your bs this morning ?

 

[azure]

I agree with @tim2000s I don't take any notice of the 'gap leaving' for meals. Sometimes I have a late breakfast and an early lunch, for example. I also eat carb snacks between meals and inject for them.

The only time I worry about insulin stacking is when I'm doing correction doses, and then I'm very careful not to stack and risk going too low.

However, as you're recently diagnosed @bobneil you should do as your DSN advises and err on the side of caution. I hope your blood sugar was ok.

 

[Lynmi]

I've only just stated taking meal time insulin and my nurse has said to just take 3 units with each meal at the moment. But I've been using the MySugar app on my phone for a while to record my levels, so set it up with my target blood range and the insulin ratio that I've been told (1/10) and once I type in my current level and the amount of carbs in my meal it calculates my dose for me taking into account any insulin still on board from the last injection. I love it, once I start full carb counting its going to so much help.

 

[mist]

Take all advice on open Internet forums with a pinch of salt. Ask your health care professional for advice before changing or altering any meds or making significant changes to your diet.

 

[bobneil]

Hello everyone. I took a correction dose of 3 units at 10 PM, to try and bring my 12.2 down to a more reasonable number before bed. I checked again at 12:30 PM and it had gone to 9.3 - at this time I took 2 more units. I shouldn't have done that, but since I hadn't been eating with these doses I assumed that by the two hour mark the 3 unit dose did the best it could.

At 3 AM I woke up sweaty and shaking, with a 3.0 hypo. I quickly ate two pieces of peanut butter toast and about 15 minutes later went back to bed.
When I got up at 10am my fasting level was 7.9 - extremely interesting, considering it only went up by 5 with no insulin, because all my past entries in the diet log for the same meal show that WITH 7-8 units of insulin it would go up by 3-5.
The dawn phenomenon didn't even show up this time.

This is all so very inconsistent. I am starting to worry about hypo unawareness because it seems like I get one every day or two lately.

 

[TheBigNewt]

New to this forum, actually new to diabetes forums in general. Here's what I recommend every Type 1 have on hand to combat hypos: Extendbar. Get it online (I think Walmart has it in the US. or Amazon). Sustained release carbs bar, 130 calories. I've never had a nocturnal hypo after eating one, or sometimes just part of one, before bedtime. Beats the old peanut butter toast (yum!) and the usual skyrocket BS afterward. Right?